Extraoral Exam Flashcards by sophie rosen

gait

manners of walking

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Hemiplegia

paralysis one side

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Hemiplegia is usually from

stroke

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Paraplegia

paralysis both sides

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Hemiparesis

Weakness one side

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Paraparesis

Weakness on both sides

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Ataxic

presence of abnormal, uncoordinated movements.

Describes signs and symptoms without reference to specific diseases

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Parkinsonian

motor disturbances-resting tremors

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parkinsonian includes (4)

tremor
rigidity
postural instability
hypokinesia

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hypokineasia

partial or complete loss of muscle control

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ataxia gait

abnormal, uncoordinated movements

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unsteady, staggering gait

walking is uncoordinated and not ordered

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symptoms of ataxic gait (5)

lack of proper coordination 
unsteady gait with a potential to stumble and fall 
frequent falling episode 
lack of muscle coordination in the legs
ambulation difficulities

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parkinsons gait

taking small, shuffling steps

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parkinsons gait (3)

moving more slowly than expected for your age
taking jerky steps
freezing of gait

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freezing of gait

lose the ability of pick up their feet, which makes them “stuck” in place

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interacting with wheelchair riders (5)

avoid presumptions about a persons physical abilities
greet a wheelchair user the same as you would anyone
speak directly to the person who uses the wheelchair
learn the locations of accessible ramps, doors, and parking
offer to help when appropriate

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triggers of freezing of gait (3)

anxiety
crowds
feeling of being rushed

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wheelchair transfer, if possible…

leave in wheelchair if possible (headrest, back recline)

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If must transfer, then (5)

Position wheelchair as close as possible 
Lock all wheels in place
Fold footrests out of way
Ask pt. what works best
Use your legs!

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Ask pt. what works best (2)

Lift under armpits?

Hold onto belt in back?

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stature (2)

short

tall

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habitus

thin

obese

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marfans syndrome

genetic disorder affects the bodys connective tissue

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marfans syndrome effects about

1-5,000

marfans syndrome symptoms (6)

``` Tall Thin Arachnodactily Wingspan > height Chest concavity Heart murmur? (can have a weakened aorta) ```

scoliosis

side curvature

kyphosis

roundback

Head Lice (4)

``` The hair should be discreetly observed for nits white egg cases not dandruff! New strain is resistant to most meds Dismiss pt and vacuum chair Fresh headrest cover for every patient ```

Facial landmarks (6)

1. Outer canthus 2. Inner canthus 3. Ala 4. Philtrum 5. Tragus 6. Nasion

outer canthus and inner canthus

where upper and lower lids meet

ala

wing of nose

philtrum

narrow groove

tragus

pointed eminence of ear

nasion

bridge of the nose

HEENT

``` head eyes ears nose throat ```

head and facial form: symmetry

``` head eyes ears nose throat ```

prognathic profile

mandible protrudes in front of maxilla (class 3 bite)

retrognathic

mandible is set further back than maxilla | can look like an overbite

head and neck exam look for (4)

lumps in neck hoarseness scratchy throat that doesnt get better pain in neck, jaws or ears

head and neck exam includes (3)

nosebleeds congestion trouble swallowing

most important symtpom during a head and neck exam

trouble swalllowing | important, doesnt go away

skin lesions

``` hands, arms, neck, face, ears rash, mole, patch chronic, non healing lesion change in pre-existing lesion sun exposure ```

most common skin cancer/lesion

basal cell

where do you find basal cell

middle 2/3 of face

basal cell wont ---

heal

basal cell is usually ---

benign

cases of basal cell per year

3 million in the US

Squamous Cell Carcinoma (3)

irregular borders “crusty” surface persistent thick rough scaly patches that may bleed

squamous cell carcinoma is -- like

wart, raised borders

melanoma (3)

multiple colors irregular borders flat or slightly raised borders and somewhat asymmetrical in form

Nodular melanomas are

aggressive lesions that have only a vertical growth

melanoma is highly ---

infiltrative

causative factor of melanoma is usually

UV exposure

melanoma is more common with (2)

fairer skin | relatives with cancer

parts of the eyes (3)

pupil: black sclera: white iris: colored

ptosis

lid lag | drooping of the eyelid

ptosis is sometimes a sign of

past stroke

Ocular hypertelorism

excess spacing between eyes

Ocular hypertelorism concern

common in syndromes and congenital diseases/defects

how should pupils retract to light

equally

Exophthalmos

abnormal protrusion of the eye

Exophthalmos is a sign of

hyperthyroidism

hepatotoxicity

yellow sclera

most common eye infection

``` occular herpes type 1 (from lips to eye) ```

swollen lymph node vs normal lymph node

normal is compressible like a grape

lymph nodes act as --

filters

lymph nodes are part of the

lymphatic system (thymus, spleen, bone marrow)

most lymph nodes that swell are on the

head/neck

lymph node groups (4)

Cervical (head / neck) Axillary (underarm) Inguinal (groin) Internal (pelvic, abdominal, thoracic)

you cant palpate the --- lymph nodes

internal

Cervical Lymph Nodes (9)

``` 1 = submental 2 = submandibular 3 = parotid / jugulodigastric 4 = preauricular 5 = postauricular 6 = occipital 7 = ant. cervical chain 8 = supraclavicular 9 = post. cervical chain ```

Lymph node palpation sequence (6)

``` Ahead and behind ear Slide down to under angle of mandible Slide down to SCM Turn head opposite way Anterior & posterior borders Slide down to above collarbone ```

Healthy lymph nodes (2)

Soft like a grape (Vs. firm like a handball) | Moveable (Vs. fixed (attached))

Lymphadenopathy is any abnormality in (3)

size consistency number

Describe any abnormality fully: (5)

``` Location Size (<1cm.>) Tenderness Consistency Mobility ```

most common lymphadenopathy

cervical (head/neck)

``` Cervical lymph node enlargement rule out (3) ```

teeth tonsils respiratory

Cervical lymph node enlargement search for watch for

cancer | 2 weeks; if still present, refer to ENT

why 2 weeks?

virus can last up to 2 weeks

Clues to routine swelling from recent infection (6)

``` Tender Mobile Current or recent viral infection Bilateral Predictable locations Long duration without change ```

Mumps

infection of the parotid gland

symptoms of mumps (2)

swelling in the cheek + sore lymph nodes

Neck (thyroid) (2)

Larynx & trachea (windpipe) | “Adam’s apple”

Thyroid exam (5)

``` Gently place fingers on either side of Adam’s Apple Then slide to just below it Ask patient to swallow Feel gland rise up, then drop back Feel for any asymmetry or lumps ```

Lip landmarks (3)

Philtrum Vermillion border Commisures

Commisures (2)

angles | corners

Angular Chelitis (2)

corners of mouth | usually, candida

Extraoral Exam Flashcards

(88 cards)