Head and neck Flashcards Preview

Clinical Med > Head and neck > Flashcards

Flashcards in Head and neck Deck (157):
1

Which test involved a 512 Hz tuning fork to be placed on the apex of the patient's head?

Weber test

2

What finding is needed to diagnose conductive hearing loss in a Weber test?

Hearing preferentially in the bad ear

3

What finding is needed to diagnose a neurosensory hearing loss in a Weber test?

Hearing preferentially in the good ear

4

Which test is more accurate for conductive hearing loss, weber or rinne?

Rinne

5

What is angular cheilosis?

Erythematous inflammation of lips to extends beyond the mouth

6

What is Brachial cleft cyst?

A congenital lesion due to the incomplete involution of the brachial left

7

What is a bulging fontanel indicate?

rise in intracranial pressure

8

What is cheilits?

cracked lips

9

What is cholesteatoma?

mass of keratinizing squamous epithelim and cholesterol in the middle ear, usually caused by chronic otitis media

10

What is crainiosynostosis?

premature closure of an infant's skull

11

What is choasma?

common facial discoloration seen in pregnancy

12

What is Encephalocele?

Neural tube defect with protrusions of brain and membranes that cover the skull (bifida of the cranial part of the spinal cord)

13

What are epstein pearls?

small, multiple white, epithelial inclusion cysys found in the midline of the palate in newborn infants

14

What are fordyce spots?

Ectopic sebaceous glands of the buccal mucosa appearing as small yellow-white raised lesions found on the inner surface and vermilion border of the lips

15

What are Koplik's spots?

Small red spots with bluish-white centers on the buccal mucosa opposite the molar teeth, appearing in the prodromal stages of measals

16

What is leukoplakia?

circumscribed, firmly attached, thick white patches on the tongue. Often precancerous.

17

What is molding when referring to newborn children?

Shape of the head

18

What is otosclerosis?

deposits of bone resulting in immobilization of the stapes

19

What is presbycusis?

impairment of heading due to aging

20

What is a thyroglossal duct cyst?

A palpable cyst in the neck due to an incomplete closure of the thyroglossal duct

21

What is tophi?

small, whitish uric acid crystals along the peripheral margins of the auricles in persons who may have gout

22

What is torus mandibularis?

a bony protuberance on the linguinal aspect of the lower jaw in the canine-premolar region

23

What is torus palatinus?

a bony protuberance in the midline of the hard palate

24

What is tympanosclerosis?

The formation of dense connective tissue in the middle ear, often resulting in hearing loss

25

What is Xerostomia?

Dry mouth

26

What is webbing?

Excessive posterior cervical skin the is often associated with chromosomal abnormalities

27

What is the findings necessary for a Rinne test to indicate conductive hearing loss?

Bone conduction heard as long, or longer than air conduction

28

What would be a normal finding in a Rinne test?

If the patient can hear the sound through the air for twice as long or more

29

What would indicate a neurosensory loss in a Rinne test?

Air conduction will be heard longer than the bone (but obviously be diminished from normal)

30

What would indicate an abnormal Romberg test?

The inability to stand for 60 seconds with feet together and eyes closed.

31

True or false: If the Romberg test is abnormal, you should continue to testing to further evaluate the extent of the cerebellar dysfunction.

False

32

Which side do patients with vestibular lesions fall toward: toward or away from the lesion?

Toward the side with the lesion

33

Which side does numbering the teeth begin on?

Top right

(to top left, then from bottom left, to bottom right)

34

Which side will the trachea deviate in lung volume loss?

Toward the lung with volume loss (like a vacuum)

35

Which side will the trachea deviate in thyroid enlargement--toward or away from the affected side?

Away from the affected side

36

Which side will the trachea deviate in tension pneumothorax--toward or away from the affected side?

Away from the affected side

37

Which side will the trachea deviate in pleural effusion--toward or away from the affected side?

Away from the affected side

38

Which side will the trachea deviate in a collapsed lung--toward or away from the affected side?

Toward the affect side

39

What is a "tug" in reference to the trachea?

It is a palpable pull out of midline with inspiration

40

Which way is the ear pulled in an adult?

Up and back

41

Which way is the ear pulled in a child?

Down and back

42

What is the typical location of a migraine headache?

Unilateral (70%) or bifrontal/global

43

What is the typical location of a tension headache?

Bilateral/generalized to back of head

44

What is the typical location of a cluster headache?

Unilateral, usually behind/around the eye

45

What is the quality and severity of a migraine headache?

Throbbing/aching
variable severity

46

What is the quality and severity of a tension headache?

pressing/tightening.
Mild to moderate severity

47

What is the quality and severity of a cluster headache?

Deep, continuous, severe

48

What is the process involved in migraine headaches?

neuronal dysfunction

49

What is the process involved in tension headaches?

