Face, Neck, & Lymphatics Flashcards
(88 cards)
1
Q
common or concerning symptoms of the head
A
headache, history of head injury
2
Q
common or concerning symptoms of the eyes
A
visual disturbances spots (scotomas) flashing lights use of corrective lenses pain redness excessive tearing double vision (diplopia)
3
Q
common or concerning symptoms of the ears
A
hearing loss ringing (tinnitus) vertigo pain discharge
4
Q
common or concerning symptoms of the nose
A
drainage (rhinorrhea)
5
Q
vertex
A
top of the head
6
Q
calvarium
A
whole head
7
Q
common or concerning symptoms of the oropharynx
A
sore throat
gum bleeding
hoarsness
8
Q
Stenson’s duct
A
secrete’s salivary fluid from parotid glands
9
Q
common or concerning symptoms of the oropharynx
A
swollen glands
goiter
10
Q
Warton’s duct
A
secrete’s salivary fluid from submandibular glands
11
Q
palpebral fissures
A
the elliptic space between the medial and lateral canthi of the two open lids
12
Q
nasolabial folds
A
fold from nares to the mouth- seen when one smiles.
Created by cranial nerve VII
13
Q
sinuses of the face
A
frontal
sphenoid
ethmoid
maxillary
14
Q
The ethmoid sinuses are filled with
A
air.
15
Q
Nasal Conchae
A
turbinates
16
Q
The nasolacrimal duct drains into…
A
the inferior meatus.
17
Q
facies
A
describes a characteristic feature of a syndrome that you can see in someone’s face.
Clinical syndromes or disorders with distinctive facial features have a specific “facies.”
18
Q
characteristic facies of Down’s Syndrome
A
Upslanting palpebral fissures Epicanthic folds Flat facial profile/flat nasal bridge Folded or dysplastic ears Low-set small ears Brachycephalic Brushfield spots Open mouth Protruding tongue Furrowed tongue Short neck Excessive skin at nape of the neck Narrow palate Abnormal teeth
19
Q
epicanthic fold
A
a skin fold of the upper eyelid, covering the inner corner (medial canthus) of the eye
20
Q
facies of Cushing’s Syndrome
A
"moon facies" round face facial flushing - plethoric facies increased fat deposits around the cheeks double chin
21
Q
prolonged corticosteroids can cause…
A
Cushing’s Syndrome
22
Q
facies of Fetal Alcohol Syndrome
A
small head low nasal bridge epicanthal folds small eye openings flat midface short nose smooth phithrum underdeveloped jaw thin upper lip and smooth philtrum
23
Q
signs and symptom’s of acromegaly
A
enlargement of hands, feet, and head frontal bossing palmar thickening coarse features Prognathism
24
Q
most common cause of acromegaly
A
pituitary adenoma
25
most common cause of gigantism
excess growth hormone before bone growth has stopped.
26
common causes of Parotid Enlargement
```
Sjogren's Syndrome
Mumps
Chronic disease - DM, obesity, liver cirrhosis
Neoplasm - Unilateral
Parotitis
```
27
How do you diagnose Sjogren's Syndrome?
look up.
28
What do Sjogren's Syndrome have a higher risk form?
Lymphoma
29
anatomy of the neck
```
hyoid bone
thyroid cartilage
cricoid cartilage
thyroid gland
larynx
trachea
clavicle
sternocleidomastoid muscle
```
30
portions of thyroid gland
thyroid lateral lobes
| isthmus
31
when one swallow's what does the thyroid do-
move's superiorly - looks assymetrical
32
thyromegaly
thyroid enlargement
33
most common cause of goiters in the world
iodine deficiency
34
common causes of goiters
Grave's Disease - hyperthyroidism
| Hoshimoto's Syndrome - hypothyroidism
35
diffuse thyromegaly
no bumpy lesions.
36
what is pathopneumonic for Grave's disease
exophthalmos
| goiter
37
multinodular thyroid
thyroiditis (viral or autoimmune)
38
what to look for in a goiter
look up
39
solitary nodule on thyroid - fixed, hard, non-tender
think malignancy
40
what if you find a solitary nodule in a child
immediate invasive biopsy
41
what if you find a solitary nodule in an adult
find out if it is hot or cold using radioactive iodine synctiography
If cold - do biopsy to determine histology
42
hot nodule of thyroid
actively produces thyroxine
43
cold nodule thyroid
does not produce thyroxine - more likely to be cancerous
44
Where is bone marrow produced?
flat bones
45
lymphadenopathy
swollen, palpable, irregular nodes
46
LAD; LAN
lymphadenopathy
47
LAD - solitary, hard, fixed, non-tender, growing
malignancy
48
LAD- solitary, erythematous, tender, fluctuant, growing
infection
49
LAD- diffuse, symmetric, nodular, static
systemic disease - HIV, malignancy
50
LAD -solitary, grouped, tender, moblie
regional or localized infection (sarcoid) or lymphoma
51
shotty lymph node
benign
characteristic of hyperplastic lymph from previous inflammatory process
52
the thoracic duct drains into
left subclavian
53
What organs contain lymphoid tissue?
