Class 1 HEENT Flashcards
Bulging fontanel
a condition of the fontanel that may indicate increased intracranial pressure
Craniosynostosis
a condition that results from the premature closing of sutures before brain growth is complete; leads to a misshapen skull (flat spot)
Chloasma
facial discoloration common during pregnancy; also called the mask of pregnancy
Encephalocele
a neural tube defect characterized by the protrusion of nervous system tissue through a defect in the skull.
Facies
general appearance of the face, head, and neck that is characteristic of a specific condition
Graves disease
an autoimmune disorder that leads to an overproduction of thyroid- stimulating hormone; characterized by exophthalmia (bulging eyes).
Hashimoto disease
an autoimmune condition characterized by the production of anti- bodies against the thyroid gland, usually leading to hypothyroidism
Hyperthyroidism
overactivity of the thyroid
Hypothyroidism
underactivity of the thyroid; more common than hyperthyroidism
Macewen
sign associated with increased intracranial pressure after fontanels are closed. Percussion (tapping) on the skull at a particular spot (near the junction of the frontal, temporal and parietal bones) yields an unusually resonant sound in the presence of hydrocephalus or a brain abscess.
Mastoid fontanel
a third (abnormal) fontanel; common in Down syndrome
Microcephaly
a condition in which the circumference of the head is smaller than normal; associated with mental retardation
Molding
an abnormal shaping of the infant’s head caused by the shifting and over- lapping of bones during vaginal deliver
Myxedema
skin and tissue disorder usually caused by severe prolonged hypothyroid- ism; characterized by mucinous edema of face.
Ossification
bone tissue formation; begins in sutures after brain growth is completed
Salivary gland tumor
a growth or mass in any of the salivary glands, but most commonly occurring in the parotid gland.
Sternocleidomastoid
referring to the area extending from upper sternum to the mastoid process
Thyroglossal duct cyst
a palpable cystic mass in the neck; a embryologic remnant
Thyroid
largest endocrine gland.
Tic
a spasmodic contraction of the face, head, or neck.
Torticollis/wry neck
a condition in which the neck is twisted; often the result of birth trauma or intrauterine malposition; acquired torticollis may be caused by tumor, trauma, palsy of cranial nerve IV, muscle spasm, infection, or drug ingestion.
Transillumination
procedure used to evaluate suspected intracranial lesion or increasing head circumference in infants.
Bright light shined at a specific body part to see the structures beneath the skin.
Webbing
excessive posterior cervical skin
Anisocoria
unequal pupillary size
Cataracts
opacity/clouding of the lens; most commonly resulting from denaturation of the lens protein caused by aging.
Confrontation
test for estimating peripheral vision
Chorioretinal inflammation
an inflammatory process involving both the choroid and the retina; most commonly caused by laser therapy for diabetic retinopathy.
Cornea
part of the eye that is optically clear, has a rich sensory innervation, and is avascular
Corneal ulcer
a disruption of the corneal epithelium and stroma; associated with connective tissue disease.
Can occur from direct injury to the eye, or from a bacterial, fungal, or viral infection. inflammation resulting in pain
Diabetic retinopathy (background)
a condition characterized by dot hemorrhages or microaneurysms and the presence of hard and soft exudates.
Diabetic retinopathy (proliferative)
a condition characterized by development of new vessels as a result of anoxic stimulation; vessels grow out of the retina toward the vitreous humor (gelatinous tissue filling the eyeball behind the lens)
ECtropion
(lower?) eyelid turned away from the eye, outwards
ENtropion
eyelid turned inward, eyelashes rub against your eyeball
Episcleritis
inflammation of the superficial layers of the sclera anterior to the insertion of the rectus muscles.
inflammation of the episclera, which is the thin vascular outer coating of the eye wall, the sclera.
