NR302 / NR 302 Exam 3 (2026/2027 Updated) Health Assessment I |Review with Questions and Verified Answers| 100% Correct | A Grade -Chamberlain

NR302 / NR 302 Exam 3 (2026/2027 Updated) Health Assessment I |Review with Questions and Verified Answers| 100% Correct | A Grade -Chamberlain Q. What tools does one use to determine breath sounds? ANSWER Diaphragm stethoscope Q. What location is the bronchial sounds heard at? ANSWER along bronchial tube of neck Q. What is a normal sound of bronchial noises? ANSWER equal loudness of breathing in/ out Q. Where can you hear Bronchovesicular sounds? ANSWER Around area of the sternum Spinal column of back (vertebral line) Q. What should the sounds of the bronchovesicular sounds be? ANSWER Moderate pitch Q. Where can you hear the vesicular sounds at? ANSWER around the peripheral of the lungs Q. What should a normal vesicular sound be? Soft ANSWER Low pitched Q. What is tachypnea? ANSWER Rapid-shallow breathing Approximately 24+ respiratory rate Q. What is tachypnea associated with? ANSWER - Exercise - Fever - Pneumonia - Anxiety - Fear Q. What is hyperventilation? ANSWER increase in respiratory rate that is deep sounding Q. What is hyperventilation associated with? ANSWER - over dosage - anxiety Q. Why is hyperventilation a major concern? ANSWER - large volumes of air are being inhaled at a fast rate - increases gas exchange at a large rate - causes a decrease in CO2 levels Q. What does hyperventilation cause? ANSWER respiratory alkalosis Q. What is bradypnea? ANSWER Slow / regular breathing patterns Q. What is bradypnea associated with? ANSWER - drugs - sleep medications Q. What is hypoventilation ANSWER Irregular / shallow breathing Q. What does hypoventilation cause? ANSWER Respiratory acidosis (CO2 levels increase) Q. What is lobar pneumonia? ANSWER infection in the lungs Q. What are the manifestations of lobar pneumonia? ANSWER - Fever - Chills - Cough - pleuritic chest pain - blood / rust colored sputum - fatigue - tachypnea -tachycardia Q. What will auscultation hear with lobar pneumonia? ANSWER Crackling noises Q. what causes the crackling auscultation noises in lobar pneumonia ANSWER secretions / inflammation of lung tissues Q. What are the manifestations of asthma? ANSWER - Bronchospasms - inflammation of airways - increased mucus production Q. What are some signs of asthma? ANSWER - wheezing - increased respiratory rate - cyanosis - accessory muscle usage - apprehension - SOB - Tachycardia (elevated HR) Q. What will someone hear while auscultation of asthma? ANSWER Wheezing noises Q. What is a pulmonary embolism? ANSWER undissolved material lodged in a pulmonary blood vessel Q. What can cause a pulmonary embolism? ANSWER - clots - fat deposits - platelet cells Q. What are signs of pulmonary embolisms? ANSWER - Chest pain - restlessness - anxiety - cyanosis - tachypnea - cough - hemoptysis - crackles - wheezing - tachycardia Q. What is does COPD stand for? ANSWER chronic obstructive pulmonary disease Q. What is the definition of COPD? ANSWER inflammation of the bronchi Q. What is the most common cause of COPD/ Emphysema? Smoking Q. What are some signs/ symptoms of COPD? ANSWER - Productive cough - clubbing - fatigue - increase mucus production - crackles - dyspnea Q. What is emphysema? ANSWER Tissue destruction within the lungs that causes a chronic enlargement of alveoli Q. What are the signs / symptoms of emphysema ANSWER - barrel chest - accessory muscle usage - tripod positioning - SOB - Decreased breath sounds Q. What is hyperresonance? ANSWER Loud, lower-pitched sound than normal resonance heard over hyperinflated lungs, Q. What is hyperresonance/ crepitus normally associated with? ANSWER emphysema What does crepitus indicate? Air in the subcutaneous tissue What does adventitious lung sounds mean? abnormal lung sounds What is crackles (rales)? fluid build up in the lungs What does crackles (rales) sound like? gurgled or bubbling sounds in the lungs on expiration What is crackles (rales) associated with pneumonia What is wheezes (rhonchi)? A sound caused by constriction of narrowing of airways heard on expiration What does wheezes (Rhonchi) sound like? Sounds like music or