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Physical Diagnosis I Exam One COPY > Head and Neck > Flashcards

Head and Neck Flashcards

1
Q

Where can one place a finger to palpate the temporomandibular joint?

A

In front of triages or in the external auditory meatus

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2
Q

A patient should be able to open their jaw wide enough to insert how many fingers vertically into the mouth?

A

3

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3
Q

What is the primary source of TMJ disorder?

A

Malocclusions (bite problems)

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4
Q

The TMJ is a favorite site for what kind of joint disease?

A

Rheumatoid arthritis

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5
Q

What condition produces crepitus in the TMJ with movement?

A

Osteoarthritis

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6
Q

What condition is to be expected with tenderness of the TMJ?

A

Rheumatoid arthritis

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7
Q

What is a sign of a displaced TMJ cartilage?

A

Clicking when opening the mouth

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8
Q

What are usually the causes of unilateral swollen salivary glands?

A

Bacterial infection (like Parotitis)
Ductal calculus in Stenson’s or Wharton’s duct
Cyst or tumor

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9
Q

Which salivary duct opens by the second upper molar? By either side of the frenulum of the tongue?

A

Second upper molar - Stenson’s

Frenulum - Wharton’s

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10
Q

What are usually the causes of bilateral swollen salivary glands?

A

Viral infection (like mumps)
Drug reactions
Lymphomas

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11
Q

Every tissue in the body with blood vessels has lymphatic vessels except what two areas?

A

Placenta and brain

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12
Q

Fluid collected in the lymphatic system from the right and left sides of the head and neck eventually empty into what vessels?

A

Right and left subclavian veins

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13
Q

Both legs, abdomen, and left chest lymphatics all drain into which vein?

A

Left subclavian vein

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14
Q

Right chest lymphatics drain into which vein?

A

Right subclavian vein

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15
Q

What are the superficial lymph node sites?

A

Head and neck
Axillary
Inguinal

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16
Q

Superficial lymph nodes of the head and neck can be palpated anterior and posterior to which major muscle?

A

SCM

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17
Q

Where are the superficial lymph nodes of the head and neck palpated?

A

Under occiput and jaw
Anterior and posterior to ear and SCM
Supraclavicular
Pretrapezial

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18
Q

Where are the superficial lymph nodes of the axillary region palpated?

A

Pectoral
Subscapular
Humeral
Dome of armpit

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19
Q

Where are the superficial lymph nodes of the inguinal region palpated?

A

Above and below inguinal ligament

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20
Q

What kind of infection produces small, mobile, and tender lymph nodes?

A

Acute

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21
Q

What kind of infection produces multiple and less tender lymph nodes?

A

Chronic

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22
Q

Describe the lymph nodes seen with Hodgkin’s disease.

A

Large rubbery nodes

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23
Q

Describe the lymph nodes seen with metastatic cancer.

A

Stony hard, non-tender nodes

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24
Q

What is a likely suspicion if a patient presents with large lymph nodes but no signs nor symptoms of infection?

A

Cancer

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25
Q

If a large lymph node but no signs nor symptoms of infection are seen in a patient, what other signs and symptoms may be present that are indicative of cancer?

A

Cachexia, skin changes, unhealed sores, digestion issues, nagging cough, unusual bleeding, etc.

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26
Q

What is the name of the swollen lymph node that can be found in the left supraclavicular group that lacks a typical explanation?

A

Virchow’s node (signal node)

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27
Q

A Virchow’s node is indicative of what condition?

A

Thoracic or abdominal cancer

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28
Q

Why is a Virchow’s node indicative of thoracic or abdominal cancer?

A

Last and only location lymphadenopathy originating in majority of trunk can be detectable

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29
Q

True or false: lymphadenopathy in a primary care setting is most commonly due to serious illness.

A

FALSE

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30
Q

What things can cause tracheal deviation?

A 
Head tilt/cervical rotation
Unilateral goiter
Extremely large lymph node
Unilateral pneumothorax or pleural effusion
Unilateral atelectasis
Pulmonary fibrosis
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31
Q

What is tracheal deviation usually a sign of?

A

Significant lung pathology

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32
Q

What muscle runs obliquely across the lobes of the thyroid gland?

A

SCM

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33
Q

What is the major function of the thyroid gland (in general)?

A

Establish metabolic rate

34
Q

What structure in the neck rises and falls upon swallowing?

A

Thyroid gland

35
Q

Which would be immobile during swallowing: lymph node or goiter? Which would be mobile?

A

Immobile - lymph node

Mobile - goiter

36
Q

What condition is congenital hypothyroidism?

A

Cretinism

37
Q

What is the cause of cretinism?

A

Iodine deficiency

38
Q

Why is cretinism rare in the United States?

A

Iodized salt

39
Q

What are the physical signs of cretinism?

A

Dwarfism, mental deficiency, puffy face, dry skin, LARGE TONGUE, muscular incoordination

40
Q

What is the number one cause of hypothyroidism in the United States?

