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N190 Midterms Focus Review4 basic Techniques of assessment:1. inspection2.auscultation3. percussion4. palpationType of instruments used in clinical setting1.Doppler – used to assess the pulse when it cannot be palpated2.Stadiometer – used to measure height3.Wood lamp – used to assess the fungal infection on the skin4.Goniometer - instrument used to measure the degree of joint flexion an extension 5.transilluminator - instrument used to detect air blood fluid or mass in body cavity SKINThe layers of the skin a.epidermis - the top layer of the skinb.dermis - the second layer which contains nerves blood vessels and hair follicles c.subcutaneous tissue - the third layer which is the and then followed by the muscles and bones the fourth layer The grading of the skin edema-when you are assessing for skin edema you have to use your finger padsand press it around the bony prominences of the body parts-3 finger padsGrading Edema0 = no edema1+ = 2 mm2+ = 4 mm3+ = 6 mm4+ = 8 mmStage of decubitusStage 1 – one layer of the skin is affected, just reddened (epidermis)Stage 2 – 2 layers of the skin involved (epidermis & dermis)Stage 3 – lesions involving 3 layers of the skin (epidermis, dermis & Subcutaneous tissue)Stage 4 – lesions involving 4 layers of the skin (epidermis, dermis, Subcutaneous tissue, muscles & bones)Types of Lesion & Shapesa.Annular lesion - one circle configurationb.Target lesion – lesion with concentric circles of colors with dot at the center; AKA “bullseye”c.Wheal lesion – reddened with irregular borders caused by insect bite or hivesd.Macule – primary lesion that is flat, change in skin color- less than 1 cmExamples:frecklespetechiaechloasma – mask of pregnancy
e.Confluent – lesions that run togetherExamples: urticaria f.Patch – type of macule that is more than 1 cmExamples:vitiligoport wine stainMongolian spotsg.Vesicles – primary lesion elevated fluid filled, round or oval with translucent wall- less than 0.5 cmExamples: chicken poxPoison IvySmall burned blistersh.Bullae – type of vesicle more than 0.5 cmExample:large burned blisteri.Port wine stain – vascular lesion on the face that is flat, deep purple red, irregular in shape- deepens in color when the person is highly emotional or cryingj.Spider angioma – vascular lesion that is flat, bright red dot with tiny radiating blood vessels- ranging from pinpoint to 2 cmk.Hemangioma – vascular lesion that is bright red and raised, does not blanch with pressure- usually present at birth and disappears by the age of 10- 2 – 10 cm l.Venous lake – vascular lesion on the face, neck, ears, or lips on elderly people- soft, compressible, slightly elevated - dark blue to purple in colorm.Keloid – secondary lesion that is elevated irregular darkened are of excess scar tissuen.Discrete – lesions that are separated and discreteExamples: Molluscumo.Grouped – lesions that appear in clustersExamples: purpural lesionp.Linear – lesions that appear as a lineExamples: Scratchesq.Polycyclic – lesions that are circular but unitedExamples: Psoriasisr.