lyrical sounds on expiration What is wheezes (Rhonchi) associated with? - asthma - COPD - Emphysema What is stride? A sound commonly associated with airway blockage due to foreign bodies and/or severely narrowed airways What does strider sound like? high pitch form of wheezing that sounds like a crowing sound What is strider typically associated with? epiglottitis allergic reactions What happens to the respiratory system involved with the aging adult? - Cartilage around rib cage becomes calcified - decrease lung capacity - thorax becomes less mobile - decrease vital capacity - decreased ability to cough - decreased gas exchange - increased AP diameter (Barrel chest) - increase in fatigue - development of Kyphosis What is vital capacity? amount of air exhaled from the lungs What is residual volume? Air left over in the lungs after an exhale What is kyphosis? -abnormal outward curvature of the upper spine - "humpback" - inability to inhale/exhale Who is most at risk for developing kyphosis? post-menopausal women What is the most important method for preventing kyphosis? Exercising What is scoliosis? abnormal lateral curvature of the spine that decreases the volume intake of the lungs due to the impact it causes on the diaphragm What is the leading cause of developing lung cancer? smoking is the leading cause What is tuberculosis? Bacterial infection of the lungs that is highly contagious How much of the worlds population is impacted by TB? 1/3rd of the world population What are risk factors for contracting TB? Homelessness Crowded places Not clean environments What is the best way to prevent asthma attacks? - avoid triggers What is the most common chronic disease in childhood? Asthma What is some subjective data related to the lungs? - cough - shortness of breath - chest pain w/ breathing - smoking history (5- A's) - History of respiratory infections - environmental exposure - patient-centered care What are the Five - A's of smoking history? - Ask - Advice - Assess - Assist - Arrange What is the definition of heart failure? - back flow of blood due to heart having not working properly What are some manifestations of heart failure? - decreased cardiac output / volume of blood - falling O2 saturations - BP decreases What are some symptoms of Heart Failure? - pallor - cyanosis - fatigue - dyspnea - cold / moist skin - vasoconstriction in limbs - dependent, pitting edema (bilaterally) What is acute coronary syndrome? Squeezing / crushing chest pain that last longer then 20 minutes or greater that does not go away with rest What are some manifestations of acute coronary syndrome - indigestion- like feeling - nausea - vomiting - dizziness - flushing - perspirations - palpitations - dyspnea - Fatigue What is angina? Chest pain that begins w/ exercise or anxiety and does not go away with rest What is some clinical manifestations of angina? - Diaphoresis - Nausea - Vomiting - Dyspnea - Fatigue What is the direction of blood flow? - Unoxygenated red blood drains into vena cava via route of venous blood - goes from liver to right atrium (RA) through vena cava - from RV, venous blood flows through pulmonic valve to pulmonary artery - Lungs oxygenate blood - From left atrium (LA), atrial blood travels through mitral valve to left ventricle (LV) - From LA, arterial blood travels through mitral valve to LV - Aorta delivers oxygenated blood to body - circulation is a continous loops that moves via pressure gradients What moves blood throughout the body? Continuous shifting pressure gradients What causes the S1 sound? Sound occurs with the closure of the Tricuspid / Mitral valves (AV) What will be the first sound you hear while auscultating for heart sounds? S1 sound What does the S1 sound signal? beginning of systole What AV is heard first? The mitral valve is heard first and then tricuspid is heard slightly afterwards What is the S2 sound? A sound of the heart's semilunar valves closing What valves make up the semilunar valves? Aortic Pulmonic What does the S2 heard sound signal? Ending of systole Where is the S2 sound heard the loudest? base of the heart at the midsternal area Which semilunar valve closes first? aortic what should be noted if a