health assessment

  1. orientation
    awareness of the objective world in relation to the self
  2. perceptions
    awareness of objects through any of the five senses
  3. dysphonia
    difficulty/discomfort in talking, abnormal pitch/volume, but articulation and language are intact
  4. dysarthia
    distorted speech sounds, sound intelligible, basic language intact
  5. mental status main points
    abct appearance behavior cognition and thought processes
    adolescents: Home environment, Education/employment, Eating, Activities, Drugs, Sexuality, Suicide, Safety
  7. minimental
    • valid detector of organic diseases. concentrates on cognitive functioning.
    • max: 30,
    • mild cognitive impairment: 18-23,
    • 0-7 severe cognitive impairment
  8. Denver II
    birth to 6 indentifys those who may be slow in development in behavioral language cognitive and psychosocial areas.
  9. Behavioral Checklist
    school age 7-11, for use beyond age wen developmental milestones are useful
  10. Levels of consciousness
    • 1 alert: awake or readily aroused oriented fully aware of stimuli and responds appropriately
    • 2 lethargic: not fully alert drifts off to sleep when not stimulated can be aroused to name when called in normal voice but looks drowsy. Responds appropriately to questions or commands but thinking seems slow/fuzzy. looses train of thought.
    • 3 Obtunded: Sleeps most of time, difficult to arouse-needs loud shout or vigorous shake acs confused when is aroused, converses in monosyllables, mumbles, and requires constant stimulation for even marginal cooperation
    • 4 Stupor/semi-coma: Spontaneously unconscious, responds only to persistent and vigorous shake or pain: has apropriate motor respnse, otherwise can only groan mumble or move restlessly
    • 5 Coma: Completely uncounscious, no response to pain or to any external or internal stimuli
  11. aphasia
    • true language disturbance, defect in word choice and grammar or defect in comprehension, defect is in higher integrative language processing
    • Global:most common/severe: speech and comprehension are absent or reduced to a few stereotyped words/sounds and the persons name
    • Brocas: Expressive/ the person can understand lanuage but cannot express him or herself
    • Wernickes: receptive/ can hear sounds and words but cannot relate them to previos experiences. Speech is fluent effortless and articulated but can often be incomprehensible
  12. lability
    raid shift of emotions
  13. ambivalence
    the existence of opposing emotions toward an idea object or person
  14. organic disorders
    due to brain disease of known specific organic cause delirium, dementia, intoxication, and withdrawal
  15. psychiatric mental illness
    In which organic etiology has not yet been established (anxiety disorder, schizophrenia)
  16. lordosis
    protruberant abdomen
  17. kyphosis
    aging person "stoop"
  18. body proportions
    • arm span = height
    • body length form crown to pubis roughly equal to length from pubis to sole
  19. BMI
    • weight in kilograms/height in meters^2
    • (weight in pounds/height in inches^2) *703
    • <18.5 underweight
    • 18.5-24.9 normal weight
    • 25-29.9 overweight
    • 30-39.9 obesity
    • >40 extreme obesity
  20. waist to hip ratio
    waist/hip 1> in men and .8> in women is indicative of android (upper body obesity)
  21. temp
    • 37 C 35.8 to 37.3
    • 98.6 F 96.4 to 99.1
  22. heart rate
    • 60-100 bpm
    • < 60 bradycardia
    • >100 is tachycardia
  23. pulse force
    • 3+ full boundind
    • 2+ normal
    • 1+ weak thready
    • 0 absent
  24. respirations
    • 10-20
    • babies 20 to 40
    • kids ~20-30
  25. korotkoff sounds
    • I tapping
    • II swooshing soft murmur follows tapping
    • III knocking crisp high itched sound
    • IV abrubt muffling sound mutes to a low pitched cushioned murmur blowing quality
    • V silence
  26. oxygen saturation
  27. hypopituitary dwarfism
    deficiency in growth hormone in childhood. <3rd percentile delayed puberty hypothyroidism and adrenal insufficiency
  28. gigantism
    excessive secretion of growth hormone by the anterior pituitary resulting in overgrowth of entire body. >height weight and delayed sexual development
  29. acromegaly (hyperpituitarism)
    excessive secretion of growth hormone in adulthood after normal completion of body growth . overgrowth of bone in face head hands and feet. no change in height. internal organs also enlarge.
