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Clinical Medicine > Exam #2: Head & Neck Examination > Flashcards

Exam #2: Head & Neck Examination Flashcards

1
Q

What are the seven attributes of a symptom?

A

1) Location
2) Quality
3) Quantity
4) Timing
5) Setting (in which it occurs)
6) Mitigating & Exacerbating Factors
7) Associated Symptoms

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2
Q

What is a primary headache?

A

A headache that is idiopathic — occurring for no obvious reason, and not the result of any underlying disease or process

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3
Q

What is a secondary headache?

A

A headache that arises from an underlying structural, systemic, or infectious cause

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4
Q

What are the different types of primary headaches?

A

1) Migraine
2) Tension
3) Cluster
4) Medication Rebound
5) Chronic Daily Headache

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5
Q

What are three potential causes of a secondary headache?

A

1) Meningitis
2) Subarachnoid Hemorrhage
3) Mass Lesion

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6
Q

Characteristics of a Migraine

A
  • Unilateral
  • Throbbing or aching
  • Peaks within 1-2 hours but can last 4-72 hours
  • More common in women
  • Associated Symptoms include nausea & vomiting
  • Prodrome
  • Triggered by missing meals, menses, birth control, stress, food
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7
Q

Characteristics of a Tension Headache

A
  • Adulthood
  • Bilateral or Unilateral
  • Band-like, constricting & non-throbbing
  • Gradual onset & lasts hours to days
  • Photophobia & Phonophobia maybe, but NO nausea
  • NO prodrome
  • Triggered by stress, anger, and teeth grinding
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8
Q

Characteristics of a Cluster Headache

A
  • Unilateral & retro-orbital
  • Intense burning, searing, knife-like
  • Abrupt onset that peaks in minutes
  • Lasts several nights for several days and then gone
  • More common in men
  • Associated symptoms: increased tearing & nasal discharge
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9
Q

Characteristics of a Medication Rebound Headache

A
  • Diffuse
  • Dull or Throbbing
  • Onset hours or days after last dose & lasts hours
  • Seen in patients taking daily analgesics w/ abrupt cessation
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10
Q

Red Flag Symptoms with Headaches

A
  • Progressively frequent or severe
  • Sudden onset- “Thunderclap”
  • “Worst headache of my life”
  • New onset after 50 years old
  • Aggravated or relieved by a change in position
  • Precipitated by the Valsalva maneuver
  • Associated with fever, night sweats, or weight loss
  • Hx of cancer, HIV infection, or pregnancy
  • Recent trauma
  • Associated papilledema, neck stiffness, or focal deficit
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11
Q

What should you consider if headache is severe and of sudden onset?

A

SAH or Meningitis

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12
Q

What is concerning of a headache that is new, persisting, & progressively severe?

A

Raises concern for tumor, abscess, or mass lesion

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13
Q

What types of headaches are unilateral?

A

Migraine & Cluster

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14
Q

What type of headache often arises in the temporal area?

A

Tension

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15
Q

What type of headache is often retro-orbital?

A

Cluster

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16
Q

What type of headache has a prodrome?

A

Migraine

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17
Q

Why is exacerbation of a headache with the Valsalva maneuver concerning?

A

May increase pain from acute sinusitis or mass lesion & ICP

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18
Q

What are important considerations in head trauma?

A
  • LOC
  • Mechanism of Injury
  • Level of Consciousness
  • Time of Injury
  • Amnesia
  • Headache
  • Vision changes
  • Bleeding from ears, nose, mouth, eyes
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19
Q

Concussion

A

Disturbance in brain function caused by a direct or indirect force to the head, resulting in a constellation of symptoms that does not necessitate LOC

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20
Q

Symptoms suspicious for concussion

A
  • Headache
  • Unsteadiness
  • Impaired brain function or confusion
  • Abnormal behavior
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21
Q

What is the Sport Concussion Assessment Tool (SCAT2)?

