Logical and Intuitive ✔️Ans - Draws reasonable conclusions (if this is so,
then it follows that... because...); uses intuition as a guide to search for
evidence; acts on intuition only with knowledge of risk involved.
Splinter hemorrhages in fingernails ✔️Ans - Red or purple-brown steak
nail bed
Causes: minor trauma, trichinosis, subacute bacterial endocarditis
paronychia ✔️Ans - Inflammation of the skin around the nail
Caused: local infection, staphylococcus aureus, herpes, Candida albicans,
pseudomonas spp.
clubbing of nails ✔️Ans - Enlargement of the fingertips, softening of the
nail bed, and flattening of the nail; angle between the nail plate and the nail
often greater than 180 degrees
, Causes: hypoxia from heart or pulmonary disease
Beau's lines ✔️Ans - Transvers ridging in nails due to a temporary half in
nail growth
Ex: nail injury, systemic injury, eczema, psoriasis, paronychia
Kolionychia or spoon nails ✔️Ans - Concave curves of the nail with
thinning of the nail plate
Causes: iron deficiency, anemia, repeated chemical trauma, syphilis
Muehrcke's nails ✔️Ans - Double band of white lines (leukonychia)
Causes: renal disease
capillary refill ✔️Ans - after blanching nail bed, color should return to
normal withing <3 secs (brisk)
Longer than 2 to 3 seconds (sluggish or slow)
aortic valve ✔️Ans - right of the sternum 2nd intercostal space
pulmonic valve ✔️Ans - left of the sternum 2nd intercostal space
Erb's point ✔️Ans - left of the sternum 3rd intercostal space
triscupid valve ✔️Ans - Left of the sternum 4th intercostal spaces
mitral valve ✔️Ans - Left of the sternum 5th intercostal space
When should you use apical pulse ✔️Ans - when heartbeat is abnormal
during radial pulse
Tracheal breath sounds ✔️Ans - High pitch
Harsh quality
Loud amplitude
Located over the trachea ju
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