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Clinical Med > Head and neck > Flashcards

Head and neck Flashcards

1
Q

Which test involved a 512 Hz tuning fork to be placed on the apex of the patient’s head?

A

Weber test

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2
Q

What finding is needed to diagnose conductive hearing loss in a Weber test?

A

Hearing preferentially in the bad ear

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3
Q

What finding is needed to diagnose a neurosensory hearing loss in a Weber test?

A

Hearing preferentially in the good ear

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4
Q

Which test is more accurate for conductive hearing loss, weber or rinne?

A

Rinne

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5
Q

What is angular cheilosis?

A

Erythematous inflammation of lips to extends beyond the mouth

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6
Q

What is Brachial cleft cyst?

A

A congenital lesion due to the incomplete involution of the brachial left

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7
Q

What is a bulging fontanel indicate?

A

rise in intracranial pressure

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8
Q

What is cheilits?

A

cracked lips

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9
Q

What is cholesteatoma?

A

mass of keratinizing squamous epithelim and cholesterol in the middle ear, usually caused by chronic otitis media

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10
Q

What is crainiosynostosis?

A

premature closure of an infant’s skull

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11
Q

What is choasma?

A

common facial discoloration seen in pregnancy

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12
Q

What is Encephalocele?

A

Neural tube defect with protrusions of brain and membranes that cover the skull (bifida of the cranial part of the spinal cord)

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13
Q

What are epstein pearls?

A

small, multiple white, epithelial inclusion cysys found in the midline of the palate in newborn infants

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14
Q

What are fordyce spots?

A

Ectopic sebaceous glands of the buccal mucosa appearing as small yellow-white raised lesions found on the inner surface and vermilion border of the lips

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15
Q

What are Koplik’s spots?

A

Small red spots with bluish-white centers on the buccal mucosa opposite the molar teeth, appearing in the prodromal stages of measals

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16
Q

What is leukoplakia?

A

circumscribed, firmly attached, thick white patches on the tongue. Often precancerous.

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17
Q

What is molding when referring to newborn children?

A

Shape of the head

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18
Q

What is otosclerosis?

A

deposits of bone resulting in immobilization of the stapes

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19
Q

What is presbycusis?

A

impairment of heading due to aging

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20
Q

What is a thyroglossal duct cyst?

A

A palpable cyst in the neck due to an incomplete closure of the thyroglossal duct

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21
Q

What is tophi?

A

small, whitish uric acid crystals along the peripheral margins of the auricles in persons who may have gout

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22
Q

What is torus mandibularis?

A

a bony protuberance on the linguinal aspect of the lower jaw in the canine-premolar region

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23
Q

What is torus palatinus?

A

a bony protuberance in the midline of the hard palate

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24
Q

What is tympanosclerosis?

A

The formation of dense connective tissue in the middle ear, often resulting in hearing loss

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25
Q

What is Xerostomia?

A

Dry mouth

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26
Q

What is webbing?

A

Excessive posterior cervical skin the is often associated with chromosomal abnormalities

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27
Q

What is the findings necessary for a Rinne test to indicate conductive hearing loss?

A

Bone conduction heard as long, or longer than air conduction

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28
Q

What would be a normal finding in a Rinne test?

A

If the patient can hear the sound through the air for twice as long or more

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29
Q

What would indicate a neurosensory loss in a Rinne test?

A

Air conduction will be heard longer than the bone (but obviously be diminished from normal)

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30
Q

What would indicate an abnormal Romberg test?

A

The inability to stand for 60 seconds with feet together and eyes closed.

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31
Q

True or false: If the Romberg test is abnormal, you should continue to testing to further evaluate the extent of the cerebellar dysfunction.

A

False

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32
Q

Which side do patients with vestibular lesions fall toward: toward or away from the lesion?

A

Toward the side with the lesion

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33
Q

Which side does numbering the teeth begin on?

A

Top right

to top left, then from bottom left, to bottom right

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34
Q

Which side will the trachea deviate in lung volume loss?