Exophthalmos
an increase in the volume in the orbital content, causing protrusion of the globes forward; most common cause is Graves disease
Glaucoma
a disease of the optic nerve wherein the nerve cells die, producing a characteristic appearance of the optic nerve (increased cupping). interocular pressure buildup damages optic nerve
Hemianopia
defective vision in half of the visual field
Hordeolum
a stye caused by staphylococcal organisms
Horner syndrome
interruption of sympathetic nerve supply to the eye, resulting in the triad of ipsilateral miosis (constricted pupil), mild pitosis (weak, droopy eyelid), and loss of hemifacial sweating; disrupted nerve pathway to 1 side from to face
Hypertelorism
eyes widely spaced apart
Lens
a biconvex, transparent structure located immediately behind the iris
Macula
also known as the fovea; near center of retina, needed to see clearly
Miosis
pupillary constriction
Mydriasis
pupillary dilation
Nystagmus
involuntary dysrhythmic movement of the eyes.
Papilledema
loss of definition of the optic disc/blind spot where optic nerve goes
intracranial mass, lesion, hemorrhage, meningitis -> increased pressure in/around brain (ICP) -> optic disc swelling
color pink
Presbyopia
loss of accommodation (ability to keep object in focus as its distance changes/abilitiy to focus between objects in different distances)
age-related farsightenedness (hard to focus on nearby objects)
Pterygium
an abnormal growth of conjunctiva that extends over the cornea from the limbus
Ptosis
drooping upper eyelid
Bells palsy, myasthenia gravis (chronic autoimmune neuromuscular disease that causes weakness in skeletal muscles), horner syndrome (symapethtic nerve supply) damage to CNIII, congenital, muscle weakness d/t aging, Cluster headaches
Red reflex
response caused by light illuminating the retina. red reflection of light on fundus/back of eye when using opthalmoscope
Retina
sensory network of the eye that transforms light impulses into electrical impulses, which are transmitted through the optic nerve.
light sensitive tissue that lines the inside of the eye. macular degeneration + diabetic retinopathy = diseasess of retina
Retinitis pigmentosa
an autosomal recessive disorder in which the genetic defects cause cell death predominantly in the rod photoreceptors
Retinoblastoma
an embryonic malignant tumor arising from the retina usually during the first 2 years of life.
Retinopathy of prematurity
disruption of the normal progression of retinal vascular development in a preterm infant.
Sclera
dense, avascular structure that appears anteriorly as the white of the eye
Strabismus
condition in which both eyes do not focus on the same object simultaneously, although either eye can focus independently; test corneal light reflex/cover-uncover test
Xanthelasma
condition characterized by elevated plaque of cholesterol; check for HLD
Acute otitis media
inflammation in the middle ear associated with a middle ear effusion that becomes infected by bacterial organisms.
Eardrum reddens, bulging = can rupture; conductive hearing loss
Whitish discoloration on membrane, marked erythema, air fluid level, bulging tympanic membrane
tylenol/motrin usually; multiple fever days/recurrent = abx
Acute pharyngitis
infection of tonsils or posterior pharynx by microorganisms
Red/beefy tonsil, smell = streptococcal
Bacterial = beefy red uvula, palatal petechiae, lymph node, Vascular redness in uvula and pillars
if no fever, no lymph enlargement, no excudate = not likely viral/bacteria
Guideline = rapid antigen testing or throat culture for dx and tx
Cerumen
earwax.
Cheilitis
dry, cracked lips
ANGULAR cheilits - radiates from corners of the mouth; give nystatin
Cholesteatoma
epithelial tissue behind the tympanic membrane that is often the result of untreated or chronic recurrent otitis MEDIA
ENT referral: cause hearing loss, surgical removal
Cleft lip and palate
common craniofacial congenital malformation; the result of the lip or palate failing to fuse during the embryonic development
Cochlea
coiled structure in inner ear
Conductive hearing loss
hearing loss resulting from reduced transmission of sound to the middle ear
Weber test - lateralize to impaired ear; Rinne test - BC>AC
hearing improves in noisy place; voice remains soft
Foreign body, tympanosclerosis, otosclerosis, bullous myringitis, otitis media, perforated ear drum
Epistaxis
nosebleed.