sound is heard during S3/S4 while auscultating the heart? abnormal findings should be noted What is a murmur? gentle, blowing, swooshing sound that can be heard on the chest wall What causes a murmur? conditions that are created by turbulent blood flow / collision currents What are conditions that cause murmurs? - velocity of blood increases - viscosity of blood decreases - structural defects in valves What happens to the heart as a patients age? - atherosclerosis can occur - orthostatic hypertension can occur - hemodynamic changes occur - cardiac disease can occur What is atherosclerosis? the buildup of fatty substances in the arteries What is orthostatic hypertension? sudden increase in blood pressure when a person stands up What are some hemodynamic changes w/ aging adults? - isolated systolic HTN - left ventricular walls becomes thicker - overall size of heart stays the same - Pulse pressure increases - No change in resting HR or cardiac output at rest What causes an isolated systolic HTN? - increase in BP due to thickening / stiffening of arteries What is cardiac disease? an increase in hypertension / blood pressure What does cardiac disease put a patient at risk for? Heart failure What are ways to prevent the development of cardiac disease? - exercise - healthy lifestyles - good nutrition What are some risk factors for cardiac diease? - Hypertension - Smoking - Serum cholesterol - Sex / gender differences What gender is at a higher risk for developing cardiac disease? Men are at a higher risk Why are men at a higher risk for developing cardiac disease? - have an elevated BP - more inclined to have cardiac conditions What is some subjective data regarding cardiac disease? - Chest pain - Dyspnea - Orthopnea - Cough - Fatigue - Cyanosis - Pallor - Bilateral edema - nocturia - past cardiac history - family cardiac history - patient - centered care (cardiac risk factors) What are some objective data regarding cardiac disease? - auscultation of carotid arteries - listen for bruit (murmurs) - listening for swishing sounds What is stenois? decreased forward flow of blood through a valve What is regurgitation? Increased backflow of blood through a valve Glaucoma Optic nerve neuropathy Characteristized by loss of peripheral vision caused by intraocular pressure Primary risk=age Higher risk for women Over 2.2 mil adults over 40 have it; another 2 million don't know they have it 2 types: open-angle and closed-angle Open-angle glaucoma More common Drainage canals of the eye gradually become clogged; causes slow build up in intraocular pressure as fluid continues to be produced at normal rates Entrance to drainage canal of the eye is clear or open and working correctly; clogging happens farther inside the canals Is gradual, painless, and causes no early symptoms Peripheral vision loss occurs first; often unnoticed because clients learn to compensate Eventually, some may not be able to see anything to either side (tunnel vision) bronchial breath sounds - also known as tracheal or tubular -high pitch -loud amplitude -inspiration is less than expiration With bronchial breath sound the quality is harsh, hallow tubular . t or f True The area you hear the bronchial breath sounds is the larynx and trachea bronchovesicular breath sounds -Breath sounds normally heard in the posterior chest between the scapulae and in the center part of the anterior chest in the adult; -softer than bronchial sounds; about equal during inspiration and expiration The bronchovesicular breath sounds has what type of pitch and amplitude -moderate pitch and amplitude Vesicular breath sounds -has a low pitch -soft amplitude -inspiration is greater than expiration vesicular sound breaths -sound like rustling , like the sound of ht wind in the trees How do the vesicular breaths sound ? sound like rustling like the sound of the wind in the trees Where can the vesicular breath be heard? over the peripheral lung field where air flows through smaller bronchioles and alveoli What is tachypnea? rapid, shallow breathing, 24 breaths per minute Tachypnea can occur because of -fear -fever -exercise Tachypnea increases with pneumonia, pleurisy, alkalosis and respiratory insufficiency