Unclear--possibly heightened CNS

50

What is the process involved in a cluster headache?

Unclear--possibly hypothalmic then trigemino-autonomic activation

51

What is the timing involved in a migraine headache (onset, duration, course)?

Onset = Rapid (peak = 1.5 hours)
Duration = 4-72 hours
Course = recurrent

52

What is the timing involved in a cluster headaches (onset, duration, course)?

Onset = abrupt
Duration = 3 hours
Course = episodic, (in clusters)

53

What is the timing involved in a tension headaches (onset, duration, course)?

Onset = gradual
Duration = 30 minutes to 7 days
Course = episodic (non-cluster)

54

What are the associated factors with migraine headaches?

n/v photophobia, phonophobia, AURA.

55

What are the associated factors with tension headaches?

NO nausea.
Sometimes photophobia/phonophobia

56

What are the associated factors with cluster headaches?

Autonomic symptoms (rhinorrhea, lacrimation)

57

What are provoking factors for migraine headaches?

EtOH/foods
stress
noise/bright lights

58

What are provoking factors for tension headaches?

Sustained muscle tension

59

What are provoking factors for cluster headaches?

EtOH? (unclear)

60

Nervousness is symptomatic of what (hypo or hyper-thyroidism)?

Hyperthyroidism

61

Fatigue/lethargy is symptomatic of what (hypo or hyper-thyroidism)?

Hypothyroidism

62

Weight loss with increased appetite is symptomatic of what (hypo or hyper-thyroidism)?

Hyperthyroidism

63

Palpitation are symptomatic of what (hypo or hyper-thyroidism)?

Hyperthyroidism

64

Modest weight gain with anorexia is symptomatic of what (hypo or hyper-thyroidism)?

Hypothyroidism

65

Dry, coarse sking is symptomatic of what (hypo or hyper-thyroidism)?

Hypothyroidism

66

Frequent BMs are symptomatic of what (hypo or hyper-thyroidism)?

Hyperthyroidism

67

Constipation is symptomatic of what (hypo or hyper-thyroidism)?

Hypothyroidism

68

Tremor/proximal muscle weakness is symptomatic of what (hypo or hyper-thyroidism)?

Hyperthyroidism

69

Cold intolerance is symptomatic of what (hypo or hyper-thyroidism)?

Hypothyroidism

70

Weakness, arthralgias is symptomatic of what (hypo or hyper-thyroidism)?

Hypothyroidism

71

Swelling of the hands/face/legs is symptomatic of what (hypo or hyper-thyroidism)?

Hypothyroidism

72

Loss of hair is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

73

Increased BP is a sign of what (hypo or hyper-thyroidism)?

Hyperthyroidism

74

Tachycardia/A-fib is a sign of what (hypo or hyper-thyroidism)?

Hyperthyroidism

75

Hyperdynamic cardiac pulsations/accentuated S1 is a sign of what (hypo or hyper-thyroidism)?

Hyperthyroidism

76

Periorbital puffiness is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

77

Decreased BP is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

78

Bradycardia is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

79

Dry, coarse, cool skin is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

80

Warm, moist skin is a sign of what (hypo or hyper-thyroidism)?

Hyperthyroidism

81

Impaired memory is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

82

Mixed hearing loss is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

83

Somnolence is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

84

Peripheral neuropathy is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

85

Carpal tunnel syndrome is a sign of what (hypo or hyper-thyroidism)?

Hypothyroidism

86

What are the questions that should be asked in head trauma (9 on handout)?

A&O?
MOI
Time of injury
LOC?
Subsequent level of alertness
Amenesia
HA
Vision changes
Bleeding from nose/ear/eyes

87

True or false: LOC is the best way to tell if a patient has had a concussion.

False - can occur without LOC

88

What are signs of a concussion?

Unsteadiness
Abnormal behavior
Impaired brain function

89

When does the anterior fontanel usually close?

18 months

90

When does the posterior fontanelle close?

2 months

91

What is a common cause of a sunken fontanelle?

Dehydration

92

What are common causes of a bulging fontanelle?

Vomiting, coughing, crying

93

What is the normal fontanelle size at birth?

4-6 cm

94

What is caput succedaneum?

Subcutaneous edema over the presenting part of he head at delivery (scalp edema)

95

How can you differentiate caput succedaneum from other etiologies?

Edema of the head usually crosses over suture lines

Transluminates

96

What is cephalhematoma?

Subperiosteal collection of blood

97

How can you differentiate cephalhematoma from other etiologies?

DOES NOT cross suture line
DOES NOT transluminate

98

What is plagiocephaly? How is it usually caused?

Asymmetry of the head
Baby laying in the same way for long periods

99

External/middle ear disorders are what type of hearing loss (conductive or sensorineural)?

Conductive

100

inner ear disorders are what type of hearing loss (conductive or sensorineural)?