Fordyce spots
bumps that may appear on the buccal mucosa; ectopic sebaceous glands
Frenulum
small fold of tissue that attaches the tongue to the floor of the mouth; is under the tongue
Ménière disease
disorder of progressive hearing loss; in some cases, has a genetic mode of transmission.
Oropharynx
area of the throat that is located between the mouth and nasopharynx
Ossicles
the three tiny bones of the inner ear known as the malleus, incus, and stapes
Otitis externa
inflammation of the auditory canal and external surface of the tympanic membrane; also called “swimmer’s ear.”
exudate can block TM
P. aeruginosa, staph epidermidis -> abx ear drops, steroid if covered
Otitis media with effusion
inflammation of the middle ear resulting in the collection of serous, mucoid, or purulent fluid
Otosclerosis
ossification that results in fixation of the stapes (part of MIDDLE ear ossicles)
Peritonsilar abcess
deep infection in the space between the soft palate and tonsil
Asymmetric enlargement of tonsil = displacement of uvula
Sore throat, gargled speech all of a sudden/drooling/hard of speech/sitting forward
surgical emergency; SOB
prbly can’t even examine b/c so sick, won’t open
bacterial infection that usually begins as a complication of untreated strep throat or tonsillitis
Pinna
projecting shell-like structure on the side of the head; auricle. Visible part of ear on outside
Presbycusis
bilateral sensorineural hearing loss associated with aging.
Retropharyngeal abscess
life-threatening infection in the lateral pharyngeal space that has the potential to occlude the airway, most commonly occurs in children
Rinne test
hearing test that compares bone conduction with air conduction of sound
Romberg test
neurologic test used to screen for equilibrium/cerebellum. Ataxia/loss of motor coordination. Feet together, semi-tandem, tandem vertical w/ eyes open 10sec and then closed 10sec in each position
Sensorineural hearing loss
hearing impairment that results from a disorder of the ear, aging, damage to cranial nerve VIII/ acoustic neuroma, genetic disorders, systemic disease, inner ear infection, or prolonged exposure to loud noise
Sinusitis
bacterial infection of one or more of the paranasal sinuses
Torus
bony protuberance on the midline of the hard palate
Uvula
conical projection that hangs from the posterior margin of the soft palate
Vertigo
illusion of rotational movement experienced by a patient; often due to a disorder of the inner ear.
Weber test
screening test for hearing that tests the lateralization of sound
Xerostomia
dry mouth
Conjunctiva
clear, thin membrane that covers part of the front surface of the eye and the inner surface of the eyelids
Cushing’s Disease
adrenal gland; high cortisol
red cheeks, hirsutism (male patterned hair growth), obesity, osteoporosis, muscle wasting, moon face
Bell’s Palsy
Palsy of CN VII
associated w/ herpes virus, acute/fast onset (in 3 wks), asymmetric facial drooping. tx w/ steroids, maybe PT d/t deficit
Mastoiditis
infection (w/ pus) of the mastoid air cells, Complication of acute otitis media, auricular tenderness/erythema/displaced auricle, refer to ED or ENT
Parotitis
Painful, inflammation of parotid salivary glands
Usually bacterial S. aureus, or virus as in mumps, or stone
Examples of sudden loss of vision (emergency)
- Amaurosis fugax (painless temporary loss of vision in one or both eyes due to a lack of blood flow to the retina)
- Retinal detachment
- Vitreous hemorrhage
- Central retinal artery occlusion
- Uveitis (inflammation of the middle layer of the eye (uvea)
Cornea(l) Arcus
old age syndrome, white/grey/blue opaque ring in corneal margin OR white ring in peripheral of iris
Argyll robertson pupil
bilateral small/irregular pupils that reduce in size on near object (accommodation), but not constrict when exposed to bright light. NO direct constriction but consensual constriction.