Hyperventilation the condition of taking abnormally fast, deep breaths hyperventilation occurs with what -extreme exertion -fear or anxiety -diabetic ketoacidosis -hepatic coma -salicylate overdose hyperventilation does what -creates the most concern bc one is taking in lots of air and it affects the gas exchange that makes CO2 decrease causing RESPIRATORY ALKALOSIS bradypnea slow breathing, a decreased , but regular rate less than 10 min Bradypnea can -increase intracranial pressure -diabetic coma -drug induced depression -can be a drug induced depression of the respiratory system (Nyquil) Hypoventilation is Irregular shallow pattern caused by an overdose of narcs or anesthetics hypoventilation can also be caused by what ? -prolonged bed rest or conscious splinting of the chest to avoid respiratory pain Hypoventilation can lead to respiratory acidosis lobar pneumonia infection of the lungs. It flames the air sacs in one or both lungs. The air sacs may fill w/ fluid , blood cells. Fever, cough/w pleuritic chest pain , blood tinged sputum , chills, SOB and fatigue are symptoms of Lobar Pneumonia lobar pneumonia leads to leads to tachycardia, loud bronchial breathing w/ patent bronchus, and bacterial infection Emphysema -caused by the destruction of pulmonary connective tissue (elastin, collagen) -characterized by permanent enlargement of air sacs, sacs distal to terminal bronchioles and rupture interalveolar walls Emphysema increases airway resistance, especially on expiration producing hyperinflated lung and increases in lung volume 80% to 90% of emphysema is due to smoking Results of emhpysea is barrel chest, use of accessory muscles related to smoking , air sacs in the lungs are damaged , tripod position and decreased breath sounds. pulmonary embolism -clot or other material lodges in vessels of the lung -can be fat -any type of undissolved material in a pulmonary blood vessel Pulmonary Embolism -chest pain -worse on deep inspiration -SOB (dyspnea) -cyanosis -tachypnea -cough -HEMOPTYSIS With the aging adult there is a decreased in vital capacity and increased residual volume : true or false? True With the aging adult there is an increase in gas exchange ? Fale In the aging adult the thorax becomes less mobile and coastal cartilages become more calcified ? True In the aging adult, the lung is more ridge structure that is harder to inflate? true Lung cancer is the 2nd most commonly diagnosed cancer in both men and women, the leading cause of cancer in the US? True Who is most likely to get infected with tuberculosis ? -homeless -group setting -long-term care Crackles that are fine are discontinuous, high pitched, short crackling, popping sounds heard during inspiration that is NOT cleared by coughing Fine crackles inhaled air collides/with previous deflated airways , suddenly pop open creating explosive crackling sound. then sudden closing examples of fine crackles -Late inspiratory crackles -Early inspiratory crackles -posturally induced crackles Crackles that are coarse -Loud, low-pitched bubbling and gurgling sounds that start in early inspiration and may be present in expiration -may decreases somewhat by suctioning or coughing , but reappear shortly coarse crackles is when inhaled air collides w/ secretions in the trachea and large bronchi What are examples of coarse crackles -pulmonary edema , pneumonia , pulmonary fibrosis What are atelectatic crackles? of adventitious sound that is not pathological. Short, popping, crackling sounds that sound like fine crackles but do not last beyond a few breaths. Examples fo atelectatic crackles In aging adults , in bedridden persons or in persons just aroused from sleep Pleural Friction Rub A very superficial sound that is coarse and low pitched ; it has grating quality as if two pieces of leather are being rubbed together Pleural Friction Rub is when pleurae become inflamed and lose their normal lubricating fluid ; their opposing roughened pleural surfaces rub together during respiration Examples of pleural rub Pleuritis , accompanied by pain w/breathing Wheeze (sibilant) high-pitched, musical sounds heard primarily during expiration but may also be heard on inspiration Sibilant