Sensorineural (involve cochlear nerve)

101

How do you determine if the ears are low in a child?

Draw a line from the side of the eye to the ear

102

What is the accumulation in the ear of newborns that prevent their TMs from being seen?

Vernix caseosa

103

Why is pneumatic otoscopy used?

To determine if a child has otitis media, as their crying/coughing/vomiting may cause their TMs to become erythematous and inflamed.

It checks for fluid.

104

How do infants breathe? (out of nose, mouth, with ribcage, abdomen etc)?

Obligate nasal breathers

105

A nasal crease is the result of what activity?

Rubbing nose due to drainage

106

Allergic shiners are what?

Pooling of blood (seen as a dark spot) beneath the eyes due to congestion.

107

When do the maxillary sinuses develop?

About 1 year old

108

When do the ethmoid sinuses develop?

About 6 years of age

109

When do the sphenoid sinuses develop?

About 6 years of age.

110

When does the frontal sinus develop?

About 10 years of age

111

When are the sinuses fully developed?

About 21 years of age.

112

Are antenatal teeth removed?

Yes

113

How long to epstein pearls last?

2-3 months after birth

114

Kissing tonsils are what grade?

4+

115

When does the peak size of tonsils occur?

Between 2-6 years of age

116

True or false: 2+ tonsils are always a worrisome sign.

False--common size for young age. Worrisome if erythematous or exudate

117

When do teeth begin to erupt?

6-7 months

118

How many teeth are added every month after the first teeth erupt?

about 4 teeth every 4 months

119

Which, generally, are the first teeth to erupt?

The upper and lower incisors

120

When is the full complement of teeth erupted?

2-3 years

121

When does shedding of teeth generally occur?

5 years old

122

When do second teeth begin to erupt?

6-7 years

123

Where are stentson's ducts found?

Near the 2nd upper molar

124

Where are Wharton's ducts found?

Below the tongue

125

A deviation of the tongue to one side may be indicative of a lesion of what nerve?

CN XII

126

If the uvula does not rise with phonoation, this may be an issues in what nerve?

CN X

127

What opthalmic emergency is indicated with flashing lights in an eye?

Retinal detachment

128

Transient loss of vision may be a medical emergency if this is the cause (among others).

Emoboli occluding the opthalmic artery.

129

Exophtalmos is most commonly caused by what?

Thyroid disease

130

What is the numerator in the Snellen eye chart?

Distance from the chart

131

What is the denominator in the Snellen eye chart?

Distance the average eye can read the chart.

132

When is a swinging light test indicated?

When you suspect Marcus Gunn Pupil

133

What does the lateral penlight test look for? Why is it important?

Estimates the depth of the anterior chamber of the eye. NEED to do this before instilling mydriatic drops to the eye.

134

A bulging TM is indicative of what?

otitis media

135

A retracted/neutral TM with other signs of infection is indicative of what?

Otitis media with effusion

136

What are the indications of an otoscopic exam for children?

1. URI
2. Tugging of ears
3. Irritability
4. Difficulty sleeping
5. Fever
6. Otalgia
7. Otorrhea
8. Hearing loss

137

what position should uncooperative children be placed in when performing an otoscopic exam?

Supine or prone, held down by parents

138

What are the signs on the eyebrows of a patient with hypothyroidism?

Short and do not extend beyond temporal canthus

139

What are xanthalasma?

Fatty deposits around the eyes that may indicate hypercholestremia

140

Fasciculations/tremors of the eyelids can be seen in what disease?

Hyper thyroidism

141

What are epicanthal folds?

The vertical fold of skin nasally that covers the lacrimal caruncle

142

What is leukocoria?

A white reflex in the eye that may be caused by a congenital cataract or retinoblastoma

143

When is visual fixation present?

Birth

144

When is visual fixation well developed?

6-9 weeks

145

When is visual following developed?

3 months

146

When is visual accommodation developed?

4 months

147

When is steropsis developed?

4 months

148

True or false: poor visual fixation after 6 months of age is ALWAYS worrisome.

True

149

What should eye screening at 6-12 months include?

Red reflex, inspection, fix and follow

150

What should eye screening at 3-5 years consist of?

Red reflex
Inspection
Visual acuity
Cover-uncover test

151

What is the normal visual acuity for children 3+?

20/40 or better

152

What is strabismus?

Misalignment of the eyes

153

What is esotropia?

Inward misalignment of the eye

154

What causes psueudostrabismus?

An apparent misalignment of the eyes that is actually caused by epicanthal folds, and is not an actual misalignment

155

How can you differentiate between pseudostrabismus and true strabismus?

Look for the light reflection--should be in the pupils for both eyes.

156

What is amblyopia?

Loss of visual acuity due to active cortical suppression of vision of the eye

157

What is the cause of amblyopia?

Untreated strabismus (among others)