  30. achondroplastic dwarfism
    congenitl skeletal malformation caused by a genetic disorder in converting cartilage to bone. large head with frontal bossing, midplace hypoplasia, short stature, and short limbs. often thoracic kyphosis, lumbar lordosis, abdominal protrusion.
  31. marfans
    connective tissue disorder. tall this stature, hyperextensible joints. arm span> height. pubis to sole >crown to pubis. cardiovascular complications cause mortality
  32. endogenious obesity
    • cushings
    • administration of adrenocorticotropin (acth or excessive productio by pituitary will stimulate the adrenal cortex to secrete excess cortisol. characterized by weight gain and edema with central trunk and cervical obesity. fragile skin muscle wasting
  33. hypotension
  34. hypertension
    • prehypertension 120-139 or 80-89
    • stage 1 hypertension 140-159 or 90-99
    • stage 2 hypertension <160 or >100
  35. layers of skin
    • epidermis: stratum germinativum basal cell layer forms new skin cells (keratin protein, melanocytes), stratum corneum outer horny cell layer dead keratinized cells constantly being shed and replaced from below
    • Dermis: connective tissue/collagen elastic tissue, hair follicles nerves vessels glands
    • subcutaneious layer: adipose tissue fat cells energy insulation protection
  36. hair types
    • vellus: covers body except palms soles fingers umbilicus penis and labia
    • terminal: scalp eyebrows axillae pubic area (men: face chest)
    • lanugo: birth
  37. glands
    • subaceous: sebum(protective lipid substance) secreted through the hair follicles lubricates skin and hair and forms emulsion not on palms or soles most abundant in scalp forehead face chin
    • sweat: eccrine colied tubules dilute saline reduces body temperature, apocrine thick milky secretion located in axillae anogenital area nipples navel secretion due to emotional and sexual stimulation bacteria on skin react with it to create musky skin odor
  38. functions of skin
    protection: physical thermal and light wave sources, prevents penetration: microorganisms, perception: touch pain temp pressure, temp regulation: sweat, identification, communication, wound repair, absorption and excretion, production of vit D
  39. edema scale
    • 1+ mild pitting, slight indentation, no perceptible swelling of the leg
    • 2+ moderate pitting, indentation subsides rapidly
    • 3+ Deep pitting, indentation remains for a short time, leg looks swollen
    • 4+ very deep pitting indentation lasts a long time leg is very swollen
  40. regular nail angle
    160 or less
  41. alopecia
    baldness hair loss
  42. bulla
    elevated cavity containing free fluid larger than 1 cm diameter
  43. cyanosis
    dusky blue color to skin or mucous membranes due to increase amount of unoxygenated hemoglobin
  44. erythema
    intense redness of the skin due to excess blood in dilated superficial capillaries as in fever or inflammation
  45. excoriation
    self inflicted abrasion on skin due to scratching
  46. furuncle
    (boil) suppurative inflammatory skin lesion due to infected hair follicle
  47. hemangioma
    skin lesion due to benign proliferation of blood vessels in the dermis
  48. iris
    skin lesion shaped like a target
  49. jaundice
    yellow color to skin palate and sclera due to excess bilirubin in the blood
  50. lichenification
    tightly packed set of paules that thickens skin from prolonged intense scratching
  51. lipoma
    benign fatty tumor
  52. maceration
    softening of tissue by soaking
  53. macule
    flat skin lesion with only a color change: freckles
  54. nevus
    (mole) circumscribed skin lesion due to excess melanocytes papule
  55. nodule
    elevated skin lesion >1cm diameter deeper than papule
  56. papule
    palpable skin lesion of <1 cm mole
  57. plaque
    skin lesion in which papules coalesce or come together.. plateu like
  58. pruritus
  59. purpura
    red-purple skin lesion due to blood in tissues form breaks in blood vessels
  60. pustule
    elevated cavity containing thick turbid fluid
  61. telangiectasia
    skin lesion due to permanently enlarged and dilated blood vessels that are visible
  62. ulcer
    sloughing of necrotic inflammatory tissue that causes a deep depression in skin, extending in dermis
  63. vesicle