wheeze sound polyphonic (multiple notes as in a musical chord) Examples of wheeze diffused airway, obstruction from acute asthma or chronic emphysema Wheeze (sonorous) low-pitched ; monophonic , single note , musical snoring , moaning sounds , heard throughout cycle, although they are more prominent on expiration ; may clear somewhat by coughing Examples of wheezing (sonorous) Ex: bronchitis , single bronchus obstruction from airway tumor Stridor High-pitched, monophonic, inspiratory, crowing sound, louder in neck than over chest wall Where does stridor originate at? In the larynx and trachea Examples of stridor Croup, laryngeal edema (post Extubation) Tonsillitis, Epiglottitis and Anaphylaxis. What is heart failure? -Decreased cardiac output when the heart fails as a pump and the circulation becomes backed up and congested In heart failure, when your pump is not working well and there is a decrease in the volume of the blood that is sent around the body ? True What is stenosis? narrowing of a valve -leads to decreased forward flow What is regurgitation? the valve does not close properly and blood backflows through the valve What is one reason that heart failure occurs? Heart failure occurs because the heart inability to pump enough blood to meet the metabolic demands of the body What is the second reason that heart failure occurs? -The kidneys compensatory mechanism of abnormal reaction of sodium and water to compensate for the decreased cardiac output ..this increases blood volume and venous return , which causes further congestion Onset reason for heart failure is acute, as following myocardial infraction when the heart contracting ability has been directly damaged Heart failure can lead to systole dysfunction and diastolic dysfunction ? True Which of the following are not symptoms of heart failure? -dilated pupils -dyspnea -weak pulse -cool moist skin -fatigue -infract -decreased urine output -tachycardia -hypotension -vomiting -hypotension Which of the following is not a symptom of heart failure? -orthopnea -crackles/wheeze -cough -decreased blood pressure -skin is pale, gray, cyanotic -ascites -dependent, pitting edema -Anxiety -Falling O2 saturation -Confusion -S3 Gallop -fever -Enlarged spleen/liver -Jugular vein distention -Fever What is acute coronary syndrome? Develops when ischemia is prolonged and not immediately reversible. acute coronary syndrome -heaviness, vise-like , squeezing, crushing , tightness , vague , burning, constricting or pressure ; poorly localized pain lasting 20-30min to hrs and does not resolve w/rest or nitroglycerin Angina a condition of episodes of severe chest pain due to inadequate blood flow to the myocardium angina pectoris chest pain, which may radiate to the left arm and jaw, that occurs when there is an insufficient supply of blood to the heart muscle examples of angina pectoris -diaphoresis -vomiting -dyspnea -pressure like pain (tightness , burning ) -last 3-5 minutes, resolves w/rest and nitroglycerin unstable angina chest pain that occurs while a person is at rest and not exerting himself Unstable angina should be treated as a medical emergency? true Heaviness, vise-like, squeezing , lasting 20-30 min -1hr , does not resolve with rest and nitroglycerin. Has flushing respiration, dizziness, perspiration, indigestion feeling, nausea describes what type of angina? Unstable angina Prinzmetal or Variant angina is caused by coronary artery spasms which restrict blood flow to the myocardium. Pain can occur at any time, even during rest and sleep Symptoms of variant angina syncope life style habits that affect the aging adult heart -diet -smoking -alcohol use -excerise pattern -stress With aging there is an increase in the systolic BP caused by arteriosclerosis Risk factors for cardiovascular -high blood pressure -smoking -Serum Cholesterol (LDL) -Physical Activity -Sex and Gender differences (men will get HTN more then women A patient complains of crushing chest pain and heaviness that goes away after 15 minutes , which action should the nurse take? -Ask the patient what triggered the attack Which are the following are a clinical manifestation of heart failure? -low BP -ascities -increased