Head and Neck Exam Flashcards

Question

Congenital Muscular Torticolis

Answer 1

1. Injury and possible bleed into sternocleidomastoid muscle at birth 2. Treatment with stretching exercises

Answer 2

1. Stand behind and to side 1-2 ft away 2. Pt places finger in the non tested ear and moves it around 3. Exhale fully and then whisper 3 numbers or letters 4. Ask the patient to repeat what they heard 5. Repeat for the other ear

Answer 3

1. Assesses hearing: helps to differentiate between neurosensory and conductive hearing loss 2. Need 512 Hz vibrating fork 3. Place in the middle of the pt's vertex 4. Ask "where do you hear sound?"

Answer 4

1. Helps to determine whether each ear detects sound better through air or bone 2. A vibrating fork (512 Hz) is placed on pt's mastoid process then ask the pt to tell you when they no longer hear the sound, note the time in seconds 3. Immediately move the fork so the vibrating tines are about 2.5 cm from the pt's auditory canal 4. Ask the pt to tell you when they can't hear the sound, note the time in seconds 5. Normal test hears sound through air longer than bone

Answer 5

1. External or middle ear disorder 2. Causes: foreign body, otitis media, perforated eardrum, otosclerosis 3. Sound lateralizes to impaired ear 4. Bone conduction longer then or equal to air conduction

Answer 6

1. Inner ear disorder involving the cochlear nerve 2. Causes: loud noise exposure, inner ear infections, trauma, acoustic neuroma, familial disorders 3. Sounds lateralizes to the good ear 4. Air conduction longer than bone conduction

Answer 7

Note position in relation to the eyes: upper portion of auricle joins the scalp at or above the level of a line drawn from the inner and outer canthus of the eye

Answer 8

1. Difficult to see the TM in the first few days of life secondary to the vernix caseosa accumulation 2. Ear canal goes directly down from the outside 3. Pull the ear gently downward to see the TM

Answer 9

1. Should be a part of every exam of the ear | 2. Diminished movement is found in ear effusions and acute otitis media

Answer 10

1. Newborns are "obligate" nose breathers 2. Test patency by occluding one nare and observe breathing pattern 3. Catheter placement if concerned 4. Assess for a crease 5. Asses for allergic shiners

Answer 11

Maxillary: 1 year Sphenoid/ Ethmoid: 6 years Frontal: 10 years

Answer 12

1. Inspect the lips for any cleft 2. Inspect the palate for any cleft 3. Inspect the mouth for antenatal teeth

Answer 13

Pin head sized white or yellow, rounded elevations that are located along the midline of the hard palate near its posterior border or gums- causes by retained secretions and disappear within a few weeks to months

Answer 14

1. Relatively larger in middle childhood than in infancy or adolescence 2. Peak size of tonsils occurs between 2-6 years of age 3. Look for other signs of infection- erythema, cobblestoning, exudate, asymmetry

Answer 15

1. Teeth begin to erupt by 6-7 months with upper and lower central incisors 2. Four teeth are added every 4 months after that 3. Full complement of teeth by 2-3 years 4. Shedding of primary teeth usually occurs at 5 years 5. Secondary teeth usually begin in the 6th or 7th year

Answer 16

1. Common in children from 9 months to 5 years 2. Chronic unilateral rhinitis or congestion 3. Foul smell or bad breath 4. Treatment: removal

Answer 17

Reddish inflammation of the lip or lips and production of fissures that radiate from the angles of the mouth

Answer 18

Absence of the sense of smell. It may be due to lesion of the olfactory nerve, obstruction of the nasal fossae, or functional, without any apparent causative lesion

Answer 19

a congenital lesion due to the incomplete involution of the branchial cleft which is usually located in the lateral neck

Answer 20

A condition of the fontanel that may indicate increased ICP

Answer 21

Microbial destruction or necrosis of teeth

Answer 22

Inflammation and cracking of the lips

Answer 23

a mass of keratinizing squamous epithelium and cholesterol in the middle ear, usually caused by chornic otitis media, with squamous metaplasia or extension of squamous epithelium inward to line an expanding cystic cavity that may involve the mastoid and erode surrounding bone

Answer 24

premature closure of sutures of the skull

Answer 25

common facial discoloration seen in pregnancy

Answer 26

A neural tube defect with protrusions of brain and membranes that cover the openings in the skull

Answer 27

Bleeding from the nose

Answer 28

Multiple, small, white epithelial inclusion cysts found in the midline of the palate in newborn infants

Answer 29

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

Answer 30

Small fold of tissue that attaches the tongue to the floor of the mouth

Answer 31

Inflammation of the gingiva

Answer 32

Overactivity of the thyroid gland

Answer 33

Underactivity of the thyroid gland

Answer 34

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

Answer 35

Circumscribed, firmly attached, thick white patches on the tongue and other mucous membranes, often occurring as a precancerous growth.