A

Toward the lung with volume loss (like a vacuum)

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35
Q

Which side will the trachea deviate in thyroid enlargement–toward or away from the affected side?

A

Away from the affected side

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36
Q

Which side will the trachea deviate in tension pneumothorax–toward or away from the affected side?

A

Away from the affected side

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37
Q

Which side will the trachea deviate in pleural effusion–toward or away from the affected side?

A

Away from the affected side

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38
Q

Which side will the trachea deviate in a collapsed lung–toward or away from the affected side?

A

Toward the affect side

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39
Q

What is a “tug” in reference to the trachea?

A

It is a palpable pull out of midline with inspiration

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40
Q

Which way is the ear pulled in an adult?

A

Up and back

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41
Q

Which way is the ear pulled in a child?

A

Down and back

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42
Q

What is the typical location of a migraine headache?

A

Unilateral (70%) or bifrontal/global

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43
Q

What is the typical location of a tension headache?

A

Bilateral/generalized to back of head

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44
Q

What is the typical location of a cluster headache?

A

Unilateral, usually behind/around the eye

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45
Q

What is the quality and severity of a migraine headache?

A

Throbbing/aching

variable severity

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46
Q

What is the quality and severity of a tension headache?

A

pressing/tightening.

Mild to moderate severity

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47
Q

What is the quality and severity of a cluster headache?

A

Deep, continuous, severe

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48
Q

What is the process involved in migraine headaches?

A

neuronal dysfunction

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49
Q

What is the process involved in tension headaches?

A

Unclear–possibly heightened CNS

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50
Q

What is the process involved in a cluster headache?

A

Unclear–possibly hypothalmic then trigemino-autonomic activation

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51
Q

What is the timing involved in a migraine headache (onset, duration, course)?

A 
Onset = Rapid (peak = 1.5 hours)
Duration = 4-72 hours
Course = recurrent
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52
Q

What is the timing involved in a cluster headaches (onset, duration, course)?

A 
Onset = abrupt
Duration = 3 hours
Course = episodic, (in clusters)
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53
Q

What is the timing involved in a tension headaches (onset, duration, course)?

A 
Onset = gradual
Duration = 30 minutes to 7 days
Course = episodic (non-cluster)
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54
Q

What are the associated factors with migraine headaches?

A

n/v photophobia, phonophobia, AURA.

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55
Q

What are the associated factors with tension headaches?

A

NO nausea.

Sometimes photophobia/phonophobia

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56
Q

What are the associated factors with cluster headaches?

A

Autonomic symptoms (rhinorrhea, lacrimation)

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57
Q

What are provoking factors for migraine headaches?

A

EtOH/foods
stress
noise/bright lights

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58
Q

What are provoking factors for tension headaches?

A

Sustained muscle tension

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59
Q

What are provoking factors for cluster headaches?

A

EtOH? (unclear)

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60
Q

Nervousness is symptomatic of what (hypo or hyper-thyroidism)?

A

Hyperthyroidism

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61
Q

Fatigue/lethargy is symptomatic of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

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62
Q

Weight loss with increased appetite is symptomatic of what (hypo or hyper-thyroidism)?

A

Hyperthyroidism

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63
Q

Palpitation are symptomatic of what (hypo or hyper-thyroidism)?

A

Hyperthyroidism

64
Q

Modest weight gain with anorexia is symptomatic of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

65
Q

Dry, coarse sking is symptomatic of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

66
Q

Frequent BMs are symptomatic of what (hypo or hyper-thyroidism)?

A

Hyperthyroidism

67
Q

Constipation is symptomatic of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

68
Q

Tremor/proximal muscle weakness is symptomatic of what (hypo or hyper-thyroidism)?

A

Hyperthyroidism

69
Q

Cold intolerance is symptomatic of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

70
Q

Weakness, arthralgias is symptomatic of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

71
Q

Swelling of the hands/face/legs is symptomatic of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

72
Q

Loss of hair is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

73
Q

Increased BP is a sign of what (hypo or hyper-thyroidism)?