A

Pre-season cognitive screening to be compared to post-injury; if athlete is not back to baseline, no participation

22
Q

Symptoms of Hyperthyroid

A
  • Nervousness
  • Weight Loss
  • Excessive sweating/ heat intolerance
  • Warm, smooth, moist skin
  • Grave’s Disease
  • Tachycardia
23
Q

Symptoms of Hypothyroid

A
  • Fatigue, Lethargy
  • Modest weight gain
  • Dry coarse skin
  • Cold intolerance
  • Swelling of face, hands, and legs
  • Bradycardia
  • Impaired memory
24
Q

Conductive Hearing Loss

A

Problems with the external or middle ear

25
Q

Sensorineural Hearing Loss

A

Problems with the inner ear, cochlear nerve, or its connections to the brain

26
Q

Difficulty understanding speech & worse hearing in noisy enviornment

A

Sensorineural

27
Q

Noisy environment improves hearing

A

Conductive

28
Q

Medications that affect hearing

A
  • aminoglycosides
  • aspirin
  • NSAIDs
  • quinine
  • furosemide
29
Q

Vertigo

A

Perception of spinning caused by problems in the labyrinths of the inner ear, peripheral lesion of CN VIII, or central lesions of CN VIII

30
Q

Sutures

A

Membranous tissue spaces that separate the bones of the skull

31
Q

Fontanelles

A

Areas that sutures intersect

32
Q

When do you need to measure head circumference in a child?

A

Birth to 24 months

33
Q

When does the anterior fontanelle close?

A

18 months

34
Q

When does the posterior fontanelle close?

A

2 months

35
Q

What is a bulging fontanelle an indication of?

A
  • Increased ICP

- As well as coughing, vomiting, cyring

36
Q

What is a sunken fontanelle an indication of?

A

Dehydration

37
Q

Microcephaly

A

Small head i.e. less than the 3rd percentile

38
Q

Hydrocephalus

A

Deficient CSF circulation causes an increase in ICP & enlargement of the calavarium

39
Q

What are normal variants seen on physical examination of the infant?

A
  • Overlapping sutures
  • Molding
  • Caput Succedaneum
  • Cephalohematoma
40
Q

Caput Succedaneum

A
  • Subcutaneous edema over the presenting part of the head during delivery
  • CROSSES the SUTURE line
  • TRANSLUMINATES
  • typically occopitalparietal
41
Q

Molding

A

Repositioning of the cranial bones to allow passage through the birth canal

42
Q

Cephalohematoma

A
  • Subperiosteal collection of blood
  • DOES NOT CROSS SUTURE
  • DOES NOT TRANSLUMINATE
  • Commonly in parietal region
  • Typically resolves within 10-14 days
43
Q

Crainosynostosis

A

Premature closure of the sutures

44
Q

Brachycephaly

A

Premature closure of the coronal suture

45
Q

Plagiocephaly

A
  • Asymmetry of the skull & face due to lying on one side
  • Treated most often with parental education
  • Typically self-resolves with age
46
Q

Microencephaly

A

small brain

47
Q

Signs & symptoms of increased ICP

A

Headache, vomiting, & papilledema

48
Q

How do you palpate the infants neck?

A

While the infant is supine and with one or two fingers

49
Q

Shotty

A

Term referring to lymph nodes in toddler & young children

50
Q

What are the five elements of hair inspection?

A

1) Color
2) Quantity
3) Distribution
4) Texture
5) Condition (nits, parasites, dandruff…etc.)

51
Q

What are the eight elements of a head exam?

A

1) Symmetry, shape, & size of head
2) Scalp symmetry & movement
3) Inspect scalp for: lesions, scaliness, lumps, infestation
4) Presence of involuntary head movement
5) Facial symmetry, shape & size
6) Movement of eyebrows, eyes, mouth
7) TMJ: alignment and presence of crepitus
8) Temporal arteries: Palpate & Auscultate

Clinical Medicine (27 decks)

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