Answer 36

Abnormal smallness of the head

Answer 37

The size and shaping of the head of a newborn in accommodation to the birth canal

Answer 38

Area of the throat that is located between the mouth and nasopharynx

Answer 39

Formation of bone tissue

Answer 40

Inflammation of the external auditory canal, usually due to bacterial or fungal infection; swimming, cerumen accumulation, foreign body, and trauma

Answer 41

Inflammation/ infection of the middle ear or tympanum

Answer 42

Deposits of bone resulting in the immobilization of the stapes

Answer 43

Deep infection in the space between the soft palate and the tonsil

Answer 44

Inflammation/ infection of the mucous membrane and underlying parts of the pharynx

Answer 45

Projecting shell- like structure on the side of the head, auricle

Answer 46

The impairment of hearing due to aging

Answer 47

Inflammation of the nasal mucosa

Answer 48

A thin watery discharge from the nose

Answer 49

A palpable cystic mass in the neck due to incomplete closure of the thyroglossal duct

Answer 50

An auditory sensation in the absence of sound heard in one or both ears, such as ringing, hissing or clicking

Answer 51

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

Answer 52

Abnormal contraction of the neck muscles resulting in an unatrual positioning of the head

Answer 53

A bony protuberance on the lingual aspect of the lower jaw in the in canine- premolar region

Answer 54

A bony protuberance in the midline of the hard palate

Answer 55

The formation of dense connective tissue in the middle ear, often resulting in hearing loss when the ossicles are involved

Answer 56

Conical projection of the posterior margin of the soft palate

Answer 57

Illusion of rotational movement in a patient that is often associated with an inner ear disorder

Answer 58

Excessive posterior cervical skin that is often associated with chromosomal anomalies

Answer 59

Do we need glasses?

Answer 60

Leading cause of blindness if not corrected

Answer 61

Leading cause of blindness <65 in the US. Cause cranial nerve paralysis of III, IV, and VI, and retinopathy

Answer 62

Central vision loss

Answer 63

Elevated pressure- peripheral vision lost first

Answer 64

Young pt may be due to migraine and in an older adult may be an emobli problem

Answer 65

Retinal detachment

Answer 66

Double vision, 2 eyes alignment problem or one eye optical problem

Answer 67

1. Position pt 20 ft from chart 2. If they use glasses other than reading use them 3. Cover one eye- read the smallest line 4. Usually start left to right in one eye and then switch eyes and go right to left for the second eye 5. Record as fraction

Answer 68

1. Testing near vision with hand held card 2. Helps identify the need for reading glasses or bifocals 3. Held 14 inches from pt's face

Answer 69

1. Testing for defect in any quadrant of the field of vision 2. Stand 3 ft from pt at eye level 3. Pt needs to focus on your eye- use glasses or contacts 4. Cover one eye, slowly bring your finger into the visual field halfway between you and the pt- 45 degree angle in each quadrant (4 per eye) 5. Request they report how many fingers they see

Answer 70

1. Eye movement is controlled by 3 cranial nerves, III, IV, and VI, and 6 extra-ocular muscles 2. Stand 3 ft from pt and have pt follow your fingers without moving head 3. Draw large "X" and then a "+" with index finger

Answer 71

A jerking or drifting of the eyes

Answer 72

Checking to see if the eyes will converge and the pupils will constrict *older patients lose this ability

Answer 73

1. Measure each pupil size- under normal light with a light shining in the eye

Answer 74

Look at pt's right eye and shine a light into it, the constriction is the direct response

Answer 75

Shine a light into the left eye and watch for constriction of the right eye

Answer 76

1. Clinical test for functional impairment in the optic nerves 2. Shine a light in one eye then rapidly swing over to the other eye 3. Should have a slight dilation in the second eye while light is crossing the bridge of the nose, but it should still constrict equally to the first eye as the light enters the pupil 4. If it continues to dilate rather than constrict an afferent defect is present (Marcus Gunn Pupil)

Answer 77

1. Helps to estimate the depth of the anterior chamber of the eye 2. Should be done before instilling mydriatic drops in the eye 3. Shine light from the temporal side of the head across the front of the eye parallel to the plane of the iris 4. Note the illumination of the iris nasally, if not lighted pt has a shallow anterior chamber indicating a risk of acute- angle glaucoma

Answer 78

1. Testing for ocular alignment by reflecting light off the pt's pupils 2. Stand in front of the pt about 2-3 ft away and shine light towards pt and observe where light reflects

Answer 79

Eye turned in, light reflected lateral to pupil

Answer 80

Eye turned out, light reflected medial to the pupil

Answer 81

1. Test used to detect tropia 2. Cover one of the pt's eyes when they are focused on a specific point 3. Observe movements in the uncovered eye

Answer 82

Eye shifts outward

Answer 83

Eye shifts inward

Answer 84

1. Used to detect presence of a phoria 2. Cover and uncover an eye and observe whether the covered eye moves 3. Results in esophoria or exophoria

Answer 85

1. Testing cranial nerve V 2. Out of line of vision, touch the cornea with a wisp of cotton 3. If intact CN V senses the touch as a FB in the eye 4. Sensory is CN V and motor response is CN VII

Answer 86

Vertical fold of skin nasally that covers the lacrimal caruncle

Answer 87

1. Orange to red light reflex from the fundus. This should be equal in both eyes and fill the pupil completely 2. Absent or abnormal reflex is reason for referral

Answer 88

A white reflex and could be caused by a congenital cataract or retinoblastoma

Answer 89

1. Red reflex and corneal light reflex 2. Inspection 3. Fix and Follow

Answer 90

1. Red reflex 2. Inspection 3. Visual Acuity 4. Cover-uncover test

Answer 91

20/400- 20/800

Answer 92

20/40 or better

Answer 93

Misalignment of the eyes

Answer 94

1. An appearance of misalignment of the eyes without actual strabismus present 2. Occurs most commonly when there is a broad nasal bridge 3. Light reflection is in the same place in both eyes

Answer 95

1. Loss of visual acuity due to active cortical suppression of the vision of the eye 2. Strabismus is one of the main causes 3. Single most effective screening test is the determination of visual acuity in noninvasive screening