Extraoral Exam Flashcards
what does atypical mean
not present in all individuals but still within normal limits
what does pathologic mean
associated with infection, trauma, neoplastic growth, errors in development
what is hemiplegia
paralysis one side usually from stroke
what is paraplegia
paralysis both sides
what is hemiparesis
weakness on one side
what is paraparesis
weakness on both sides
what is ataxic gait
presence of abnormal uncoordinated movements
-unsteady, staggering gait
-walking is uncoordinated and not ordered
what are parkisonian gaits and examples
motor disturbances-resting tremors
-tremor
-rigidity
-postural instability
-hypokinesia
what are the guidelines of interacting with wheelchair riders
-avoid presumptions
-greet normal
-speak directly
-learn locations of ramps
-offer help
how do you do a wheelchair transfer
-position wheelchair as close as possible
-lock wheels
-fold footrest out of the way
what is marfans syndrome and incidence
genetic disorder that affects the bodys connective tissue, effects about 1-5,000
what are symptoms of marfans syndrome
-tall
-thin
-arachnodactily
- wingspan> height
- chest concavity
-heart murmur
-spine abnormalities
what to do if you notice head lice
dismiss patient and vacuum chair
what does HEENT stand for
head, eyes, ears, nose, throat
what is prognathic
protruding mandible
what is retrognathic
retrusive mandible
what are the cancer precautions
-if on chemo they are immunocompromised
-head and neck radiation therapy: xerostomia, mucosal irritation, cervical caries
what is the most common skin disorder, where is it located, and what is the incidence rate
basal cell, middle 2/3 of face, more than 3 million cases in the US per year
describe squamous cell carcinoma
-irregular borders
-crusty surface
-persistent thick rough scaly patches
what percentage of cancers does squamous cell carcinoma make up
90%
describe a melanoma
-multiple colors
-irregular borders
-flat or slightly raised borders and somewhat asymmetrical in form
-highly infiltrative
what are nodular melanomas
aggressive lesions that have only a vertical growth
what is ptosis and what can it indicate
eyelid lag, sometimes sign of past stroke
what is occular hypertelorism
excess spacing between eyes
what is exophthalmos
abnormal protrusion of the eye
what is exophthalmos a sign of
hyperhtyroidism
what are the lymph node groups
-cervical
-axillary
-inguinal
-internal (pelvis, abdominal, thoracic
what are the cervical lymph nodes
-submental
-submandibular
-tonsilar/jugulodigastric
-preauricular
-postauricular
-occipital
-anterior cervical chain
-supraclavicular
-posterior cervical chain
where are submental lymph nodes located
below chin
where are submandibular lymph nodes
3-6 nodes below the mandible
describe the size of tonsillar lymph nodes
some of the largest lymph nodes in the cervical chain due to lots of lymphatic drainage. decreases in size with age in cancer free patients
where is the anterior cervical chain nodes
on top and beneath the SCM, from the angle of the mandible to the top of the clavicle
where are the supraclavicular lymph nodes
in the hollow above the clavicle just lateral to where it joins the sternum
where is the posterior cervical chain located
extends in a line posterior to the SCM but in front of the trapezius
describe how infected lymph nodes appear
firm tender, enlarged and warm, overlying skin may be inflamed
how do malignant lymph nodes feel
firm, non-tender, matted, fixed and increase in size over time
what area is the most common lymphadenopathy
cervical
what are some clues to routine swelling in lymph nodes from recent infection
-tender
-mobile
-current or recent viral infection
-bilateral (not always)
-predictable locations
-long lasting without change
what are mumphs
infection of the parotid gland
what are symptoms of mumphs
swelling in the cheek and sore lymph nodes
where is the thyroid located and can you palpate it
inferior to the larynx and just superior to the clavicles, cannot palpate
how do you do a thyroid exam
- place fingers on either side of adam’s apple
-then slide to just below it
-ask patient to swallow
-feel gland rise up then drop back
-feel for any aymmetry or lumps
what percentage of the US have TMJ issues
20%
what percentage of TMJ sufferers are women
85.4%
what are TMD symptoms
-joint pain
-headaches
-tinnitus
-insomnia
-neck ache
-teeth sensitive to hot and cold
what are the causes of TMD
-bruxism
-clenching
-stress
-malocclusion
-arthritis
-trauma
-stimulants
what are the 3 diagnostic classes of TMD
-muscles
-soft tissue of the joint
- hard tissues of the joint
what does referred pain in temporalis mean
anterior teeth pain
what does referred pain in masseter mean
posterior teeth pain
what are the components of a TMD exam
-excessive tooth mobility
-widened PDL
-migration in the absence of period ds
-buccal mucosa ridging
-lateral tongue scalloping
-inspect symmetry and alignment of face jaws and dental arches
what are splints for TMD used for
-redistribute occlusal forces
-relax the masticatory muscles and stabilize the joint
- protect dentition and dental work
what are treatment options for TMD
-NSAIDs
-anti-anxiety
-muscle relaxers
-botox
-physical therapy
-surgery
-joint rest, limit joint movement, keep teeth ajar
-soft food diet
- medications to relieve pain and relax muscles
-hot or cold compress
-TMJ physical therapy
-wearing a night guard
what abnormal things do you look for in head and neck exam
-nosebleeds
-congestion
-trouble swallowing
- lumps in neck, hoarseness, scratchy throat that doesnt get better
-pain in neck, jaw, or ears
what is angular cheilitis and where is it found
on corners of mouth, usually candida
what is one of the first signs of bruxism
teeth become sensitive to hot and cold
