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PE midterm > Head and neck > Flashcards

Head and neck Flashcards

(95 cards)

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1
Q

If a patient sees flashing lights, what is it a sign of?

A

detached retina

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2
Q

What is the vertex of the head?

A

the top of the head

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3
Q

What is wharton’s duct?

A

secretes saliva from submandibular gland

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4
Q

What does the parotid gland secrete saliva via?

A

Stensen’s duct located behind molars

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5
Q

What is the most commonly fractured bone in orbital floor fracture?

A

Zygomatic arch

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6
Q

Where is ear pain often referred to?

A

TMJ

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7
Q

Mental protuberance

A

chin

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8
Q

Frontal eminence

A

forehead

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9
Q

laryngeal prominence

A

Adam’s apple

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10
Q

Palpebral fissures

A

the slit between your eyelids

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11
Q

Describe the palpebral fissures of a person with Trisomy 13, 18 or 21

A

up-slanted

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12
Q

Describe the palpebral fissures of a person with FAS

A

horizontal

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13
Q

Epicanthal folds

A

skin folds near the nasolacrimal gland - thicker in people with down’s syndrome

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14
Q

Nasolabial folds

A

lines made from the nares to the lateral aspect of the mouth when smiling

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15
Q

When will nasolabial folds not occur?

A

in a person who suffered a CVA - due to damage to CN VII on the contralateral side of the affected area

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16
Q

What sinuses are associated with the face

A

frontal, sphenoid, ethmoid (bubbles), maxillary

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17
Q

What does the NLS drain into?

A

inferior meatus

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18
Q

What are facies

A

Characteristic of a certain syndrome or disorder with distinct facial features

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19
Q

What are characteristics of people with down’s syndrome?

A

Prominent epicanthal folds, low-set ears, macroglossia, flat nasal bridge, brush-field spots on iris

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20
Q

What are characteristics of people with Cushing’s syndrome?

A

Moon facies: fat cheeks, brittle bones, cataracts, plethoric face, double chin, thin skin, allopecia

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21
Q

What are characteristics of people with FAS?

A

low nasal bridge, short nose, diminished epicanthal folds, small head, flat face, thin upper lip and smooth philtrum, underdeveloped jaw

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22
Q

When does FAS generally occur?

A

first trimester (12 wks)

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23
Q

What causes acromegaly?

A

excess GH from a pituitary adenoma after fusion of the epiphyseal growth plates

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24
Q

What causes gigantism?