urine output -rhonchi -frothy sputum -orthopnea -low BP -ascites -frothy sputum -orthopnea A patient has a respiratory rate of 30, breathing is very deeply ; this is known as hyperventilation Blood flow through the heart SVC -- Rt atria -- Tricuspid -- Rt ventricle -- Pulmonic valve -- Lungs -- Lt atria -- Mitral valve -- Lt ventricle -- aortic valve -- aorta -- Body Closed-angle glaucoma Less common Drainage canals blocked or covered by the outer edge of the iris when the pupil enlarges too much or too quickly Is most often acute but can be chronic Acute: sudden onset of symptoms including eye pain, headaches, nausea/vomiting, blurred/sudden loss of vision, rainbow-colored halos around lights especially at night; if untreated, vision loss can happen within 2-3 hours Primary Angle-Closure Glaucoma (same as closed angle???) Table 14-6 Acute version shows circumcorneal redness around iris with dilated pupil; pupil is oval/dilated; cornea looks "steamy" and anterior chamber is shallow Occurs with sudden increase in intraocular pressure from blocked outflow from anterior chamber Person experiences sudden clouding of vision, sudden eye pain, and halos around lights Requires emergency treatment to avoid permanent vision loss Periorbital Edema Swollen/puffy lids Lid tissues are loosely connected so excess fluid is easily apparent Occurs with local infections, crying, systemic conditions like CHF, renal failure, allergy, hypothyroidism (myxedema) Hordeolum AKA: Stye Acute localized staphylococcal infection of hair follicles at the lid margin Painful, red, swollen Superficial, elevated pustule at the lid margin Rubbing the eyes can cause cross-contamination and development of another stye Conjunctivitis AKA: pink eye Infection of the conjunctiva Red, beefy-looking vessels at periphery; usually clearer around iris Commonly from viral or bacterial infection, allergy, or chemical irritation Purulent discharge if bacterial Preauricular lymph node often swollen/painful with history of upper respiratory infection Symptoms: itching, burning, foreign body sensation, eyelids stuck together on awakening They have normal vision, pupil size, and reaction to light TABLE 14-10 Was not told to ignore but not given specifics to know Otitis Externa AKA: Swimmer's Ear Infection of the outer ear With severe painful movement of the pinna and tragus Redness/swelling of pinna and canal Scanty purulent discharge Scaling, itching, fever, and enlarged tender regional lymph nodes Hearing is normal or slightly diminished More common in hot/humid weather Swimming causes canal to be waterlogged and swell; skinfolds set up for infection Prevent with rubbing alcohol or 2% acetic acid ear drops after every swim Keloid Overgrowth of scar tissue that invades original site of trauma More common in dark-skin but occurs in Whites In the ear, its most common on lobule where ear was pierced Excessive Cerumen Produced or impacted because of narrow, tortuous canal or poor cleaning method May show as round ball partially obscuring drum or totally occluding canal Even when canal is 90-95% blocked, hearing stays normal When last 5-10% of canal is totally occluded (when cerumen expands after swimming or showering), person has ear fullness and sudden hearing loss Acute Otitis Media (AOM) Results when middle ear fluid is infected Absent light reflex from increasing middle ear pressure is an early sign Redness and bulging are first noted in superior part of drum (pars flaccida) along with earache and fever Then, fiery red bulging of entire drum occurs with deep throbbing pain Also possible fever and transient hearing loss Pneumatic otoscopy shows drum hypomobility Perforation (eardrum) If AOM isn't treated, drum may rupture from increased pressure Also occur from trauma like a slap on the ear Usually appears as round or oval darkened area on drum Central perforations: pars tensa Marginal perforations: annulus; called attic perforations" when they occur in superior part of drum (pars flaccida) Hemotympanum Blue Drum Indicates blood in the middle ear Occurs in trauma resulting in skull fracture WEBER TEST MORE INFO Normally sound is equally loud in both ears; sound doesn't lateralize