Stye vs Chalazion vs Dacryocystitis vs Blepharitis
Stye = eyelid MARGIN, painful, pus + white on actual bump
Chalazion = not painful; HARD NODULE, benign lipoma
usually hard lump, but can be infected
in the tear gland of eyelid; inside lid, NOT eyelid margin
Dacryocystitis = tear duct infection d/t fluid back up; under the medial canthus (inner corner) near the side of the nose; red/swelling around entire eye seen
Blepharitis = CHRONIC inflammation of eyelid, eyelash follicles; INFECTION of EYELASH DUCT
Peripheral vertigo table (5 types)
1) Benign positional Vertigo
2) Vestibular neuronitis (labyrinthritis)
3) Meniere’s disease
4) Drug Toxicity
5) Acoustic Neuroma (CN VIII compression), 1 sided hearing impaired, sensorineural loss, benign tumor develops on balance (vestibular) + hearing, OR auditory (cochlear) nerve leading from inner ear to brain
Causes of periorbital edema
Edema around the eyes
allergies, myxedema/hypothyroid, nephrotic syndrome, localized rxn (like makeup)
Acute Iritis
immediate referral, emergency
Pupil small/irregular (weird border), cornea cloudy or clear, pain, decreased vision, photophobia, r/t systemic infection (herpes zoster, TB)
Tonic pupil/ Adie pupil
pupil large/regular/usually unilateral reaction to light very reduced or none blurred vision d/t slow accommodation near reaction slow but present deep tendon reflexes decreased idiopathic, can be d/t tumor/trauma/sx/infection
Arteriovenous crossing or nicking
When (small artery) arteriole crosses venule (small vein) = compresses vein = vein bulges on either side of crossing
Abnormal; Causes are Retinopathy or pressure (Diabetic, HTN)
Sensorineural hearing loss
impairment of CN VIII (vestibulocochlear) or neuronal impulse
higher tones lost, voice become louder
Weber test - lateralize to good ear; Rinne test - AC>BC
aging, exposure to loud noise, inner ear infection, trauma, acoustic neuroma
Exostosis
benign, nontender bone outgrowth/bumps in ear canal, seen in swimmers, can lose hearing if too big
Serous otitis
Most common cause of ear pain (otalgia)
pressure change -> earache
most common cause = Viral upper resp infection (Decongestion like Flonase helps)
Flying
Bullous myringitis
Painful vesicles on TM
Caused by mycoplasma, viral, or bacterial otitis media
Tx macrolide (abx like azithromycin)
Tympanosclerosis
healed perforations
Hyaline material deposits after several OM -> Large, chalky white patches w/ irregular margins
cause conductive hearing loss
Viral rhinitis vs allergic rhinitis
Viral - reddened and swollen mucosa; can be bacterial on top of viral if not get better
Allergic - pale/boggy/swollen turbinates; can be pale/bluish/red; find polyps/allergic shiners (nose line)/ allergic salute (underbags); seasonal itchy/sneeze
Nasal polps
Chronic inflammation/irritation, usually chronic allergic rhinitis
Pale, semi-translucent masses, usually from middle meatus
Septal perforation
Hole in nasal septum connecting both sides
causes: trauma, sx, intranasal use of cocaine or amphetamines
Geographic tongue
benign, scattered areas (patchy) w/ no papillae
Smooth tongue
smooth/shiny looking
chronic anemia, vitB deficiency
deficient in riboflavin, niacin, folic acid, vitB12, pyridoxine iron, tx w/ chemo
Black tongue
fungus, yeast build up
Grading tonsil sizes
1+ = visible
2+ = halfway between pillars and uvula; risk for sleep apnea
3+ = touching uvula
4+ = touching each other usually can’t even see uvula
Normal: 1+ - 2+ Not visible: retracted or removed
Karposi sarcoma
Cancer that causes patches of abnormal tissue to grow under skin, lymph nodes, mouth/nose/throat
Often w/ Deep purple color lesions; raised or flat
Commonly tumor in ppl w/ AIDS/HIV
Herpangina (coxsackie)
viral illness, ulcers and lesions (sores) form inside the mouth, and there is sore throat and fever.
same as hand/foot/mouth disease
Fever, headache, Loss of appetite, Sore throat, or painful swallowing,
