Head and Neck Clinical Lecture

Question 1

how would you examine the throat?

Answer 1

fibre optic nasolaryngoscopy

Question 2

name the two major salivary glands

Answer 2

parotid and submandibular

Question 3

when auscultating the neck you hear a thyroid bruit. what does this indicate?

Answer 3

that there is graves thyroiditis

Question 4

what wold cause a carotid bruit to be heard on auscultation?

Answer 4

carotid stenosis

Question 5

what investigations are there for the head and neck?

Answer 5

> fine needle aspiration cytology
> CT
> MRI
> PET
> ultrasound
> X-ray
> contrast swallow
> endoscopy

Question 6

what investigation is the most important investigation for neck lumps?

Answer 6

fine needle aspiration cytology

Question 7

what are the seven s’s to think of when examining a neck lump?

Answer 7

> site
> size
> shape
> sore
> skin
> stuck
> soft

Question 8

what can cause a neck lump?

Answer 8

> brachial cyst
lipoma
thyroglossal cyst
reactive lymph node

Question 9

describe the characteristics of a reactive lymph node

Answer 9

> oval
> soft 
> smooth
> mobile
> tender

Question 10

what can cause swelling of the salivary glands?

Answer 10

> tumours (pleomorphic adenoma)

> inflammation (parotitis)

Question 11

what can vocal cord problems can cause hoarseness?

Answer 11

> nodules
cysts
vocal abuse

Question 12

what can laryngitis, smoking, reflux and laryngeal cancer all cause?

Answer 12

hoarseness

Question 13

what oesophageal lumen problems can lead to dysphagia?

Answer 13

foreign bodies

Question 14

what wall changes tot he oesophagus can lead to dysphagia?

Answer 14

> tumour
stricture
neuromuscular
pouch

Question 15

what extra-luminal changes can cause dysphagia?

Answer 15

> thyroid
heart
mediastinal mass

Question 16

what would you suspect the cause dysphagia to be if liquids are difficult to swallow not food stuffs?

Answer 16

neuromuscular problem

Question 17

what is FOSIT, globus pharyngeus?

Answer 17

feeling of a lump in the throat with no dysphagia. It is related to stress, anxiety and acid reflux. it is not a red flag symptom.

Question 18

describe the characteristics of a malignant neck node

Answer 18

> round
> firm
> irregular
> fixed
> non-tender

Question 19

how may you treat an emergency airway obstruction?

Answer 19

> intubate
> tracheostomy
> humidified O2
> steroids
> adrenaline nebuliser

Question 20

what is bacterial tonsillitis?

Answer 20

pus covering, neck nodes, fever and no cough

Question 21

when would you offer a tonsillectomy?

Answer 21

> 6-7 tonsillitis attacks in one year (5 over 2yrs, 3 per yr over 3yrs)
disruption of daily activities
more than one quinsy