Head and Neck Exam 2 Flashcards
Mouth and Throat PE Question
Any problems with your mouth, throat, tongue or teeth such as pain, bumps, lumps, etc.?
Neck PE Exam
Any lumps or stiffness in your neck?
What happens in Angular Cheilitis?
Saliva wets and macerates the infolded skin, often leading to secondary infection with Candida
What happens in Actinic Cheilitis?
Lip loses its normal redness and may become scaly
What first develops in Herpes Simplex?
Cluster of vesicles
Angioedema
Swelling seen in allergic reactions
Where is associated Urticaria and Pruritis uncommonly seen?
Angioedema in bradykinin and complement-derived mediators
What is Hereditary Hemorrhagic Telangiectasia? (Olser-Weber-Rendu Syndrome)
Multiple small red spots on the lips
What is accompanied in Peutz-Jeghers Syndrome?
Numerous intestinal polyps
Chancre of Primary Syphilis
Ulcerated papule with an indurated edge
Carcinoma of the Lip
Usually affects lower lip commonly seen in fair skinned people with over exposure to the sun
What are Koplik’s Spots an early sign for?
Measles (rubeola)
What do we do for Gingival Hyperplasia?
Phenytoin therapy
Smooth Tongue (Atrophic Glossitis)
A smooth and often sore tongue that has lost its papillae suggests a deficiency in riboflavin, niacin, folic acid, vitamin B12, pyridoxine, iron, or treatment with chemotherapy
Can Hairy Leukoplakia be scraped off? Where are they seen?
No; HIV and AIDS
What 5 things do we look for in the tonsils?
- Color and symmetry
- Exudate
- Swelling
- Ulceration
- Tonsillar enlargement
Pharyngitis
Redness is diffuse and intense
What would a patient complain of in Pharyngitis?
Sore throat or at least a scratchy one
What 2 things could cause Pharyngitis?
Virus or bacteria
What 2 common causes are of little chance for Pharyngitis if the patient has no fever, exudate, or enlargement of cervical lymph nodes?
- Group A Streptococci
2. Epstein-Barr virus (infectious mononucleosis)
Cause of Diphtheria
Acute infection caused by Corynebacterium Diphtheriae
What does the deep purple color of lesions in the pharynx suggest?
Kaposi’s Carcinoma seen in AIDS - low-grade vascular tumor associated with Human Herpesvirus 8
What do we note and look for in the neck?
Symmetry and any masses or scars; enlargement of parotid or submandibular glands or any visible lymph nodes
What is a clue to unsuspected thyroid disease?
Scar of past thyroid surgery
What does enlargement of a supraclavicular node, especially on the left, suggest?
Possible metastasis from a thoracic or an abdominal malignancy
Do we palpate the lymph nodes?
Yes - pads of middle and index fingers
What do we note in lymph nodes?
Size, shape, delimitation (discrete or matted together), mobility, consistency, and any tenderness
What do tender nodes suggest?
Inflammation
What do hard or fixed nodes suggest?
Malignancy
What measurement is significant for lymph nodes in supraclavicular fossa?
> 1cm
normally <2cm is insignificant
What do we look for in the trachea?
Any deviation from midline due to something like a mass
What could tracheal deviation possibly suggest besides a tracheal mass?
Mediastinal mass, atelectasis, or a large pneumothorax
Goiter
Enlarged lymph node of twice its normal size
Do we palpate the thyroid gland?
Yes - can be difficult
