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NP Health Assessment > EENT > Flashcards

EENT Flashcards

1
Q

Define exophthalmos. Who typically experiences this disorder?

A

increased axial projection (eye protrusion)

Common finding in. thyroid eye disease and found in about 60% of patients

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2
Q

Define ptosis and causes

A

Drooping of the upper eyelid.

Causes: senescence (deterioration with age), myasthenia gravis, or damage to the oculomotor nerve (CNIII)

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3
Q

What condition is this?

More common in elderly population

Inward turning of the lid margin. The lower lashes irritate the conjunctiva and lower cornea. Lower lashes may be invisible when turned inward

A

Entropion

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4
Q

What condition is this?

Lower lid margin turns outward, exposing the palpebral conjunctiva. When this occurs the eye no longer drains well

More common in older adults

A

Ectropion

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5
Q

What condition is related to elevated intracranial pressure that causes intra-axonal edema along the optic nerve, leading to engorgement and swelling of the optic disc?

A

papilledema

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6
Q

what sinuses are typically affected when patients present with sinus pressure or sinus infection?

A

Maxillary sinus (near the cheeks) and ethmoid sinus (near the bridge of the nose)

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7
Q

at what age does the frontal sinus develop. Describe their location

A

7 years old; near the forehead

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8
Q

What are causes of rhinorrhea

A

Viral infections. allergic rhinitis (hay fever), and vasomotor rhinitis (itching favors allergic cause)

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9
Q

What term defines unequal pupils

A

aniscoria

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10
Q

movement of the auricle and tragus is painful in _____ but not painful in _____.

A

acute otitis externa (inflammation of the ear canal)

not painful in otitis media (inflammation of the middle ear)

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11
Q

What are causes of sensorineural hearing loss

A

loud noise exposure, inner ear infections, trauma, acoustic neuroma, congenital and familial disorders, and aging

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12
Q

What are the effects of sensorineural hearing loss

A

Higher registers are lost, so sound may be distorted

Hearing worsens in noisy environment

Voice may be loud because hearing is difficult (due to cochlear nerve and neuronal impulse transmission to the brain is affected)

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13
Q

What are the causes of conductive hearing loss

A

foreign body, otitis media, perforated eardrum, and otosclerosis of ossicles

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14
Q

What are the effects of conductive hearing loss

A

little effect on sound

Hearing seems to improve in noisy environment

Voice remains soft because inner ear and cochlear nerve are intact

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15
Q

Acute otitis media with purulent effusion is commonly caused by what bacteria

A

S. pneumoniae or H. influenzae

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16
Q

xerostomia

A

dry mouth

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17
Q

white, cottage cheese‐like lesions that can be easily removed with swab is called what?

What is it treated with

A

Thrush (candida - fungal); treated with anti-fungal

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18
Q

recurrent single or multiple shallow, painful ulcers, that are scattered or grouped are called what?

What is treatment?

A

Aphthous ulcers

Symptomatic treatment with “Magic Mouthwash”

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19
Q

Multiple ulcers on tonsils, soft palate, uvula (May also
have lesions on hands and soles of feet).

What population does this primarily affect?

A

Herpangina (Coxsackie virus)

Seen more in kids

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20
Q

painless punched out ulceration on lip, tonsil or palate is called what?

What is treatment?

A

Syphillis chancre

Treated with PCN.

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21
Q

painful, similar in appearance to aphthous ulcers, but only on mucosa attached to bony
structures is descriptive of what condition?

What is treatment?

A

Herpes

Treated with anti‐virals.

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22
Q

halitosis

A

malodorous breath

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23
Q

what structures are part of the oropharynx

A

uvula, soft palate, palatine tonsils, and posterior wall of the oropharynx

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24
Q

A hump in the middle of the nose is called what?

A

dorsum convexity

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25
Q

Saddling of the middle of the nose is called what?

A

dorsum concavity

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26
Q

asymmetric protrusion of the tongue suggests a lesion of what cranial nerve? What way would the tongue turn if there is a lesion?

A

CN XII

tongue points toward the side of the lesion

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27
Q

what are common causes of otitis media?

A
  • edema and congestion in Eustachian tube
  • refulux of bacteria from the nasopharynx
  • accumulation of secretions in middle ear increase pathogen growth
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28
Q

Name the structures of the middle ear

A

malleus, incus, stapes, tympanic membrane (eardrum), tympanic cavity, semicircular canals

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29
Q

Name the structures of the inner ear

A

cochlea, vestibular nerve, cochlear nerve, estachian tube

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30
Q

Name the structures of the outer ear

A

auricular lobule (earlobe)
Concha
antihelix
tringular fossa
scapha
helix
temporal muscle
temporal bone
external acoustic meatus (ear canal)

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31
Q

Extraocular muscles:

What movement does the superior rectus muscle control?

What cranial nerve moves it

A

Moves the eye upward (elevation)

CN III

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32
Q

Extraocular muscle:

What movement does the inferior rectus control

What cranial nerve moves it

A

Moves the eye downward (depression)

CN III

33
Q

Extraocular muscle:

What movement does the Medial rectus control

What cranial nerve is associated

A

Moves the eye inward toward the nose (adduction)

CN III

34
Q

Extraocular muscle:

What movement does the lateral rectus muscles control

What cranial nerve is associated

A

Moves the eye outward away from the nose (abduction)

CN VI

35
Q

Extraocular muscles:

What movement does the superior oblique control

What CN is associated

A

Rotates the top of the eye toward the nose around the long axis (torsion) and downward

CN VI

36
Q

Extraocular muscles:

What movement does the inferior oblique muscle control

What CN is associated

A

Rotates the top of the eye away from the nose around the long axis (extorsion) and moves the eye upward (elevation)

CN III

37
Q

Name the cranial nerves:

CN VI
CN IV
CN III

A

CN VI: abducens nerve
CN IV: trochlear nerve
CN III: oculomotor nerve

38
Q

What cranial nerve control facial expressions and facial muscles?

