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Systemic III > Head and Neck Exams > Flashcards

Head and Neck Exams Flashcards

1
Q

What should you generally observe when you walk a patient to an exam room regarding head and neck?

A

Size and Shape
Surgery or trauma
Cyanosis or jaundice
Pallor or pigment

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2
Q

Which tissues do not have lymphatics?

A

Brain, inner ear, bones, cartilage

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3
Q

Lymph system is an accessory route for interstitial fluid to go back into the blood

A

Free card

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4
Q

What’s the purpose of the lymph system?

A

Drainage of interstitial fluid to the blood
Drains plasma proteins and cellular garbage
Absorbs and transports fats from the GI system
Protects from infection
Defense mechanism!

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5
Q

Where does the lymph system drain into?

A

Lymph > veins > kidneys > out

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6
Q

What are lymph nodes made out of?

A

T and B cells

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7
Q

What is the purpose of B and T cells? Where are they most often found?

A

Phagocytize foreign proteins and prevent spread of infection to rest of body

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8
Q

What’s the most common reason for lymph adenopathy?

A

Viral infection

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9
Q

What can cause lymph adenopathy?

A 
Hyper-/neo-plasm
Autoimmune
Cancer
Inflammation
Leukocytic infiltrates
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10
Q

What does tender lymph nodes indicate?

A

Acute inflammation

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11
Q

How many lymph nodes are in the head?

A

300

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12
Q

Which lymph chains of the head drain more specific areas? Small or large? What can you learn about an infection?

A

Small areas drain more specifically. Will tell you where an infection may be

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13
Q

What are the smaller chains of the head?

A 
Occipital
Pre auricular
Post auricular
Submandibular
Submental
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14
Q

What does occipital drain? Where is it?

A

Under little occipital bump
Small chain lymph
Drains posterior scalp

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15
Q

What does posterior auricular lymph drain? Where is it?

A

Small chain lymph behind ear

Drains scalp, pinna and meatus

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16
Q

What does the submandibular lymph drain? Where is it?

A

Small chain under jawline
Upper lip, cheek, 1/3 lower lid
Anterior nasal cavity and sinuses
Tongue, soft palate, floor of mouth

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17
Q

What does the submental drain? Where is it?

A

Small chain cold sore bump
Lower lip, chin skin
Tip of tongue, floor of mouth

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18
Q

What does the preauricular (AKA anterior auricular) drain? Where is it?

A

Upper and medial 2/3 lids

Pinna and auditory meatus

19
Q

Which nodes drain from around the eyes?

A

Submandibular and preauricular

20
Q

What are the larger chains of the head?

A

Posterior cervical, superficial cervical, deep cervical, supraclavicular

21
Q

What does the posterior cervical lymph drain? Where is it?

A

Large chain. Posterior to sternocleidomastoid. Scalp, neck, occipital and postauricular

22
Q

What does the superficial cervical lymph drain? Where is it?

A

Large chain. On top of sternocleidomastoid. Cheek, neck

23
Q

What does the deep cervical lymph drain? Where is it?

A

Large chain. Underneath/behind sternocleidomastoid. Most of head and neck

24
Q

What do tonsillar nodes drain?

A

Tonsils and tongue

25
Q

Where are the supraclavicular lymph nodes

A

Right above clavicles

26
Q

In what order should you evaluate the nodes?

A

Occipital, Posterior auriculuar, Posterior cervical, Superficial cervical, Deep Cervical, Anterior auricular, Tonsillar, Submandibular, Submental

27
Q

How should you approach palpating the lymph nodes?

A

Walk four fingers along lymph nodes using pads of fingers.

Do both sides at same time

28
Q

How would you evaluate the lymph nodes

A 
Difficult to feel = normal
Tender = acute
Soft = inflamed
Hard and rubbery = metastatic/cancer (lymphoma)
Fixed and matted = Malignant
29
Q

How big would a lymph node be to be considered abnormal?

A

> 1cm (unless fought off prolonged infection)

30
Q

What is the largest endocrine gland in the body?

A

Thyroid

31
Q

Where is the thyroid gland ?

A

At base of neck where bowtie would go

Medial to sternocleidomastoid

32
Q

What does the thyroid gland do?

A

Produce hormones that affect
Growth/maturation
Heart rate and output
Thermoregulation and carb metabolism

33
Q

What would an anterior approach to palpating the thyroid be? How would you make sure the thyroid was free moving?

A

Have pt turn head to side you’re palpating to relax sternocleidomastoid
Push larynx over with thumb and palpate with other hand
Have patient swallow to ensure it’s free moving
Repeat on other side

34
Q

How would you do the posterior approach to palpating the thyroid? What’s the disadvantage?

A

From back, palpate both sides of thyroid using pads of fingers

35
Q

How would you interpret your findings with palpating the thyroid

A

Hard to feel = normal
Soft = goiter/inflam
Hard and rubbery = cancer
Tender = hemhorrage/infection

36
Q

When would you do a nose or throat exam on a patient?

A

Epiphora/dryness, proptosis, conjunctivitis, double vision
Headache, eye ache, bitemporal and occipital pain
Autoimmune or infective conditions

37
Q

What’s the purpose of the turbinates?

A

Warm, clean, moisten air
Lower = nasolacrimal drainage
Middle = most sinus drainage

38
Q

What do you want to examine when looking at the nose?

A

Shape (congenital anomalies)
Trauma
Inflammation

39
Q

How would you look into a patient’s nose? How far back do you need to go?

A

Have pt tilt head back, pignose them with thumb, brace hand and insert otoscope
Need to shine light past hairs

40
Q

What are you looking at when evaluating the nose?

A

Straightness of septum
State of the mucosa (inflam? discharge?)
Patency of nostrils, symmetry

41
Q

What is the light line on the nose of little kids called? What does it indicate?

A

Transverse lateral crease
Sign of allergies
Kids push their little noses up to wipe them

42
Q

What are you looking for when examining the mouth?

A

Color, symmetry, growths

43
Q

How do you look at the pharynx and tonsils

A

Place depressor in middle third of tongue, press down and have them say “ah”

44
Q

What are you keeping a careful lookout for when looking for lesions in the mouth?

A

Kaposi’s sarcoma

Systemic III (8 decks)

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