Head and neck history and examinations Flashcards
What are the sections of head and neck exam?
inspection
palpation
percussion
auscultation
List five things in inspection
scars and deformities
sinuses
lumps
skin lesions
appliances e.g. tracheostomy
What are the areas to assess in palpation
parotids
anterior triangle
posterior triangle
inferior neck midline for thyroid mass whilst swallowing and tongue protrusion
What are you assessing for when you ask patient to stick out tongue and feel midline inferior neck?
thyroglossal cyst
Why do you percuss?
to detect goitre- retrosternal extent
Why do you auscultate?
assess for bruit in vascular lesions e.g. carotid body tumour
List two imaging investigations you would do following findings in head and neck exam
USS for neck lumps + FNAC/core biopsy
MRI for soft tissue detail and CT for bone detail
List three blood tests that would be appropriate following head and neck exam
FBC
CRP
Thyroid profile if thyroid lump suspected
Autoimmune screen
Which blood test for sarcoid
ACE
Which blood test for wegners granulomatosis
cANCA
Which blood test for sjorgens syndrome?
SS-A and SS-B
List two features of Sjorgens syndrome
parotid swelling, dry mouth and eyes
Which three areas of the mouth would you inspect in mouth exam?
oral cavity
buccal cavity
oropharynx
What would you palpate in the mouth examination?
parotid duct
floor of mouth and submandibular duct
tongue base
temporomandibular joint
neck- cervical lymphadenopathy
What imaging could you offer following mouth exam?
USS for salivary gland architecture/stones
silaography for stones/sticture
List three red flag symptoms for head and neck history
hoarseness
dysphagia
lump
pain-neck, ear (otalgia), on swallowing (odynophagia)
(smoking- not symptom but strong aetiological link)
List four risk factors for head and neck cancers
smoking
male
age >40 years
HPV infection
wood workers
Which HPV infections are risk factors for head and neck cancers
16-18
Name a cancer that wood workers are at risk of developing
sino-nasal tumour- adenocarcinoma
List three differentials for salivary glands swellings
stones
infection
ranula??
benign neoplasia
malignant neoplasia
Name the salivary glands
parotid
submandibular
sublingual x2
What is ranula?
A ranula is a spit-filled cyst that forms under your tongue. It can result from a blocked salivary gland.
