Head and Neck Flashcards
order of areas
hair/scalp, face, ears, eyes, throat, neck (lymph nodes, thyroid)
What to look for: hair
quality (fine = hyperthyroidism, coarse = hypothyroidism), white ovoid granules (nits), dandruff (seborrheoeic eczema)
What to look for: Scalp
redness (seborrheic dermatitis / eczema), redness w plaques (psoriasis), soft lumps (pilar cysts), pigmented nevi (moles, check for signs of melanoma)
What to look for: skull
observe general size, inspect any depressions
What to look for: face
facial expressions, symmetry (Bell’s palsy), pigmentation (port wine stain), hair distribution (hirsutism - women w PCOS), acne, lesions
Cushing Syndrome
moon face, red cheeks, excessive hair growth
Nephrotic syndrome
swelling around the exes, pale looking, puffy face
Parkinson’s
Hypomania (decreased face mobility, stare)
Temporal Arteritis
aka: Giant Cell Arteritis
>60 y.o., females > males, associated w polymyalgia rheumatica
Temporal Arteritis S&S
Severe, localised head pain, tenderness over artery, new persistent headache, later: vision loss
What to look for: Forehead
sinuses, arteries
Sinusitis
polyps, infection (usually viral), allergies, deviated septum
What to look for: ear
cerumen, inflammation, foreign bodies, swelling, blood
look at: tympanic membrane, cone of light, malleus, short process of malleus & incus
DDX: ear pain (otalgia)
pinna, middle, external and other
Pinna pain
perichondritis, cellulitis, neoplasm (basal cell or squamous cell)
external ear pain
otitis externa, impacted wax, foreign bodies, herpes zoster
middle ear pain
acute otitis media, otitis media with effusion (glued ear), Eustachian tube obstruction
other pain around the ear / referred pain
teeth, tongue, pharynx, sinus, TMJ, Cx Spine
DDX: ear discharge
external: otitis externa, middle ear: acute supportive otitis media, chronic suppurative otitis media
inner: fracture (CSF leak)
Eye examination
inspection, focus on changes to the normal appearance, inspection of the eyebrows, cranial nerves covered in Neuro-ortho
What to look for: Eyebrows
equal? hair loss? lateral thinning?
loss -> SLE, lateral thinning -> Hypothyroidism
What to look for: Eyes / Eyelids
Ptosis (Horner’s Syndrome, Myasthenia Gravis), Xanthelasma, Exophthalmos, lid retraction (Hyperthyroidism, Grave’s disease)
