Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EENT > Face and Neck > Flashcards

Face and Neck Flashcards

1
Q

Painful syndrome involving the mandibular joint

A

Temporomandibular Joint Dysfunction (TMJ)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 subtypes of Temporomandibular Joint Dysfunction (TMJ)

A
  1. Myofascial pain and dysfunction
    - MC subtype
    - Affects masseter, temporal, pterygoids
  2. Internal derangement
    - Dislocation of the articular disc in the glenoid fossa
  3. Osteoarthritis
    - Degeneration of the articular cartilage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

epidemiology of TMJ

A
  1. 31% adults, 11% children
  2. 1.5x in females
  3. 18 - 44 y/o
  4. associated with mood disorders, other psychiatric comorbidities
  5. increased prevalence with rheumatoid arthritis
  6. bruxism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

cause of TMJ

A
  1. Exact cause unknown
  2. Can be associated with trauma
  3. Orthodontic treatment
  4. Arthritis
  5. Excessive use of joint and muscles of mastication
    - Nail biting
    - Gum chewing
    - Teeth gritting
  6. Psychogenic causes also linked to TMJ
    - often have depression, anxiety, stress
    - Psychogenic factors thought to exacerbate symptoms, rather than cause them
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

clinical findings of TMJ

A
  1. Joint pain
  2. Joint noise
    - Clicks
    - Crepitus
  3. Abnormal mandibular movement
  4. Masticatory muscle tenderness
  5. Patients may complain of pain using their jaw, their jaw locking, or their bite not feeling right
  6. HA - frontal, temporal, occipital
  7. Dizziness or vertigo that is associated with aural fullness or otalgia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

hx of TMJ

A
  1. Facial pain -Pain with jaw function, limitation of movement, cracking or popping, jaw muscle fatigue after eating.
  2. Ear sx - pain, aural fullness, tinnitus, vertigo, hearing loss.
  3. Pain in the head, neck, shoulder, and upper back
    Headaches
  4. Hx of previous TMJ surgery or trauma.
  5. Hx of arthritis
  6. “Habits” such as pencil biting, gum chewing, or clenching, gritting or grinding of teeth.
  7. Bruxism, either night (sleep-related) or daytime (awake).
  8. Evaluation for depression and anxiety as well as the presence of other chronic pain symptoms
  9. Sleep quality
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

PE of TMJ

A
  1. Abnormal Jaw Movements
  2. Palpation for tenderness or crepitus
  3. Pain with dynamic loading - pt bite down on tongue blade
  4. Evaluate for bruxism - look for wearing down of teeth
  5. Evaluate postural asymmetry
    assess posture - does pt favor one side?
  6. Neuromuscular exam
    - inspect and palpate the muscles of the neck and shoulders
    - assess cranial nerves - special consideration for CN V and VII
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

tx for TMJ

A
  1. Joint rest
    - To allow muscles of mastication to relax
    - Reduce mandibular condyle movement
  2. Avoid chewing gum, biting nails, excessive talking
  3. Eat a soft diet
  4. Reduce stress
  5. Physical therapy
    - Exercises include mouth opening and closing in a straight line
  6. Intra-oral devices
    - Splints, night guards, bite guards
  7. Botox injections
    - Muscle relaxation
    - Only temporary relief - 3-4 months

Diagnosis is usually clinical

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

when to refer for TMJ

A

Symptoms do not improve after 6 months of joint rest
Progressive difficulty in opening the mouth
Inability to eat a normal diet
Recurrent dislocation of the temporomandibular joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

MC head and neck cancer

A

SCC
paranasal sinuses, oral cavity, nasopharynx, oropharynx, hypopharynx, and larynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Tumors of what differ from the more common carcinomas of the head and neck

A

salivary glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Tumors of what differ from the more common carcinomas of the head and neck

A

salivary glands

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

risk factors of head and neck cancer

A
  1. Alcohol, Tobacco, Smokeless tobacco
  2. Marijuana
  3. Occupational exposures
    - Dry cleaning
    - Farming - pesticides
    - Construction - asbestos
  4. Nickel refining
  5. Exposure to textile fibers
  6. Radiation therapy
  7. Genetics
  8. Poor oral hygiene
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Viral etiology of head and neck cancer

