H&N Flashcards
What are important questions into hoarseness?
How long? Persistent or Intermittent? Pain? Cough/Choking/Swallowing? Voice use? Asthma/Rhinosinusitis/Reflux? Smoker? Medication?
What are the important history questions regarding H&N history?
Symptoms Sore Throat Dysphonia - Hoarseness Dysphagia Odynophagia Mouth/Throat Ulcer Neck Lump Smoking/Alcohol Family history
What are the areas to be examined in a H&N history?
Neck Oral cavity Pharynx Nasopharynx Oropharynx Hypopharynx Larynx Supraglottis Glottis (vocal cords) Subglottis Nose/Ears/Salivary Glands
What can you auscultate in the neck?
Bruits
>Thyroid (grave’s thyroiditis)
>Carotid (carotid stenosis)
What are the common investigations in H&N?
FNAC!!! CT/MRI/PET US scan Plain x-ray Contrast swallow Endoscopy
What is the important history of a neck lump?
How long? Site? Fluctuates? Sore? H&N symptoms? B symptoms? (systemic symptoms, weight loss etc) Travel?
What is the important examination of a neck lump?
Site Size Shape Sore Skin Stuck Soft
What are the important questions of dysphagia?
What is difficult? - solid (obstruction), liquid (neuromuscular)?
Persistent/Intermittent?
Pain?
Where?
What are the common causes of dysphagia?
Well Localised in Neck
Poorly localised lower down.
Lumen: foreign body
Wall: tumour, stricture, neuromuscular, pouch
Extra luminal: Thyroid, Heart, Mediastinal mass
What is the important history for ENT?
Birth history >Pre term? >Traumatic birth? >Neonatal jaundice +/- phototherapy Breast vs bottle feeding? Passive smoking Speech development