Head and Neck Flashcards
polymyalgia rheumatica symptoms
pain and stiffness where? when are symptoms worse? generalized feelings? weakness? other conditions associated with PR? what lab would you take?
pain and stiffness in proximal muscles worse in morning and after prolonged inactivity fever, weight loss, fatigue, depression no weakness giant cell arteritis sedimentation rate
giant cell arteritis symptoms
headache
temporal complaint
jaw claudication
anterior cervical lymph nodes drain what
posterior cervical lymph nodes drain what
anterior - internal throat, posterior pharynx, tonsils, thyroid
posterior - skin on back of head and URI
tonsillar lymph nodes drain what
submandibular lymph nodes drain what
submental lymph nodes drain what
tonsillar - tonsils, posterior pharynx
submandibular - floor of mouth
submental - teeth, intraoral cavity
preauricular lymph nodes drain what
post auricular lymph nodes drain what
preauricular - eyes and external ear
postauricular - scalp
occipital lymph nodes drain what
supraclavicular lymph nodes drain what
occipital - skin back of head
supraclavicular - thoracic cavity and abdomen
does lypmphadenopathy occurs more locally or generalized
most common
locally
most common in head and neck
what are you looking for on lymph node palpation
tenderness - pain or no pain
mobility - mobile or non mobile
texture - hard or soft
what are possible findings on thyroid exam
diffuse enlargement
single nodule
multiple nodules
tenderness - thyroiditis
what are symptoms of hypothyroid
fatigue cold intolerance weight gain depression/lethargic hair loss loss lateral 1/3 of eyebrow dry coarse brittle hair dry rough skin thin brittle nails cold hands and feet constipation puffiness around periorbital region enophthalmos heavy and more frequent menstruation
what symptoms of hyperthyroid
heat intolerance weight loss nervousness, irritability, anxiety fine thin hair warm velvety smooth skin increased appetite tremors exophthalmos lid lag - eyelid lags behind globe movement on downward gaze increased basal metabolic rate light and less frequent menstruation muscle weakness
what are happens to DTRs, pulse, and BP when talking about hyperthyroid and hypothyroid
DTRs, pulse, and BP increase in hyperthyroid
DTRs, pulse, and BP decrease in hypothyroid
patient presents with fine hair, smooth skin, and exophthalmos
hyperthyroid
patient presents with coarse hair, dry skin, and enophthalmos
hypothyroid
what is the dominant thyroid hormone
T3
what is the endocrine process of thyroid gland
hypothalamus - TRH
pituitary gland - TSH
thyroid gland - T3 and T4
tissues - T4 converted to T3
too much T3/T4 shuts down hypothalamus and pituitary gland from releasing
thyroid symptoms occur when excess __ prevents what
why is the excess __ produced?
excess cortisol and CRH from hypothalamus
excess cortisol prevents T4 to T3 conversion in tissues
CRH prevents production of TSH from pituitary
excess cortisol is produced in response to stress, physiological trauma, infection, allergies, and dysbiosis
what is the thyroid self test
barnes test
basal metabolic rate and temperature
normal range 97.8 - 98.2
hypothyroid - below 97.8
hyperthyroid - above 98.2
what is a competitive inhibitor of T3
reverse T3
giant cell arteritis symptoms
what is the cause
what vessels does the condition affect
are bruits common with this condition
treatment
jaw claudication, tender temporal region, headache
unknown cause
medium and large arteries
BRUITS are NOT common with this conditon
corticosteroids