What movements activate the cranial nerve

A

Cranial nerve VII (the facial nerve)

Ask person to smile, frown, close eyes tightly, lift eyebrows, show teeth

39
Q

Describe location of the submental lymph nodes and their direction of lymphatic drainage

A

in the midline a few centimeters behind the tip of the mandible

external and internal lymphatic drainage (from the mouth and throat)

40
Q

Describe the location of the submandibular lymph node group and their direction of drainage.

A

Midway between the angle and the tip of the mandible.

External and internal lymphatic (from the mouth and throat)

41
Q

Describe the location of the preauricular lymph node group and their direction of lymph drainage

A

in front of the ear

external lymphatic drainage

42
Q

Describe the location of the posterior auricular lymph node group and their direction of lymph drainage

A

superficial to the mastoid process

external lymphatic drainage

43
Q

Describe the location of the tonsillar (jugulodigastric) lymph node group and their direction of lymph drainage

A

at the angle of the mandible

internal lymphatic drainage (from the mouth and throat)

44
Q

Describe the location of the occipital lymph node group and their direction of lymph drainage

A

at the base of the skull posteriorly

external lymphatic drainage

45
Q

Describe the location of the anterior superficial cervical lymph node group and their direction of drainage

A

superficial to the SCM muscle

external lymph drainage

46
Q

Describe the location of the posterior cervical lymph node group and the direction of drainage

A

along the anterior edge of the trapezius

external lymph drainage

47
Q

Describe the location of the deep cervical chain lymph node group and the direction of drainage

A

Deep to the SCM muscle and often inaccessible to examination

no direction of drainage

48
Q

Describe the location of the supraclavicular lymph node group and the direction of drainage

A

deep in the angle formed by the clavicle and the SCM muscle

external lymph drain

49
Q

Enlarged tender lymph nodes commonly accompany what condition

A

pharyngitis

50
Q

Describe symptoms of hypothyroidism

A

intolerance to cold, weight gain, dry skin, and slowed heart rate

51
Q

Describe symptoms of hyperthyroidism

A

intolerance to heat, weight loss, moist velvety skin, and palpitations

52
Q

redness and scaling on the scalp may indicate what condition

A

Seborrheic dermatitis

53
Q

What are the characteristics of lymph nodes during acute infections

A

nodes are bilateral, enlarged, warm, tender, and firm but freely movable

54
Q

What are the characteristics of lymph nodes with chronic inflammation, such as tuberculosis

A

the nodes are clumped

55
Q

What are the characteristics of cancerous lymph nodes

A

hard, unilateral, nontender, and fixed

56
Q

What are the characteristics of lymph nodes with HIV infection

A

enlarged, firm, non-tender, and mobile

57
Q

What are the characteristics of lymph nodes when neoplasm in thorax or abdomen is present

A

single, enlarged, non-tender, hard, left, supraclavicular node (Virchow’s node)

58
Q

What are the characteristics of lymph nodes when Hodgkin’s lymphoma is present

A

painless, rubbery, discrete nodes that gradually appear

59
Q

A tracheal shift pushed to the unaffected side could indicate what conditions?

A

Aortic aneurysm, tumor, unilateral thyroid lobe enlargement, and pneumothorax

60
Q

A tracheal shift with the trachea puled toward the affected side could indicate what conditions?

A

large atelectasis, pleural adhesions, or fibrosis

61
Q

Lymph nodes greater than how many cm is considered enlargement

A

> 1 cm

62
Q

Test muscle strength and status of cranial nerve XI by what movement

A

trying to resist person’s movements with your hands as person shrugs shoulders and turns head to each side

63
Q

the internal carotid supplies what area

A

runs upward to supply the brain

64
Q

The external carotid supplies what area

A

the face, salivary glands, and superficial temporal area

65
Q

What part of the ear mediates conductive hearing

A

outer and middle ear

66
Q

What part of the ear mediates sensorineural hearing

A

the inner ear

67
Q

What are the 3 pairs of salivary glands and where are they located

A

Parotid glands: in the cheeks over the mandible anterior to and below the ear

Submandibular glands: beneath the mandible at angle of the jaw

Sublingual glands: in the floor of the mouth

68
Q

What is the function of the lymphatic system

A

filter lymph and engulf pathogens, preventing potentially harmful substances from entering the circulation

69
Q

What do the posterior auricular nodes drain

A

ear canal, posterior neck and upper ear

70
Q

What do the superficial cervical nodes drain and what are possible differentials

A

drains tongue, larynx, oropharynx

Differential: mono, upper respiratory infection, dental disease

71
Q

What do the supraclavicular lymph nodes drain? What are the differentials

A

Drains GI/GU tract and pulmonary

Can be a sign of abdominal cancers that metastasize by the lymph system like gastric cancer

72
Q

What do the submandibular drain and what are the differentials associated

A

oral cavity

Same as superficial cervical; Differential: mono, upper respiratory infection, dental disease

73
Q

Where do the epitrochlear lymph nodes drain and what are the differentials associated

A

Drains the last 2-3 fingers

Differential: lymphoma or melanoma or upper limb infection

74
Q

What nodes are known as tumor draining nodes

A

epitrochlear and axillary nodes

75
Q

Where is lice more likely to be located

A

at the nape (base of the neck)

76
Q

What is the light reflex test assessing and what might you be concerned about

A

assessing brain stem function; might be concerned of possible lesion or tumor at the brain stem

77
Q

What drug class can cause an abnormal light reflex

A

barbituates

78
Q
A

NP Health Assessment (2 decks)

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