A

Hyperthyroidism

74
Q

Tachycardia/A-fib is a sign of what (hypo or hyper-thyroidism)?

A

Hyperthyroidism

75
Q

Hyperdynamic cardiac pulsations/accentuated S1 is a sign of what (hypo or hyper-thyroidism)?

A

Hyperthyroidism

76
Q

Periorbital puffiness is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

77
Q

Decreased BP is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

78
Q

Bradycardia is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

79
Q

Dry, coarse, cool skin is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

80
Q

Warm, moist skin is a sign of what (hypo or hyper-thyroidism)?

A

Hyperthyroidism

81
Q

Impaired memory is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

82
Q

Mixed hearing loss is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

83
Q

Somnolence is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

84
Q

Peripheral neuropathy is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

85
Q

Carpal tunnel syndrome is a sign of what (hypo or hyper-thyroidism)?

A

Hypothyroidism

86
Q

What are the questions that should be asked in head trauma (9 on handout)?

A 
A&O?
MOI
Time of injury
LOC?
Subsequent level of alertness
Amenesia
HA
Vision changes
Bleeding from nose/ear/eyes
87
Q

True or false: LOC is the best way to tell if a patient has had a concussion.

A

False - can occur without LOC

88
Q

What are signs of a concussion?

A

Unsteadiness
Abnormal behavior
Impaired brain function

89
Q

When does the anterior fontanel usually close?

A

18 months

90
Q

When does the posterior fontanelle close?

A

2 months

91
Q

What is a common cause of a sunken fontanelle?

A

Dehydration

92
Q

What are common causes of a bulging fontanelle?

A

Vomiting, coughing, crying

93
Q

What is the normal fontanelle size at birth?

A

4-6 cm

94
Q

What is caput succedaneum?

A

Subcutaneous edema over the presenting part of he head at delivery (scalp edema)

95
Q

How can you differentiate caput succedaneum from other etiologies?

A

Edema of the head usually crosses over suture lines

Transluminates

96
Q

What is cephalhematoma?

A

Subperiosteal collection of blood

97
Q

How can you differentiate cephalhematoma from other etiologies?

A

DOES NOT cross suture line

DOES NOT transluminate

98
Q

What is plagiocephaly? How is it usually caused?

A

Asymmetry of the head

Baby laying in the same way for long periods

99
Q

External/middle ear disorders are what type of hearing loss (conductive or sensorineural)?

A

Conductive

100
Q

inner ear disorders are what type of hearing loss (conductive or sensorineural)?

A

Sensorineural (involve cochlear nerve)

101
Q

How do you determine if the ears are low in a child?

A

Draw a line from the side of the eye to the ear

102
Q

What is the accumulation in the ear of newborns that prevent their TMs from being seen?

A

Vernix caseosa

103
Q

Why is pneumatic otoscopy used?

A

To determine if a child has otitis media, as their crying/coughing/vomiting may cause their TMs to become erythematous and inflamed.

It checks for fluid.

104
Q

How do infants breathe? (out of nose, mouth, with ribcage, abdomen etc)?

A

Obligate nasal breathers

105
Q

A nasal crease is the result of what activity?

A

Rubbing nose due to drainage

106
Q

Allergic shiners are what?

A

Pooling of blood (seen as a dark spot) beneath the eyes due to congestion.

107
Q

When do the maxillary sinuses develop?

A

About 1 year old

108
Q

When do the ethmoid sinuses develop?

A

About 6 years of age

109
Q

When do the sphenoid sinuses develop?

A

About 6 years of age.

110
Q

When does the frontal sinus develop?

A

About 10 years of age

111
Q

When are the sinuses fully developed?

A

About 21 years of age.

112
Q

Are antenatal teeth removed?

A

Yes

113
Q

How long to epstein pearls last?

A

2-3 months after birth

114
Q

Kissing tonsils are what grade?

A

4+

115
Q

When does the peak size of tonsils occur?

A

Between 2-6 years of age

116
Q

True or false: 2+ tonsils are always a worrisome sign.

A

False–common size for young age. Worrisome if erythematous or exudate

117
Q

When do teeth begin to erupt?

