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PE midterm > Head and neck > Flashcards

Head and neck Flashcards

1
Q

If a patient sees flashing lights, what is it a sign of?

A

detached retina

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2
Q

What is the vertex of the head?

A

the top of the head

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3
Q

What is wharton’s duct?

A

secretes saliva from submandibular gland

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4
Q

What does the parotid gland secrete saliva via?

A

Stensen’s duct located behind molars

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5
Q

What is the most commonly fractured bone in orbital floor fracture?

A

Zygomatic arch

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6
Q

Where is ear pain often referred to?

A

TMJ

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7
Q

Mental protuberance

A

chin

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8
Q

Frontal eminence

A

forehead

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9
Q

laryngeal prominence

A

Adam’s apple

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10
Q

Palpebral fissures

A

the slit between your eyelids

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11
Q

Describe the palpebral fissures of a person with Trisomy 13, 18 or 21

A

up-slanted

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12
Q

Describe the palpebral fissures of a person with FAS

A

horizontal

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13
Q

Epicanthal folds

A

skin folds near the nasolacrimal gland - thicker in people with down’s syndrome

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14
Q

Nasolabial folds

A

lines made from the nares to the lateral aspect of the mouth when smiling

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15
Q

When will nasolabial folds not occur?

A

in a person who suffered a CVA - due to damage to CN VII on the contralateral side of the affected area

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16
Q

What sinuses are associated with the face

A

frontal, sphenoid, ethmoid (bubbles), maxillary

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17
Q

What does the NLS drain into?

A

inferior meatus

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18
Q

What are facies

A

Characteristic of a certain syndrome or disorder with distinct facial features

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19
Q

What are characteristics of people with down’s syndrome?

A

Prominent epicanthal folds, low-set ears, macroglossia, flat nasal bridge, brush-field spots on iris

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20
Q

What are characteristics of people with Cushing’s syndrome?

A

Moon facies: fat cheeks, brittle bones, cataracts, plethoric face, double chin, thin skin, allopecia

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21
Q

What are characteristics of people with FAS?

A

low nasal bridge, short nose, diminished epicanthal folds, small head, flat face, thin upper lip and smooth philtrum, underdeveloped jaw

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22
Q

When does FAS generally occur?

A

first trimester (12 wks)

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23
Q

What causes acromegaly?

A

excess GH from a pituitary adenoma after fusion of the epiphyseal growth plates

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24
Q

What causes gigantism?

A

excess GH from a pituitary adenoma before fusion of the epiphyseal growth plates

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25
Q

What are characteristics of people with acromegaly?

A

large hands, feet, head, frontal bossing, palmar thickening, coarse features, prognathism

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26
Q

What can cause parotid enlargement?

A

Sjogren’s syndrome, Mumps, Neoplasm (if unilateral), chronic disease (DM, obesity, liver cirrhosis)

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27
Q

What should be considered with any unilateral mass?

A

neoplasm

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28
Q

Describe Sjogren’s syndrome

A

Occurs in pts with HLA phenotype, autoimmune disease that attacks mucus producing cells, associated with dry eyes and mouth, arthritis. Dx with SSA and SSB antibodies with a negative rheumatoid factor, Tx with steroids, higher probability of getting lymphoma

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29
Q

What can cause parotitis? S/S?

A

S. aureus, tender, warm, red parotid glands - palpate with mouth open and if pus comes out of Stensen’s gland then it indicates a suppuratous infection

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30
Q

How can you treat parotitis?

A

Sialogogues (increase saliva), heat, massage from posterior to anterior, hydration

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31
Q

What is the hyoid bone important for? Why is it unique?

A

Swallowing, tongue movements, not articulated

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32
Q

If a patient cannot have oropharyngeal intubation what is an option?

A

Make an opening in the cricoid cartilage

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33
Q

What is the middle of the thyroid gland called? Where is it located?

A

isthmus - lacated between the SCM

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34
Q

What happens to the thyroid when you swallow?

A

it moves superiorly and loos asymmetric

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35
Q

What is the most common cause of thyromegaly?

A

Iodine deficiency - hypo/hyperthyroidism and increased TSH (Hashimoto’s and Grave’s diseases)

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36
Q

True or false: diffuse thyromegaly is benign.

A

TRUE

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37
Q

What normally causes diffuse thyromegaly?

A

autoimmune disease

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38
Q

What are characteristics of Grave’s disease?

A

exopthalmus - autoimmune response that causes hyperthyroidism also attacks the tissue around the eyes

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39
Q

What disease other than grave’s disease shows exopthalmos?

A

orbital tumor - unilateral exopthalmos

40
Q

True or false: multinodular goiters are benign.

A

TRUE

41
Q

What can cause thyroiditis?

A

viral/autoimmune

42
Q

What type of thyroid abnormality is indicative of malignancy?

A

solitary nodule that is firm, not tender, fixed

43
Q

What age group has a higher likelihood of thyroid malignancy?

A

children

44
Q

How can you diagnose thyroid malignancy?

A

Radial iodine scintography will tell you if it is hot or cold (cold = malignant and not active) plus FNA for histology

45
Q

What characteristics are important to describe for thyroid nodules?