A

excess GH from a pituitary adenoma before fusion of the epiphyseal growth plates

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25
What are characteristics of people with acromegaly?
large hands, feet, head, frontal bossing, palmar thickening, coarse features, prognathism
26
What can cause parotid enlargement?
Sjogren's syndrome, Mumps, Neoplasm (if unilateral), chronic disease (DM, obesity, liver cirrhosis)
27
What should be considered with any unilateral mass?
neoplasm
28
Describe Sjogren's syndrome
Occurs in pts with HLA phenotype, autoimmune disease that attacks mucus producing cells, associated with dry eyes and mouth, arthritis. Dx with SSA and SSB antibodies with a negative rheumatoid factor, Tx with steroids, higher probability of getting lymphoma
29
What can cause parotitis? S/S?
S. aureus, tender, warm, red parotid glands - palpate with mouth open and if pus comes out of Stensen's gland then it indicates a suppuratous infection
30
How can you treat parotitis?
Sialogogues (increase saliva), heat, massage from posterior to anterior, hydration
31
What is the hyoid bone important for? Why is it unique?
Swallowing, tongue movements, not articulated
32
If a patient cannot have oropharyngeal intubation what is an option?
Make an opening in the cricoid cartilage
33
What is the middle of the thyroid gland called? Where is it located?
isthmus - lacated between the SCM
34
What happens to the thyroid when you swallow?
it moves superiorly and loos asymmetric
35
What is the most common cause of thyromegaly?
Iodine deficiency - hypo/hyperthyroidism and increased TSH (Hashimoto's and Grave's diseases)
36
True or false: diffuse thyromegaly is benign.
TRUE
37
What normally causes diffuse thyromegaly?
autoimmune disease
38
What are characteristics of Grave's disease?
exopthalmus - autoimmune response that causes hyperthyroidism also attacks the tissue around the eyes
39
What disease other than grave's disease shows exopthalmos?
orbital tumor - unilateral exopthalmos
40
True or false: multinodular goiters are benign.
TRUE
41
What can cause thyroiditis?
viral/autoimmune
42
What type of thyroid abnormality is indicative of malignancy?
solitary nodule that is firm, not tender, fixed
43
What age group has a higher likelihood of thyroid malignancy?
children
44
How can you diagnose thyroid malignancy?
Radial iodine scintography will tell you if it is hot or cold (cold = malignant and not active) plus FNA for histology
45
What characteristics are important to describe for thyroid nodules?
location, consistency, size, pain, erythema, symmetry
46
What are the borders of the anterior neck triangle?
SCM, midline of neck, jaw
47
What are the borders of the posterior neck triangle?
SCM, clavicle, trapezius
48
What does the jugular vein traverse?
SCM
49
Where is bone marrow made?
flat bones: sternum, pelvis
50
Where can lymph tissue be found?
liver, spleen, gut (Peyer's patches)
51
Where does the right lymphatic duct drain into?
SVC
52
Where does the left lymphatic duct drain into?
subclavian vein via thoracic duct
53
LAD that is solitary, fixed, non-tender, growing
malignant
54
LAD that is solitary, erythematous, tender, fluctuant, growing
infection (suppurative)
55
LAD that is diffuse, symmetric, nodular, static
systemic disease - HIV or malignancy
56
LAD that is solitary or grouped, tender and mobile
regional (local) infection/inflammation (sarcoidosis) or lymphoma
57
Sarcoidosis
inflammation occurs in the lymph nodes, lungs, liver, skin, eyes, or other tissue
58
What are shotty lymph nodes?
hyperplastic lymph from previous inflammatory process - should be mobile and non-tender
59
What is the difference in age groups of effected patients with hodgkin's vs. non-hodgkin's lymphoma?
Hodgkin's: bimodal, Non-hodgkin's: older and immunocompromised
60
Where should LAN absolutely NOT be?
Supraclavicular lymph nodes - indicates mediastinal malignancy and lung or gastric CA
61
What node can be palpated with metastatic gastric CA?
Irish's node - left anterior axillary lymph node, virchow's node, trosier's node
62
What axillary lymph nodes can be palpated?
lateral axillary, central axillary, subscapular, pectoral
63
What lymph nodes might be inflammed with Rheumatoid arthritis?
Epitrochlear
64
What is the function of the epitrochlear lymph nodes?
drain ulnar aspect of the hand
65
How should the epitrochlear lymph nodes be palpated?
arm at 90\*, superior to medial epicondyle of humerus
66
What can cause inguinal LAN?
HSV, LGV (lymphogranuloma venereum)
67
What is the function of the popliteal lymph nodes?
drain lower 1/2 of the leg
68
What do bruits in thyroid gland indicate?
hypermetabolic activity or infection
69
What does scaling of the scalp indicate?
seborrheic dermatitis, tx with selenium sulfate (H&S)
70
Why is it impportant to check the scalp of children?
They easily get tinea capitis: allopecia with excalamtion point hairs over lesion
71
What can tinea capitis turn into if it is not treated?
Kereon: fungal mass - treat with systemic drugs
72
What are warning signs of a headache?
more frequent/severe over 3 months, new onset after 50, fever, sweats, weight loss, HIV, known CA, pregnancy, neck stiffness (others are obvious)
73
Why is HA bad in pregnancy?
indicates preeclampsia
74
What could cause edema of the face?
diabetes, HTN, allergic reaction, cellulitis
75
Why is palpation of the temporal artery so important?
it branches to the opthalmic artery and could cause blindness if occluded
76
How is the TMJ palpated and how do you treat TMJ syndrome?
palpate with the ulnar aspect of the hands, treat with NSAIDs
77
What is giant cell arteritis?
temporal arteritis: occurs in people over 50 with TMJ pain, bounding, tender temporal artery, autoimmune disease, increased ESR, untreated can lead to blindness, tx with corticosteroids
78
How would a pt with PCOS present onf PE?
hirsutism due to increased T
79
Where is the most common place to find basal cell carcinoma?
on the nose/face
80
What type of facies do people with Parkinson's have?
flat facies
81
How is bacterial sinusitis diagnosed?
sxs \> 7 days, purulent nasal drainage, facial pain/toothache, fever, tenderness to palpation
82
What could cause tracheal deviation?
pneumothorax
83
What is the curve of the C-spine?
lordosed
84
What portion of the SCM are the superficial cervical lymph nodes and the posterior clavicular lymph nodes located?
superficial: sternal portion of SCM, posterior: clavicular portion of SCM
85
If the thyroid is enlarged on PE what hsould you do?
listen for bruits
86
T10 dermatome
umbilicus
87
What nerves are responsible for the patellar reflex?
L4, L5
88
What nerve is responsible for the achilles reflex?
S1
89
S1 dermatome
lateral foot
90
L4 dermatome
big toe
91
S5 dermatome
anus
92
S2, S3 dermatomes
genitals
93
C6 dermatome
thumb
94
C7 dermatome
index/middle finger
95
C8 dermatome
ring/little fingers

PE midterm (10 decks)

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