607 Exam 2 Study Guide
Modules 5-9
This is a guide only and is not inclusive.
***Examination techniques of organ systems covered in these modules***
1. -Breast self-exam – techniques & when to perform:
a. Lawn mower, in shower, five to seven days after menses
b. Use pads of 2nd, 3rd, and 4th fingers.
c. Systematic – vertical strip pattern in small, concentric circle w/ light,
medium, and deep pressure.
[Nodes that are larger >1-2cm and firm/hard, matted together, or fixed to the
skin suggest malignancy].
2. -Breast cancer –familial high-risk factors, lymph nodes associated with
breast cancer:
a. 1st degree relative
b. Inherited genetic – BRCA1/ BRCA2.
c. Age at menarche
d. Age at first birth
e. Age at menopause
f. Prior breast biopsies
g. Use of hormonal meds.
h. Hard, irregular poorly circumscribed nodules, fixed to the skin or
underlying tissues can be CA.
i. Unilateral, bloody discharge from 1 or 2 ducts could be breast CA.
(clear, serous, green, black, or nonbloody discharge that are
multiductal are usually benign).
j. Central lymph nodes are associated w/ breast CA.
Skin w/ breast CA:
Redness can be inflammatory CA
Peau d’orange = thickening and prominent pores.
3. -Breast masses:
a. breast cancer (irregular, firm/hard, fixed to skin or underlying tissues,
nontender),
b. fibroadenoma (round, disc-like or lobular, soft, but usually firm,
mobile, nontender),
c. fibrocystic changes (nodular, rope-like, tender/painful),
d. mastitis – red, angry inflammation, painful.
4. -Lymph node differentiation/locations/normal/abnormal (6 groups):
a. Anterior (pectoral) lower border of pectoralis minor behind
pectoralis major.
, b. Central – (Rotter’s Nodes) along chest wall high in axilla, MOST
LIKELY to be felt.
c. Infraclavicular (deltopectoral) not really axillary… lie between
pectoralis major and deltoid muscles – receive lymph from lateral side
of hand, forearm and arm.
d. Posterior (Subscapular) posterior lateral border of scapula,
e. Lateral (Humeral or deep) upper arm, goes into medial side of
axilla.
f. Apical (terminal) final common pathway for all axillary lymph
nodes; lying at the apex of axilla/lateral border for 1st rib.
5. -COPD – confirmation of:
a. spirometry and pulmonary testing
6. -Tonsils and adenoids – findings with abnormals:
a. 1-4+; rock mouth with tonsilitis; peritonsillar abscess unilateral; strep
pharyngitis
7. -Bronchitis – characteristics of:
a. crackles, wheezes, or ronchi clear with coughing
8. -Congenital eye conditions:
a. Brushfield spots – most associated w/ down syndrome harmless
connective tissue aggregations.
b. Strabismus – misalignment of eyes,
c. Ptosis (drooping),
d. Cataracts,
e. Colobomas – key shaped pupil from incomplete closure of embryonic
optic fissure increased risk of cataracts, vision loss/blind spots.
9. -Osteoporosis risk factors:
a. Postmenopausal
b. Age 50 and older,
c. Low BMI/Calcium/Vit D,
d. Tobacco/alcohol use,
e. Immobilization
10. -Tissue abnormalities – cancerous masses, lipomas, cysts
11.-Otitis media, externa, serous otitis in children
12.-Costochondritis presentation and location:
a. below left breast, stabbing
13. -Post menopausal bleeding – causes and red flags:
a. Endometrial cancer, HRT, uterine/cervical polyps
Modules 5-9
This is a guide only and is not inclusive.
***Examination techniques of organ systems covered in these modules***
1. -Breast self-exam – techniques & when to perform:
a. Lawn mower, in shower, five to seven days after menses
b. Use pads of 2nd, 3rd, and 4th fingers.
c. Systematic – vertical strip pattern in small, concentric circle w/ light,
medium, and deep pressure.
[Nodes that are larger >1-2cm and firm/hard, matted together, or fixed to the
skin suggest malignancy].
2. -Breast cancer –familial high-risk factors, lymph nodes associated with
breast cancer:
a. 1st degree relative
b. Inherited genetic – BRCA1/ BRCA2.
c. Age at menarche
d. Age at first birth
e. Age at menopause
f. Prior breast biopsies
g. Use of hormonal meds.
h. Hard, irregular poorly circumscribed nodules, fixed to the skin or
underlying tissues can be CA.
i. Unilateral, bloody discharge from 1 or 2 ducts could be breast CA.
(clear, serous, green, black, or nonbloody discharge that are
multiductal are usually benign).
j. Central lymph nodes are associated w/ breast CA.
Skin w/ breast CA:
Redness can be inflammatory CA
Peau d’orange = thickening and prominent pores.
3. -Breast masses:
a. breast cancer (irregular, firm/hard, fixed to skin or underlying tissues,
nontender),
b. fibroadenoma (round, disc-like or lobular, soft, but usually firm,
mobile, nontender),
c. fibrocystic changes (nodular, rope-like, tender/painful),
d. mastitis – red, angry inflammation, painful.
4. -Lymph node differentiation/locations/normal/abnormal (6 groups):
a. Anterior (pectoral) lower border of pectoralis minor behind
pectoralis major.
, b. Central – (Rotter’s Nodes) along chest wall high in axilla, MOST
LIKELY to be felt.
c. Infraclavicular (deltopectoral) not really axillary… lie between
pectoralis major and deltoid muscles – receive lymph from lateral side
of hand, forearm and arm.
d. Posterior (Subscapular) posterior lateral border of scapula,
e. Lateral (Humeral or deep) upper arm, goes into medial side of
axilla.
f. Apical (terminal) final common pathway for all axillary lymph
nodes; lying at the apex of axilla/lateral border for 1st rib.
5. -COPD – confirmation of:
a. spirometry and pulmonary testing
6. -Tonsils and adenoids – findings with abnormals:
a. 1-4+; rock mouth with tonsilitis; peritonsillar abscess unilateral; strep
pharyngitis
7. -Bronchitis – characteristics of:
a. crackles, wheezes, or ronchi clear with coughing
8. -Congenital eye conditions:
a. Brushfield spots – most associated w/ down syndrome harmless
connective tissue aggregations.
b. Strabismus – misalignment of eyes,
c. Ptosis (drooping),
d. Cataracts,
e. Colobomas – key shaped pupil from incomplete closure of embryonic
optic fissure increased risk of cataracts, vision loss/blind spots.
9. -Osteoporosis risk factors:
a. Postmenopausal
b. Age 50 and older,
c. Low BMI/Calcium/Vit D,
d. Tobacco/alcohol use,
e. Immobilization
10. -Tissue abnormalities – cancerous masses, lipomas, cysts
11.-Otitis media, externa, serous otitis in children
12.-Costochondritis presentation and location:
a. below left breast, stabbing
13. -Post menopausal bleeding – causes and red flags:
a. Endometrial cancer, HRT, uterine/cervical polyps