A

Hashimoto’s Disease

41
Q

What is the number one cause of hypothyroidism worldwide?

A

Cretinism

42
Q

What condition is a severe, advanced form of adult-onset hypothyroidism?

A

Myxedema

43
Q

What are the physical signs and symptoms of Hashimoto’s Disease?

A

Goiter, weight gain, mental and physical lethargy, cold intolerance, dry skin, constipation, arthritis

44
Q

How and why can a woman’s voice change with Hashimoto’s Disease?

A

Become huskier due to edema

45
Q

What are the physical signs and symptoms of hyperthyroidism?

A

Goiter, weight loss, nervousness, tremors, fatigue, heat intolerance, diarrhea, palpitations

46
Q

What is the most common form of hyperthyroidism?

A

Grave’s disease

47
Q

What extra sign is exhibited in Grave’s disease?

A

Exopthlamos

48
Q

What is the motor test for the trigeminal nerve?

A

Feel muscles of mastication when patient clenches teeth

49
Q

What is the sensory test for the trigeminal nerve?

A

Ask the patient to respond when they feel a light touch not the brow, cheek, and chin with their eyes closed

50
Q

If a sensory defect of cranial nerve 5 is detected, what test should be done?

A

Temperature check using tuning fork: fork will feel warmer on impaired side

51
Q

The corneal reflex tests which cranial nerve?

A

5 (trigeminal) and 7 (facial)

52
Q

What is the motor test for cranial nerve 7, the facial nerve?

A

Analyze bilateral symmetry when a patient raises eyebrows and shows teeth

53
Q

What is the sensory test for cranial nerve 7, the facial nerve?

A

Have patient identify salty and sugary tastes on anterior tongue

54
Q

What cranial nerve is responsible for identification of sour and bitter tastes on the posterior tongue?

A

9 (glossopharyngeal)

55
Q

Taste bud information on the epiglottis are transmitted by which cranial nerve?

A

10 (vagus)

56
Q

What is the motor test for cranial nerve 11, the spinal accessory nerve?

A

Patient rotates head against resistance (SCM) then shrugs shoulders against resistance (trapezius)

57
Q

Is trapezius weakness most often due to neck/shoulder pain or cranial nerve 11 lesions?

A

Neck/shoulder pain

58
Q

What injury precedes a whiplash headache?

A

Flexion-extension injury

59
Q

What are the first two symptoms of a whiplash injury?

A

1 stiff neck

2 new, atypical headache

60
Q

What movement makes a whiplash headache feel worse?

A

Flexion

61
Q

What are the diagnostic studies involved with a whiplash injury/headache?

A

Flexion-extension X-rays can show soft tissue damage

MR = definitive

62
Q

What type of headache may be the most common in a chiropractic office?

A

Whiplash

63
Q

What are symptoms of a concussion headache?

A

Amnesia, confusion

64
Q

What diagnostic study is used for a concussion headache?

A

Head CT

65
Q

What are risk factors for a dissecting vertebral artery headache?

A

Smoking, high BP, atherosclerosis

66
Q

What type of headache is expected when a patient describes it as the “worst headache ever”?

A

Dissecting vertebral artery

67
Q

What are the symptoms of a dissecting vertebral artery headache?

A

5 D’s and 3 N’s:
Dizziness, double vision, dysarthria, difficulty walking, dysphagia
Nausea, numbness, nystagmus

68
Q

What are the diagnostic studies involved with a dissecting vertebral artery headache?

A

Doppler ultrasound, MRA of head

69
Q

What is the location of pain for a dissecting vertebral artery headache?

A

Unilateral behind one ear and occipital area

70
Q

What gender is more likely to experience migraine headaches?

A

Females

71
Q

What kind of headache has a familial history rate of about 90%?

A

Migraine headaches

72
Q

What are triggers for migraine headaches?

A

Hormonal shifts, stress, lack of sleep, certain foods

73
Q

For what kind of headaches are neurologic and vascular exams essentially negative?

A

Migraine headaches

74
Q

When does a patient with migraine headaches typically experience their first episode?

A

Childhood or young adulthood

75
Q

What kind of headache is seen in adolescents or adults experiencing emotional or physical stress?

A

Tension

76
Q

What kind of headaches exhibit pressure and pain in the “hatband” area of the head and why?

A

Tension; due to contraction of neck, scalp, face, and jaw muscles

77
Q

What is the timeline for chronic tension headaches?

A

More than 15 days a month for at least three consecutive months

78
Q

What moment can aggravate sinusitis?

A

Bending over (increases pressure)

79
Q

What are risk factors for sinusitis?

A

Cigarette smoke, allergies, polyps, recurrent and chronic respiratory conditions

80
Q

What kind of discharge can be seen in sinusitis?

A

Blood stained, mucopurulent

81
Q

What are the salivary glands?

A

Parotid, submandibular, and sublingual glands

Physical Diagnosis I Exam One COPY (4 decks)

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