    elevated cavity containing free fluid up to 1cm diameter blister
  64. wheal
    raised red skin lesion due to interstitial fluid ... mosquito bite allergic reaction
  65. zosteriform
    linear shape of skin lesion along a nerve route
  66. leukonychia striata
    white hairline linear markings from trauma or picking normal
  67. erythema toxicum
    common rash in first 3-4 days of life.. tiny punctate red macules and papules on the cheeks trunk chest back and buttocks
  68. acrocyanosis
    newobrn bluish color around the lips hands fingernails feet and toenails should go away with warming and time
  69. cutis marmorata
    transient mottling in the trunk and extremities in response to cool temp red or blue pattern
  70. milia
    infant tiny white papules on cheeks forehead nose chin, resolve in weeks
  71. senile lentigines
    liver spots small flat brown macules elderly
  72. keratoses (seborrheic keratosis)
    raised thickened areas of pigmentation that look crusted scaly and warty (dark greasy stuck on) (elderly)
  73. xerosis
    dry skin ... (elderl)
  74. acrochordons
    skin tags eyelids cheeks neck axillae trunk overgrowths of normal skin... elderly
  75. sebaceious hyperplasia
    raised yellow papules with central deppresion forhead and cheeks... look pebbly... elderly men normal
  76. gyrate lesions
    twisted coiled spiral
  77. polycyclic lesions
    annular lesions grow together (psoriasis)
  78. tumor
    larger than a few centimeters in diameter firm or soft, deep into dermis
  79. urticaria
    hives wheals coalesce to form extensive reaction pruritic
  80. cyst
    encapsulated fluid filled cavity in dermis or subcutaneous layer tensely elevating skin
  81. erosion
    scooped out but shallow depression no scarring
  82. apthous ulcers
    canker sores small painful round ulcers in the oral mucosa of unknown cause
  83. candidiasis
    white cheesy curdlike patch on buccal mucosa due to superficial fungal infection
  84. caries
    decay in the teeth
  85. crypts
    indentations on surface of tonsils
  86. cheilitis
    red scaling shallow painful fissures at corners of mouth
  87. choanal atresia
    closure of nasal cavity due to congenital septum between nasal cavity and pharynx
  88. epistaxis
    nosebleed usually from anterior septum
  89. epulis
    nontender fibrous nodule of the gum
  90. fordyces granules
    small isolated white yellow papules on oral mucosa
  91. kopliks spots
    small blue white spots with red halo over oral mucosa (early sign measels)
  92. leukoplakia
    chalky white thick raised patcho n sides of tongue precancerous
  93. malocclusion
    upper or lower dental arches out of alignment
  94. parotid glands
    pair of salivary glands in the cheeks in front of the ears duct opens by 2nd molar
  95. pharyngitis
    swelling of the throat
  96. polyp
    smooth pale gray nodules in the nasal cavity due to chronic allergic rhinitis
  97. rhinitis
    red swollen inflammation of nasal mucosa
  98. thrush
    oral candidiasis in newborn
  99. turbinate
    one of 3 bony projections into nasal cavity
  100. 4 sets of sinuses
    • frontal maxillary ethmoid sphenoid
    • lighten weight of skul and provide mucous
  101. submandibular gland
    walnut size beneath mandible at angle of jaw, duct opens at frenulum
  102. sublingual gland
    almond shaped floor of mouth under tongue, many small openings along sublingual fold under tongue
  103. deviated/perforated septum
    • deviated a hump or shelf in one nasal cavity
    • perferated (hole) spot of light from one side of nares to other with penlight
  104. torus palatinus
    nodular ridge on hard palate
  105. tonsils grading
    • 1 visible
    • 2 1/2 between tonsillar pillars and uvula
    • 3 touching uvula
    • 4 touching eachother
  106. 3 infant mouth findings
    • sucking tubercle small pad in middle of upper lip
    • epsteins pearls small white papules on hard palate and gums
    • bednars aphthae traumatic areas or ulcers on posterior hard palate
  107. transillumination
    a diffuse red glow is normal
  108. frenulum
    connects tongue to floor of mouth midline
  109. sinuses accessible for examination
    frontal and maxillary
  110. rhinorrhea
    nasal discharge
  111. dysphagia
    difficulty swallowing
Card Set
health assessment
exam 1