Head, Face, Neck, & Lymphatics

Question 1

Where does Wharton’s duct enter?

Answer 1

Part of the submandibular gland, ducts to floor of mouth

Question 2

What is the calvarium?

Answer 2

The scalp

Question 3

What are palpebral fissures

Answer 3

Space between folds of eye

Question 4

Down slanted palpebral fissures seen in

Answer 4

down syndrome- trisomy 21

Question 5

shorter horizontal palpebral fissures seen in

Answer 5

fetal alcohol syndrome

Question 6

What is the “smile line”, nares to lateral aspects of mouth

Answer 6

Nasolabial folds

Question 7

Facial droop is diagnostic of stroke to CN_____ on _____ side

Answer 7

CN 7 is compromised on contralateral side

Question 8

What sinuses are inferior to the orbits?

Answer 8

Maxillary

Question 9

What sinuses are superior to the eyebrow?

Answer 9

Frontal

Question 10

What are the characteristics in facies of Down’s Syndrome patients?

Answer 10

Down slanted palpebral fissures
Flattened nasal bridge
Prominent epicanthal folds
Low set ears
Large tongue
Brushfield spots on the iris

Question 11

What are the characteristics in facies of Cushing’s Syndrome?

Answer 11

“Moon Facies”
Round face, double chin, increased cheek fat deposits, facial flushing
-leading to cataracts, thin skin, loss of hair, trunk obesity

Question 12

What are the characteristics in facies of Fetal Alcohol Syndrome (FAS)?

Answer 12

Microcephaly

Thin upper lip and smooth philtrum

Question 13

What are the characteristics in facies of Acromegaly?

Answer 13

Frontal bossing- prominent forehead
Coarse Features
Prognathism- protruding jaw
\+Enlagrement of hands, feet, and head
\+Palmar thickening

*consider Paget’s Bone disease as well

Question 14

What ddx would you consider in parotid enlargement?

Answer 14

Sjogren’s Syndrome (dry eyes, dry mouth, arthritis)
Mumps
Chronic Disease (DM, obesity, liver cirrhosis)
Neoplasm- esp if unilateral

Question 15

A patient has left unilateral erythematous parotid enlargement. Upon palpation it is tender and fluctuates. Pus enters mouth on palpation. What is you diagnoses?

Answer 15

Bacterial suppurative infection
-Most often Staph aureus
tx IV abx, sx if no resolution
-Most common viral is Mumps

Question 16

What bone is not attached and aides in swallowing and tongue movement?

Answer 16

Hyoid bone

Question 17

What is the most common cause world wide for thyromegaly?

Answer 17

Iodine deficiency

Question 18

Is thyromegaly seen in hyper or hypothyroidism?

Answer 18

Can see it in both states

Question 19

What type of thyroid appearance is more likely a malignancy?

Answer 19

Thyroid nodule

Question 20

What structures make up the anterior triangle of the neck?

Answer 20

SCM, mandible, neck midline

Question 21

What structures make up the posterior triangle of the neck?

Answer 21

trapezius, SCM, clavicle

Question 22

What vessel traverses the SCM muscle?

Answer 22

Jugular

Question 23

Where does the thoracic duct drain?

Answer 23

Left subclavian

Question 24

Where does the right lymphatic duct drain?

Answer 24

SVC

Question 25

What and to where does Stensen's duct drain

Answer 25

Parotid duct to inner bucal mucosa near the second molar

Question 26

What is LAD or LAN

Answer 26

Lymphadenopathy, swollen palpable irregular nodes

Question 27

What is tinea capitis

Answer 27

Fungal infection of the scalp, common in kids, causes alopecia and exclamation point hairs, if untreated can become kerion

Question 28

Blunt flat facial affect/expression of face is noted in

Answer 28

Parkinson's

Question 29

EBM guidelines for bacterial sinusitis

Answer 29

- Pts have had symptoms >7 days - Purulent nasal drainage - Distinct facial pain (toothache, maxillary pain) - Tenderness to palpation of sinus - Fever

Question 30

What could cause tracheal deviation?

Answer 30

pneumothorax, mediastinal mass, atelectasis

Question 31

What kind of curve does the cervical spine have?

Answer 31

Lordotic

Question 32

The most prominent vertebrae in the C-spine is the

Answer 32

C7

Question 33

Where does the trapezius insert into?

Answer 33

Lateral clavicle Acromion process Scapular spine

Question 34

True of False: The thyroid isthmus may not be palpable

Answer 34

True

Question 35

True of False: A bruit auscultates over the lateral lobe is expected

Answer 35

False