Exam 3 Flashcards
Which sinuses are palpable on exam?
Ch 17
- Maxillary sinus
- Frontal sinus
Describe the difference in the hard & soft palates
Ch 17
- Hard Palate: anterior, more white
- Soft Palate: more pink, posterior
List the salivary glands
Ch 17
- Parotid
- Submandibular
- Sublingual
Which salivary gland is the largest & where is it located?
Ch 17
Parotid: in the cheeks
What is important to keep in mind regarding aging adults when examening the nose, mouth, & throat?
Ch 17
Aging Adults have…
- Diminished smell
- Atrophic tissues (no bulk)
- Dental changes (dentures, teeth loss, etc.)
What are some symptoms of dehydration?
Ch 17
- fissures on the tongue
- dehydrated / dry mucosa
Health History Questions to ask regarding examining the nose
Ch 17
- Discharge: what color is it? what does it look like? how often?
- Frequent Colds: how often?
- Trauma: broken nose? septal deviation?
- Sinus Pain, epistaxis, Allergies, Altered Smell
What steps are done when examining the nose?
Ch 17
Inspect & Palpate
What parts of the nasal cavity should you examine?
Ch 17
- Nasal Septum
- Turbinates
What step(s) are done to examine the sinuses?
Ch 17
Palpate
Palpate the maxillary & frontal sinuses
What step(s) are performed to examine the mouth & what parts of the mouth should be examined?
Ch 17
Inspect
- lips, tongue, buccal mucosa, palate, uvula, teeth, & gums
What step(s) should be performed to examine the throat?
Ch 17
Inspect
Explain the Tonsil Grading Scale
Ch 17
- 1+ = visible
- 2+ = halfway between tonsillar pillars & uvula
- 3+ = touching the uvula
- 4+ = touching one another
What is Herpes Simplex & how long does it take to heal?
Ch 17
- contagious cold sore
- spreads via direct contact
- clear vesicle
- indurated, hard, erythematous at the base
- heals within 4 - 10 days
What is carcinoma & explain the healing process
Ch 17
- hard & indurated
- any lesion lasting MORE THAN 2 WEEKS should be evaluated
What is the major difference between Herpes Simplex & a Carcinoma?
Ch 17
Herpes Simplex usually heals within 4 - 10 days while a any lesion lasting more than 2 weeks should be evaluated as it may be a carcinoma
Explain Candidiasis (or monilial infection)
Ch 17
- White, cheesy patches on the buccal mucosa or tongue (can be scraped off & usually bleeds easily)
- also known as oral thrush / yeast infection
- Common in patients who are on chemotherapy or use antibiotics on a regular basis
What are the signs & symptoms of acute tonsillitis & pharyngitis?
Ch 17
- fever
- sore throat
- pain with swallowing
- enlarged tonsils
- tonsillar exudate
- cervical lymph node enlargement
- rheumatic fever
rheumatic fever is due to untreated strep infection
What is rheumatic fever caused by and what are some symptoms?
Ch 17
Rheumatic Fever: due to untreated strep infection
- causes many multi-system problems
Which of the following is likely to elicit the most information?
a.) How often do you brush your teeth?
b.) Has your sense of taste changed?
c.) Tell me about your daily dental care.
d.) Do you have any problems with your dentures?
Ch 17
c.) Tell me about your daily dental care
Which is an expected finding in darkly pigmented people?
a.) Circumolar pallor
b.) Dappled brown patches on the buccal mucosa
c.) Bluish lips
d.) A chalky white raised patch on the mucosa of the tongue
Ch 17 – KNOW THIS!!!
c.) Bluish lips
Where is the temporomandibular (TMJ) joint located?
Ch 23
anterior to the tragus
What questions should be asked when obtaining health history about joints?
Ch 23
- do you have any pain?
- do you have any stiffness?
- do you have any swelling, heat, or redness?
What questions should be asked when obtaining health history about bones?
Ch 23
- do you have any pain?
- do you have any history of deformity or trauma (fracture, sprain, dislocation) to any bones?
- do you have a history of surgery?
What is important to keep in mind / know when evaluating a patient’s functional assessment (activities of daily living) & self-care behaviors?
Ch 23
Know the patient’s baseline!
What step(s) should be performed when assessing the temporomandibular joint (TMJ)?
Ch 23
- Inspect
- Palpate
What are examples of things to inspect when assessing the temporomandibular joint (TMJ)?
Ch 23
- size
- skin color
- swelling
- masses
- deformities
What should you look for when palpating someone’s temporomandibular joint (TMJ)?
Ch 23
- tenderness
- temperature
- swelling
- masses
- palpate muscles of mastication
What is one other way to assess the temporomandibular joint in addition to inspection & palpation?
Ch 23
- check for ROM (limited or full)
What is the difference in active & passive ROM?
