Head And Neck - History Taking Flashcards

(36 cards)

1
Q

What symptoms should be asked in a head and neck history?

A

Sore throat
Dysphonia- hoarseness
Dysphagia
Mouth/throat ulcer
Neck lump

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2
Q

What id a lifestyle factor to consider in history?

A

Smoking
Alcohol

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3
Q

What is another important aspect to history in head and neck?

A

Family history (thyroid problem)

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4
Q

Where should you examine for head and neck?

A

Neck
Oral cavity
Pharynx
Larynx
Nose/ears/salivary glands

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5
Q

What nodes are in level 1 of the neck nodes?

A

Submental
Submandibular

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6
Q

What nodes are in level 2, 3 and 4 of the neck nodes?

A

Nodes in the anterior edge of SCM

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7
Q

What nodes are in level 5 of the neck nodes?

A

Posterior triangle
Feel for posterior nodes
Include supraclavicular fossa

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8
Q

What nodes are in level 6 of the neck nodes?

A

Pretracheal

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9
Q

How should salivary glands be palpated?

A

Bimanual palpation
Feel gland and associated duct

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10
Q

What should you ausculatate for in head and neck?

A

Thyroid bruit (grave’s thyroiditis)
Carotid bruit (carotid stenosis)

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11
Q

What can be used for throat examination?

A

Indirect laryngoscopy
Fibre optic nasolaryngoscopy
Rigid larygoscopy

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12
Q

What investigations should be done for head and neck?

A

Fine needle aspiration cytology
CT/MRI/PET scan
Us scan
Plain X-ray
Contrast swallow
Endoscopy

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13
Q

What should be considered when a patient present with a neck lump?

A

How long?
Site?
Fluctuates?
Sore?
H&N symptoms?
B symptoms
Travel?

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14
Q

What should be examined for in neck lumps?

A

Site
Size
Shape
Sore
Skin
Stuck
Soft

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15
Q

What would a reactive lymph node feel like?

A

Oval
Soft
Smooth
Mobile
Tender

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16
Q

What can be causes of salivary gland swelling?

A

Tumour eg benign pleomorphic adenoma
Inflammation- parotitis

17
Q

What should be asked in history of hoarseness?

A

How long?
Recent URTI?
Persistent or intermittent?
Pain?
Cough/ choking/ swallowing?
Asthma/ rhinosinusitis/ reflux?
Voice use?
Smoker?
Medication?

18
Q

What are benign causes of hoarseness?

A

Nodules
Cysts
Vocal abuse
Laryngitis
Infection
Smoking
Reflux

19
Q

What can be a non benign cause of hoarseness?

A

Laryngeal carcinoma

20
Q

What should be asked with dysphagia?

A

What is difficult?
Persistent/ intermittent?
Pain?
Where?

21
Q

What is a cause of dysphagia in the lumen?

22
Q

What is a cause of dysphagia in the wall?

A

Tumour
Stricture
Neuromuscular
Pouch

23
Q

What is a cause of dysphagia that is extra luminal?

A

Thyroid
Heart
Mediastinal mass

24
Q

What can be used to investigate the cause of dysphagia?

A

Barium swallow

25
What is FOSIT?
Feeling of something in throat Globus pharyngeus
26
Does FOSIT present with dysphagia?
No
27
Is FOSIT a red flag symptom?
No
28
What can FOSIT be caused by?
Acid reflux “silent” (laryngopharngeal reflux) Stress/ anxiety
29
Where are common sites of head and neck cancer?
Oral cavity Larynx Oropharynx Nasopharynx Hypopharynx
30
What does a malignant neck node feel like?
Round Firm Irregular Fixed Non-tender
31
What is the symptom of airway obstruction?
Difficulty breathing
32
What are the signs of airway obstruction?
Stridor -inspiratory = obst above vocal cord level) - expiratory = wheeze - biphasic = below vocal cords and above trachea
33
What are causes of airway obstruction?
Infection Tumour Foreign body
34
How should airway obstruction be treated?
ABC Humidifies O2 Steroids Adrenaline nebuliser Secure the airway (intubate; FONA - cricothyroidotomy, tacheostomy)
35
How does bacterial tonsilitis present?
Pus covering Neck nodes Fever No cough
36
When should tonsilectomy be offered?
6-7 attacks in 1 year Disrupts daily activities More than 1 quinsy