Appendix
| Large intestine
54
lymph nodes of the face
```
anterior auricular
posterior auricular
occipital
posterior cervical
supraclavicular
deep cervical
submental
submaxillary
tonsillar
```
55
enlargement of the supraclavicular node - especially on the left suggests...
mets from thoracic or lung malignancy
56
epitrochlear nodes drain
the ulnar aspect of the hand
57
everything except the ulnar aspect of the arm and hand drain into
infraclavicular nodes
58
When are epitrochlear nodes best noted?
when arm is flexed at 90 degrees and palpated between the biceps and triceps
59
What does inflammation of the epitrochlear nodes indicate?
Sever Infection
| Rheumatoid Arthritis
60
inguinal adenopathy is seen with
STD
lymphogranuloma vinarium (LGV)
genital infections
61
NAVL of the femoral region
nerve
artery
vein
empty space (or lymph node if inflammed)
62
the popliteal nodes drain
the lower extremity below the knee
63
bruit
the term for the unusual sound that blood makes when it rushes past an obstruction (called turbulent flow) in an artery when the sound is auscultated with the bell portion of a stethoscope.
64
equipment for the head and neck exam
stethoscope
cup of water
transilluminator
65
inspection of the head includes:
```
hair distribution (quantity)
scalp - scaling, nevi
skull - size, contour
face - expression, contours
skin- color, pigmentation, hair distribution, lesions
```
66
palpation of the head includes:
hair texture
skull- lumps
face- sinuses
skin- texture, temperature
67
tinea capitis
also known as "Herpes tonsurans","Ringworm of the hair," "Ringworm of the scalp," "Scalp ringworm", and "Tinea tonsurans") is a superficial fungal infection (dermatophytosis) of the scalp. The disease is primarily caused by dermatophytes in the Trichophyton and Microsporum genera that invade the hair shaft. The clinical presentation is typically single or multiple patches of hair loss, sometimes with a 'black dot' pattern (often with broken-off hairs), that may be accompanied by inflammation, scaling, pustules, and itching. Uncommon in adults, tinea capitis is predominantly seen in pre-pubertal children, more often boys than girls.
68
warning signs for headache
```
more frequent/severe over 3 months
"thunderclap", "worst of my life"
new onset after 50
fever, sweats, wt loss
known Ca, HIV, or pregnancy
recent head trauma
focal deficits, vision changes, neck stiffness
```
69
What should be examined in the face?
```
symmetry
skin lesions
edema
color
expression
```
70
palpate in the face
temporal arteries
TMJ
parotid glands
71
palpate and percuss - face
frontal sinuses
| maxillary sinuses
72
temporal arteritis
```
giant cell arteritis
frequently occurs >50 yo
inflammatory condition of the arteries
autoimmune
bounding or tender temporal artery
TMJ pain
if untreated - leads to blindness
```
73
if there is increased pain in the sinuses when the bends forward it indicates
sinusitis
74
bacterial sinusitis
```
pain greater than 7 days
purulent nasal drainage
distinct facial pain (toothache)
tenderness to palpation
fever
```
75
transillumination of the sinuses
frontal sinus
maxillary sinus
bacterial sinusitis
76
anterior triangle margins of neck
sternocleidomastod
mandible
neck midline
77
posterior triangle margins of neck
trapezius
sternocleidomastoid
clavicle
78
main causes trachea displacement
pneumothorax
mediastinal mass
atelectasis
79
inspect the neck for
symmetry, masses, scars, enlargement of glands or lymph nodes
80
inspect the trachea for
position
| alignment
81
inspect the thyroid gland for
symmetry
82
palpate the neck
lymph nodes (size, shape, delimination - ex 1 cm x 2 cm, mobility, consistency tenderness)
83
lymph nodes of neck
```
preauricular
posterior auricular
occipital
tonsillar
submandibular
submental
superficial cervical
posterior cervical
deep cervical chain
supraclavicular
```
84
exam of range of motion of the neck (6)
flexion
extension
rotation (both sides)
bending (lateral flexion)
each passively and actively (against resistance)
85
Inspect the neck
use direct light and tangential light
look for tracheal deviation
look for masses
look for skin lesions
86
lymph nodes to remember
```
preauricular
posterior auricular
occipital
tonsillar
submandibular
submental
anterior cervical (superficial and deep)
posterior cervical
supraclavicular
```
87
palpation of the neck includes
C-Spine at rest and during ROM
Trachea
Muscles- paravertebral, trapezius, SCM
Palpation of the thyroid
88
palpation of the thyroid includes
flex neck slightly forward
place fingers of both hands with index fingers just below the cricoid cartilage
ask patient to swallow; feel for the thyroid isthmus rising up under your finger pads (not always palpable)
displace trachea to the right and palpate laterally for teh right lobe of the thyroid; repeat on left side
note the size, shape, and consistency
Identify any nodules or tenderness
If enlarged, listed over lateral lobes to detect a bruit