Ch 23
- Active ROM: patient moves themselves
- Passive ROM: WE move the patient
What is active range of motion?
Ch 23
patient moves body parts being assesed themselves
What is passive range of motion?
Ch 23
when WE move the patient
What is Flexion?
Ch 23
Bending a limb at a joint
What is Extension?
Ch 23
Straghtening a limb at a joint
What is Abduction?
Ch 23
Moving a limb away from the body
What is Adduction?
Ch 23
Adding a limb back to the body
What is Eversion?
Ch 23
Moving the sole of the food outward at the ankle
What is Inversion?
Ch 23
Moving the sole of the food inward at the ankle
What is Pronation?
Ch 23
Turning the forearm so the palm is down
What is Supination?
Ch 23
Turning the forearm so the palm is upward
“Holding a cup of SOUP”
List the 12 cranial nerves
Ch 24
- I: Olfactory
- II: Optic
- III: Oculomotor
- IV: Trochlear
- V: Trigeminal
- VI: Abducens
- VII: Facial
- VIII: Vestibulocochlear
- IX: Glossopharyngeal
- X: Vagus
- XI: Accessory (spinal)
- XII: Hypoglossal
What is a mnemonic to remember the 12 cranial nerves?
Ch 24
- I: Oh
- II: Once
- III: One
- IV: Takes
- V: The
- VI: Anatomy
- VII: Final
- VIII: Very
- IX: Good,
- X: Vacations
- XI: Are
- XII: Heavenly
How many cervical vertebrae are there?
Ch 24
C1 - C7
How many thoracic vertebrae are there?
Ch 24
T1 - T12
How many lumbar vertebrae are there?
Ch 24
L1 - L5
How many sacral & coccyx vertebrae are there?
Ch 24
S1 - S5 & Coccyx
List all the vertebrae
(Include sacrum & coccyx)
Ch 24
- C1 - C7
- T1 - T12
- L1 - L5
- S1 - S5
- Coccyx
What is CN VI and what does it do?
Ch 15
Abducens
- abducts eye
innervates lateral rectus muscle
What is CN IV and what does it do?
Ch 15
Trochlear
- need it to “cross” your eyes
innervates superior oblique
What is CN III and what does it do?
Ch 15
Oculomotor
Innervates the rest of the eye
What is nystagmus?
Ch 15
Parallel tracking of the eye & lack of muscle control bilaterally
What is strabismus?
Ch 15
cross-eyed or misalignment of the eyes
What is diplopia?
Ch 15
double vision
What is glaucoma & what is it associated with?
Ch 15
Peripheral vision changes
- Can cause vision loss & blindness due to damage to the optic nerve
- peripheral vision changes
Associated with: aging & increased intraocular pressure
checked during eye exam
What are common causes of perioribital edema?
CH 15
- Congestive heart failure
- eye infection
What is a hordeolum?
Ch 15
Stye
What is blepharitis?
Ch 15
Inflammation of the eye
What is ptosis?
Ch 15
drooping of the eyelid
common after a stroke
What is ptosis?
Ch 15
drooping of the eyelid
common after a stroke
What should the conjunctiva & sclera look like?
Ch 15
- Conjunctiva should be clear
- Sclera should be white
What is anisocoria?
Ch 15
Unequal pupils
What is the biggest concern regarding the eyes when a head injury occurs?
Ch 15
Pupils are quick to change
- unequal pupils (can be caused by anything that changes intracranial pressure)
What is accommodation?
Ch 15
How pupils constrict to near objects
Which CN are responsible for accommodation?
CH 15
CN III (oculomotor) & CN IV (trochlear)
How do you test for accommodation?
CH 15
1.) Have patient focus on something far away so that the pupils relax & dilate
2.) Put an object 12 inches away (close) & the pupils should constrict
What is the difference in checking direct & consensual light reflex?
Ch 15
- Direct: checks the pupil you shine the light directly into
- Consensual: Check the eye you do NOT shine the light directly into (shine light into same eye you checked direct with & watch the opposite eye)
How do we write pupil size?
Ch 15
Fraction
- 3/1 –> 3 is at rest & 1 is when stimuli is applied
What CN does visual acuity test for?
Ch 15
CN II (optic)
Explain how the snellen chart works?
Ch 15
- If the patient misses more than 1 letter in a line, then go up a line
- Numerator: indicates the distance from the chart (always 20 feet away from the chart)
- Denominator: indicates the distance at which a normal eye could have read that line
What does it mean as the denominator on the Snellen Chart Score INCREASES?
Ch 15
your vision is WORSE
What does a Snellen Chart Score of 20/30 mean?
Ch 15
At 20 feet (numerator), the normal eye can read at 30 feet
What is the red reflex?
Ch 15
Reflexion of the light (from the opthalmoscope) on the retina
lighter & brighter with a lighter iris