A

EBV - Nasopharyngeal cancer
HPV - Oropharynx
HSV
Hep C
HIV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

what Dietary factors may contribute to head and neck cancer

A

Higher incidence with low consumption of fruits and vegetables

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

specific risk factors of MC pt presentation of head and neck cancer

A

If tobacco related, usually > 60 y/o
HPV related, usually younger ~ 40-50 y/o
Males more frequently affected

17
Q

Unilateral serous otitis media / otalgia
Unilateral or bilateral nasal obstruction
Epistaxis
Advanced carcinoma may cause CN neuropathies
where is this cancer

A

nasopharynx

18
Q

Persistent hoarseness
where could the cancer be

A

larynx

19
Q

Non-healing ulcers
Changes in the fit of dentures
Painful lesions
where could the cancer be?

A

oral cavity

20
Q

Changes in tongue mobility
Alterations in speech
where is the cancer

A

tongue

21
Q

Sore throat
where could be the cancer

A

Oropharynx and hypopharynx

22
Q

work up for neck mass

A
  1. H&P to delineate into 3 possible categories:
    - infectious
    - malignant
    - nonmalignant
  2. This will direct further evaluation with lab tests, imaging, biopsies, and referrals
23
Q

what type of etiology is suspected based on a hx of the mass developing within a few days/weeks of an upper respiratory infection, dental infection, trauma, travel

A

infectious

24
Q

Stand alone features for neck mass not malignant

A
  1. History
    - Lack of infectious etiology
    - Duration of greater than 2 weeks or unknown
  2. PE
    - size > 1.5cm
    - Firm texture/fixed mobility
    - ulceration of overlying skin
25
Q

Rapid growing usually ___ cause, while firm, slowly enlarging masses are usually ___

A

infectious
neoplastic

26
Q

supporting features of a neck mass not malignant

A
  1. History
    - age > 40
    - tobacco use/alcohol use
    - history of head/neck cancer
    - history of skin cancer of head/neck/face
    - immunocompromised status
  2. PE
    - hoarseness/recent voice change
    - oral cavity/oropharyngeal ulcer
    - odynophagia/dysphagia
    - constant “sore throat”
    - hemoptysis
    - unexplained weight loss
27
Q

if Suspected malignancy, what is the next step/workup of the neck mass

A

Refer to ENT
1. Blood work
- CBC
- ESR
- C-reactive protein
- EBV
- CMV
- HIV
2. Imaging
- Contrast CT initial study of choice
- MRI
- PET SCAN (positron emission tomography)
- Ultrasound

28
Q

diagnostic studies of suspected malignant neck mass

A
  1. Fine Needle Aspiration (FNA): preferred option
  2. Core biopsy
  3. Ultrasound or CT guided FNA
  4. Incisional Biopsy
29
Q

congenital ddc of neck masses

A

branchial cleft cyst
thyroglossal duct cyst
vascular anomalies
dermoid cyst
teratoma

30
Q

inflammatory ddx neck masses

A

bacterial lymphadenopathy
viral lymphadenopathy
parasitic lymphadenopathy

31
Q

neoplastic ddx of neck masses

A

Thyroid masses
Schwannoma
Lipomas

32
Q

how do you stage head and neck masses in general

A

TNM Staging system (Tumor, Node, Metastasis)
1. Tumor - size and extent of main tumor
2. Nodes - number of nearby lymph nodes that have cancer
3. Metastasized - spread to other areas: from primary tumor to other sites/parts of the body

33
Q

tx for SCC on head and neck

A
  1. Localized disease (early stage: I and II)
    - Surgery (removal of tumor/cancerous lesion) or Radiation Therapy
  2. Locoregionally advanced disease (stage III/IV)
    - high risk of recurrence and metastasis
    - Combined modalities: Surgery, Radiation Therapy and or chemotherapy
  3. Metastatic
    - Palliative chemotherapy, supportive care
34
Q

what viral infection can infect the oral mucosa and has been associated with squamous cell carcinoma of the oral cavity

A

HPV 16
IMPORTANCE OF VACCINATION!
HPV associated cancers have increased dramatically and have substantially altered the epidemiology of oropharyngeal squamous cell carcinoma

EENT (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions