Head and Face Flashcards
What are you looking for when you inspect facial features?
Symmetry, any abnormalities
How can you test CN VII (facial nerve)
facial symmetry
wrinkle forehead, raise eyebrows, squeeze eyes shut
Smile and puff out cheeks
How can you test CN V (trigeminal) sensory
check for light touch to ophthalmic , maxillary and mandibular (forehead, cheeks, chin)
How can you test for motor function of masseter (CN V)
ask pt to close mouth and “bite down”
Temporal arthritis (aka giant cell arthritis) what is it? What symptoms do these patients present with?
Inflammation of arteries around the scalp
Headache. “It hurts when I comb my hair”
Can lead to blindness.
If you have a concern for temporal arteritis what should you do in your PE?
palpate the temporal arteries for tenderness
Define facies
expression or appearance of the face, head or neck that is characteristic of a clinical condition ex. acromegaly, down syndrome, myxedema
What is Acromegaly? facies for these patients?
Results for excessive growth hormone. Usually due to benign tumor or pituitary gland.
Generalized expansion of the skull. Pronounced brow protrusion, often with ocular distention. Pronounced lower jaw protrusion. Macroglossia (teeth gapping)
What is cushing’s Syndrome?
facies?
Hypercortisolism
“moon face” facial swelling, red cheeks, hirsutism
What is Myxedema? facies?
Severe hypothyroidism
Dry, coarse, and sparse hair. Thin lateral eyebrows. Puffy face. Puffy eyes.
Parkinson’s Disease? facies?
Decreased facial ability.
Stare, blunted expression, mask-like face.
What can cause parotid gland enlargement
major salivary gland
Enlargement can be caused by Parotitis (infectious/blockage), measles, chronic bilateral enlargement can be seen with obesity, DM and cirrhosis
Bell’s Palsy
Idiopathic paralysis of the facial nerve
Unable to perform functions involving facial nerve i.e wrinkle forehead, squeeze eyes shut.
What is generally included in a head/face exam?
- inspect facial features
- test muscle/CN function
- palpate facial features and sinuses
- test muscle/ CN
- inspect & palpate the hair, scalp and skull
What should you look for when inspecting hair, scalp and skull?
Hair: quantity, distribution and texture
Scalp: redness? scaling? Lesions? wildlife?
Skull: size, shape, symmetry, deformities or tenderness
Male pattern baldness
begins above both temples., hair also thins at the crown of the head
Alopecia areata
clearly demarcated round or oval patches of hair loss. Usually affects young adults and kids. Can be caused by lots of stress
Seborrheic dermatitis
results from overproduction of sebum. Flaky white to yellowish scales on oily skin.
Hirsutism
Male pattern hair growth on a women. Due to excess androgen
symptom of disease, including Polycystic Ovarian Syndrome
Paronychia? Cause?
Acute or chronic inflammation of the nail folds. Nail folds are swollen, red and tender.
Caused by local trauma (nail bitting) or frequent hand immersion in water
Leukonychia
nonuniform white spots that grow slowly out with the nail.
Caused by trauma
Koilonychia
spoon nails.
Abnormally thin nails, may become concave.
Associated with iron deficiency anemia and Plummer-Vinson syndrome
Onycholysis
painless separation of the whitened opaque nail plate from the pinker translucent nail ben
Caused by trauma and by some systemic diseased (DM, anemia, hyperthyroidism)
Onychocryptosis
ingrown toenail, nail grows into dermis.
Cause: improperly cutting toenails. Tight shoes
Oncyomycosis
fungal infection of the nail bed, plate or matrix
Cause: occlusive footwear ,, looker room exposure
Terry’s nails
nail plate turn white with distal band of reddish brown
Cause: aging, some chronic disease ( liver disease, cirrhosis, DM)
Beau’s lines
transverse linear depressions of nail plate, usually bilateral
Cause: temporary disruption of proximal nail growth from systemic illness
nail pitting
punctate depressions of the nail plate
Cause: defecting layering of the superficial nail plate
Nail clubbing
bullous swelling of the soft tissue at the nail base with loss of normal angle
Nail bed feels spongy or floating
Cause: conditions associated with hypoxia (congenital heart disease, lung diseases)