A

location, consistency, size, pain, erythema, symmetry

46
Q

What are the borders of the anterior neck triangle?

A

SCM, midline of neck, jaw

47
Q

What are the borders of the posterior neck triangle?

A

SCM, clavicle, trapezius

48
Q

What does the jugular vein traverse?

A

SCM

49
Q

Where is bone marrow made?

A

flat bones: sternum, pelvis

50
Q

Where can lymph tissue be found?

A

liver, spleen, gut (Peyer’s patches)

51
Q

Where does the right lymphatic duct drain into?

A

SVC

52
Q

Where does the left lymphatic duct drain into?

A

subclavian vein via thoracic duct

53
Q

LAD that is solitary, fixed, non-tender, growing

A

malignant

54
Q

LAD that is solitary, erythematous, tender, fluctuant, growing

A

infection (suppurative)

55
Q

LAD that is diffuse, symmetric, nodular, static

A

systemic disease - HIV or malignancy

56
Q

LAD that is solitary or grouped, tender and mobile

A

regional (local) infection/inflammation (sarcoidosis) or lymphoma

57
Q

Sarcoidosis

A

inflammation occurs in the lymph nodes, lungs, liver, skin, eyes, or other tissue

58
Q

What are shotty lymph nodes?

A

hyperplastic lymph from previous inflammatory process - should be mobile and non-tender

59
Q

What is the difference in age groups of effected patients with hodgkin’s vs. non-hodgkin’s lymphoma?

A

Hodgkin’s: bimodal, Non-hodgkin’s: older and immunocompromised

60
Q

Where should LAN absolutely NOT be?

A

Supraclavicular lymph nodes - indicates mediastinal malignancy and lung or gastric CA

61
Q

What node can be palpated with metastatic gastric CA?

A

Irish’s node - left anterior axillary lymph node, virchow’s node, trosier’s node

62
Q

What axillary lymph nodes can be palpated?

A

lateral axillary, central axillary, subscapular, pectoral

63
Q

What lymph nodes might be inflammed with Rheumatoid arthritis?

A

Epitrochlear

64
Q

What is the function of the epitrochlear lymph nodes?

A

drain ulnar aspect of the hand

65
Q

How should the epitrochlear lymph nodes be palpated?

A

arm at 90*, superior to medial epicondyle of humerus

66
Q

What can cause inguinal LAN?

A

HSV, LGV (lymphogranuloma venereum)

67
Q

What is the function of the popliteal lymph nodes?

A

drain lower 1/2 of the leg

68
Q

What do bruits in thyroid gland indicate?

A

hypermetabolic activity or infection

69
Q

What does scaling of the scalp indicate?

A

seborrheic dermatitis, tx with selenium sulfate (H&S)

70
Q

Why is it impportant to check the scalp of children?

A

They easily get tinea capitis: allopecia with excalamtion point hairs over lesion

71
Q

What can tinea capitis turn into if it is not treated?

A

Kereon: fungal mass - treat with systemic drugs

72
Q

What are warning signs of a headache?

A

more frequent/severe over 3 months, new onset after 50, fever, sweats, weight loss, HIV, known CA, pregnancy, neck stiffness (others are obvious)

73
Q

Why is HA bad in pregnancy?

A

indicates preeclampsia

74
Q

What could cause edema of the face?

A

diabetes, HTN, allergic reaction, cellulitis

75
Q

Why is palpation of the temporal artery so important?

A

it branches to the opthalmic artery and could cause blindness if occluded

76
Q

How is the TMJ palpated and how do you treat TMJ syndrome?

A

palpate with the ulnar aspect of the hands, treat with NSAIDs

77
Q

What is giant cell arteritis?

A

temporal arteritis: occurs in people over 50 with TMJ pain, bounding, tender temporal artery, autoimmune disease, increased ESR, untreated can lead to blindness, tx with corticosteroids

78
Q

How would a pt with PCOS present onf PE?

A

hirsutism due to increased T

79
Q

Where is the most common place to find basal cell carcinoma?

A

on the nose/face

80
Q

What type of facies do people with Parkinson’s have?

A

flat facies

81
Q

How is bacterial sinusitis diagnosed?

A

sxs > 7 days, purulent nasal drainage, facial pain/toothache, fever, tenderness to palpation

82
Q

What could cause tracheal deviation?

A

pneumothorax

83
Q

What is the curve of the C-spine?

A

lordosed

84
Q

What portion of the SCM are the superficial cervical lymph nodes and the posterior clavicular lymph nodes located?

A

superficial: sternal portion of SCM, posterior: clavicular portion of SCM

85
Q

If the thyroid is enlarged on PE what hsould you do?

A

listen for bruits

86
Q

T10 dermatome

A

umbilicus

87
Q

What nerves are responsible for the patellar reflex?

A

L4, L5

88
Q

What nerve is responsible for the achilles reflex?

A

S1

89
Q

S1 dermatome

A

lateral foot

90
Q

L4 dermatome

A

big toe

91
Q

S5 dermatome

A

anus

92
Q

S2, S3 dermatomes

A

genitals

93
Q

C6 dermatome

A

thumb

94
Q

C7 dermatome

A

index/middle finger

95
Q

C8 dermatome

A

ring/little fingers

PE midterm (10 decks)

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