RINNE TEST MORE INFO Normally sound is heard twice as long by air conduction (AC) than by bone conduction (BC); this is a "positive" Rinne or ACBC Sinusitis Inflamed infected sinus areas after URI Most often viral and don't require antibiotics Consider bacterial cause if signs last 7-10 days Major signs: MUCOPURULENT DRAINAGE, nasal obstruction, facial pain or pressure, loss of sense of smell May also have fever, chills, malaise Maxillary sinusitis has dull, throbbing pain in cheek and teeth; pain with palpation and when bending over Frontal sinusitis has pain above supraorbital ridge Seasonal Allergic Rhinitis AKA: Hay Fever FIND CHARACTERISTICS OF DISCHARGE Most common type of rhinitis presents with rhinorrhea, itchy nose/eyes, lacrimation, nasal congestion, and sneezing Note serous ethema and swelling of turbinates to fill the air space Turbinates usually pale (or may be violet) and surface looks smooth/glistening Common allergens: dust mite, animal dander, mold, pollen When severe, produces disordered sleep, obstructive sleep apnea, sinusitis, and poor work performance Acute Rhinitis First sign is CLEAR, WATERY DISCHARGE, RHINORRHEA, WHICH LATER BECOMES PURULENT Accompanied by sneezing, nasal itching, stimulation of cough reflex, and inflamed mucosa causing nasal obstruction Turbinates are dark red and swollen Cleft Lip Maxillofacial clefts are most common congenital deformities; associated with phenytoin (Dilantin), maternal smoking and alcohol use, benzodiazepines, and corticosteroids Early treatment preserves functions of speech, language formation, and deglutition (swallowing) Herpes Simplex 1 Cold sores are groups of clear vesicles with surrounding indurated erythematous base Vesicles evolve into pustules that rupture, weep, and crust; heal in 4-10 days Most likely site is lip-skin junction; infection often recurs in same site Caused by HSV-1 Lesion is highly contagious and spread by direct contact Recurrent infections may be precipitated by sunlight, fever, colds, and allergy Very common; affects 50% of adults Aphthous Ulcers AKA: canker sore Vesicle at first then a small, round, "punched-out" ulcer with white base surrounded by red halo Quite painful; lasts 1-2 weeks Unknown cause but associated with stress, fatigue, and food allergy Candidiasis AKA: Monillial Infection; thrush in newborns White, cheesy, curd-like patch on buccal mucosa and tongue Scrapes off, leaving a raw/red surface that bleeds easily Opportunistic infection occurring after use of antibiotics and corticosteroids in immunosuppressed people Ankyloglossia Short lingual frenulum Congenital defect Can fix the tongue tip to the floor of the mouth and gums (tongue-tie) If tongue tip can't be elevated to alveolar ridge, it limits mobility and affects speech (pronunciation of a, d, n) Atrophic Glossitis AKA: Smooth, Glossy Tongue Surface is slick/shiny Mucosa thins and looks red from decreased papillae Dryness of tongue and burning Occurs with vitamin B12 deficiency (pernicious anemia), folic acid deficiency, and iron deficiency anemia Black Hairy Tongue Not really hair but is elongation of filiform papillae and painless overgrowth of mycelial threads of fungus infection on the tongue Color varies from black-brown to yellow Occurs after using antibiotics which inhibits normal bacteria and allows proliferation of fungus Also occurs with heavy smoking Cleft Palate Congenital defect Failure of fusion of maxillary process Wide variation occurs in extent of cleft formation from upper lip only, palate only, uvula only, to cleft of the nostril and the hard and soft palates Acute Tonsillitis and Pharyngitis Bright red throat, swollen tonsils, white or yellow exudate on tonsils and pharynx, swollen uvula, and enlarged/tender anterior cervical and tonsillar nodes Sudden onset of severe sore throat, painful swallowing, fever 101 F If bacterial, may have absence of cough When severe symptoms or sore throat lasting 3-5 days, consider streptococcal infection as cause; confirm with rapid antigen testing or throat culture; if positive, treat with antibiotics Untreated GAS pharyngitis may cause peritonsillar abscess, lymphadenitis, acute rheumatic fever (rare in US now)