Head and Neck Examination Flashcards
Order of areas
Hair/Scalp -> Face -> Ears -> Eyes -> Nose -> Throat -> Neck (Lymph nodes/Thyroid)
What to look for: Hair
Hair Quality:
Fine Hair – Hyperthyroidism
Course Hair – Hypothyroidism
Tiny white Ovoid granules – nits (lice eggs)
Dandruff (Seb dem, Ezxema, Psoriasis)
What to look for: Scalp
Redness – Seborrheic dermatitis / Eczema
Redness with plaques – Psoriasis
Soft lumps - pilar cysts
Brown moles - May raise concern for melanoma
What to look for: Skull
observe general size, inspect any depressions
What to look for: Face
Facial Expression
Asymmetry
Pigmentation – port wine stain
Acne
Bells palsy
What to look for: Face - Cushing syndrome
moon face, red cheeks, excessive hair growth
What to look for: Face - Nephrotic syndrome
swelling around the exes, pale looking, puffy face
What to look for: Face - Parkinsons
Hypomania (decreased face mobility, stare)
What to too look for: Forehead
Temporal arteritis
SInusitis at Frontal Sinus
What to look for: Ears
Inspect the auricle and surrounding tissue
Observing for Deformities, Lumps, Bumps, Skin lesions, Cauliflower ears, Tophi or Discharge
Ear Tug test: Gently pull down on the ear lobe, or press
the tragus to see if it causes pain
Pain – Otitis Externa
No Pain – Otitis Media
What to look for: Eyes
Eyebrows, Eyes, Eyelids, Iris of Eyes
Eyebrows
Hair loss - SLE
Lateral Thinning - HYpothyroidism
Eyes/Eyelids
Ptosis - Horners syndrome, Myasthenia gravis
Xanthelsma -
Exopthalmos & Lid retraction - Hypothyroidism; Graves Disease
Eyes/Eyelids
Red and Painful eye - Conjunctivitis
Epiphora - Watering eyes
Absence of tearing - Dry eyes (drug side effect, environmental)
Yellow eyes - Sign of jaundice
Iris of eyes
Wilson’s Disease
* Kayser- Fleisher Ring
* Brown Ring around the eye - Copper Deposits
Arcus Senilis
* Grey / White ring, common in elder
Eye Examination
Gentle pressure, be aware this is a close up examination!
* Use of the fingers
* Examine the palpebral conjunctiva and sclera
* Ask patient to look up/down to see the sclera
Lips
Blue lips – cyanosis
Cheilitis – Inflammation of lips
Herpes Simplex
Angioedema
Mouth ulcers
Carcinoma of lips
What to look for: Nose
Palpate sinuses
Record any difference in pressure from left to right
Look for deviation of nose laterally or superiorly/inferiorly
Septum deviation/damage due to drug use
Nasal drip (allergies, cold, flu,)
Epistaxis (nose bleeds)
Broken nose
Gums
Gums (gingiva) - Should be a healthy pink/red colour
Gengivitis - Red swollen bleeding gums
What to look for: Mouth
Lips, Gums, Teeth, Tongue
Examine the external lips first, Use two fingers from each hand to gently look at the internal lips, gingiva and teeth
Tongue
Ask patient to protrude tongue
Normal colour (Pink)
Red (B 12 deffiiency)
Tonsilitis
Enlarged Tonsils
Teeth
Yellow Staining (smoking)
Brown staining (Coffee)
Neck
Inspection: Symmetry, Torticollis, Tracheal deviation
Checking thyroid - Goitre (swelling of thyroid)
Palpation - Stand behind patient, Ask them to swalow (Observe any deviations)
Trachea - Locate below the cricoid cartilage, Look for any obvious deviation,
Palpate either side and note the distance to the SCM (Distance should be the same)