A

6-7 months

118
Q

How many teeth are added every month after the first teeth erupt?

A

about 4 teeth every 4 months

119
Q

Which, generally, are the first teeth to erupt?

A

The upper and lower incisors

120
Q

When is the full complement of teeth erupted?

A

2-3 years

121
Q

When does shedding of teeth generally occur?

A

5 years old

122
Q

When do second teeth begin to erupt?

A

6-7 years

123
Q

Where are stentson’s ducts found?

A

Near the 2nd upper molar

124
Q

Where are Wharton’s ducts found?

A

Below the tongue

125
Q

A deviation of the tongue to one side may be indicative of a lesion of what nerve?

A

CN XII

126
Q

If the uvula does not rise with phonoation, this may be an issues in what nerve?

A

CN X

127
Q

What opthalmic emergency is indicated with flashing lights in an eye?

A

Retinal detachment

128
Q

Transient loss of vision may be a medical emergency if this is the cause (among others).

A

Emoboli occluding the opthalmic artery.

129
Q

Exophtalmos is most commonly caused by what?

A

Thyroid disease

130
Q

What is the numerator in the Snellen eye chart?

A

Distance from the chart

131
Q

What is the denominator in the Snellen eye chart?

A

Distance the average eye can read the chart.

132
Q

When is a swinging light test indicated?

A

When you suspect Marcus Gunn Pupil

133
Q

What does the lateral penlight test look for? Why is it important?

A

Estimates the depth of the anterior chamber of the eye. NEED to do this before instilling mydriatic drops to the eye.

134
Q

A bulging TM is indicative of what?

A

otitis media

135
Q

A retracted/neutral TM with other signs of infection is indicative of what?

A

Otitis media with effusion

136
Q

What are the indications of an otoscopic exam for children?

A
  1. URI
  2. Tugging of ears
  3. Irritability
  4. Difficulty sleeping
  5. Fever
  6. Otalgia
  7. Otorrhea
  8. Hearing loss
137
Q

what position should uncooperative children be placed in when performing an otoscopic exam?

A

Supine or prone, held down by parents

138
Q

What are the signs on the eyebrows of a patient with hypothyroidism?

A

Short and do not extend beyond temporal canthus

139
Q

What are xanthalasma?

A

Fatty deposits around the eyes that may indicate hypercholestremia

140
Q

Fasciculations/tremors of the eyelids can be seen in what disease?

A

Hyper thyroidism

141
Q

What are epicanthal folds?

A

The vertical fold of skin nasally that covers the lacrimal caruncle

142
Q

What is leukocoria?

A

A white reflex in the eye that may be caused by a congenital cataract or retinoblastoma

143
Q

When is visual fixation present?

A

Birth

144
Q

When is visual fixation well developed?

A

6-9 weeks

145
Q

When is visual following developed?

A

3 months

146
Q

When is visual accommodation developed?

A

4 months

147
Q

When is steropsis developed?

A

4 months

148
Q

True or false: poor visual fixation after 6 months of age is ALWAYS worrisome.

A

True

149
Q

What should eye screening at 6-12 months include?

A

Red reflex, inspection, fix and follow

150
Q

What should eye screening at 3-5 years consist of?

A

Red reflex
Inspection
Visual acuity
Cover-uncover test

151
Q

What is the normal visual acuity for children 3+?

A

20/40 or better

152
Q

What is strabismus?

A

Misalignment of the eyes

153
Q

What is esotropia?

A

Inward misalignment of the eye

154
Q

What causes psueudostrabismus?

A

An apparent misalignment of the eyes that is actually caused by epicanthal folds, and is not an actual misalignment

155
Q

How can you differentiate between pseudostrabismus and true strabismus?

A

Look for the light reflection–should be in the pupils for both eyes.

156
Q

What is amblyopia?

A

Loss of visual acuity due to active cortical suppression of vision of the eye

157
Q

What is the cause of amblyopia?

A

Untreated strabismus (among others)

Clinical Med (30 decks)

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