Head and Neck History Taking Flashcards
What are the methods of throat examination?
Indirect laryngoscopy
Fibre optic nasolaryngoscopy
When might auscultation be used?
- Thyroid bruit (Grave’s thyroiditis)
- Carotid bruit (carotid stenosis)
What are the relevant head and neck investigations?
FNAC
CT/MRI/PET scan
US scan
Plain X-ray
Contrast Swallow
Endoscopy
What is the first line investigation for neck lump?
FNAC
When is FNAC contraindicated?
In pulsatile lumps
When do you get enlarged salivary glands?
Tumour – e.g.Pleomorphic Adenoma
Inflammation - Parotitis
What is a common pathology of the submandibular gland?
Duct calculi
What might you ask a patient suffering from hoarseness?
- How long?
- Persistent or Intermittent?
- Pain?
- Cough/Choking/Swallowing?
- Voice use?
- Asthma/Rhinosinusitis/Reflux?
- Smoker?
- Medication?
INhalers can become irritating to volcal chords
What causes hoarseness?
- Nodules
- Cysts
- Vocal abuse
- Laryngitis
- Infection
- Smoking
- Reflux
Laryngeal cancer
Which nerve compression may result in hoarseness?
Recurrent laryngeal nerve
What questions are useful when the patient has dysphagia?
- What is difficult? food? water?
- Persistent/Intermittent?
- Pain?
- Where?
- Well Localised in Neck
- Poorly localised lower down.
What are the luminal causes of dysphagia?
Foreign body
What are the wall causes of dysphagia?
Tumour, stricture, neuromuscular, pouch
What are the mediastinal causes of dysphagia?
Thyroid, heart, mediastinal mass
What is the cause of dysphagia if food goes down but water doesn’t?
Neuromuscular
What is meant by FOSIT?
Feeling of something in throat
What causes FOSIT?
Globus pharyngeus,
Spasm of the ring of muscle associated with the cricoid cartilage (cricopharyngeus)
What causes globus pharyngeus?
Acid reflux
Anxiety, stress
Does Globus pharyngeus cause dysphagia?
NO - easier with food
Not a red flag symptom
What are the benign and malignant H and N disorders?
What is treatment for head and neck cancer?
Surgery
Radiotherapy
Chemotherapy
Pallation
What are causes of airway obstruction?
Infection
Tumour
Foreign body
How do you treat with ABC for airway obstruction?
Secure the airway e.g. Intubate; ?Tracheostomy, Humidified O2 , Steroids, Adrenaline nebuliser.
Where is a cricothyroidotomy made?
What is defined as bacterial tonsilitis?
- Bacterial Tonsillitis: (pus covering, neck nodes, fever, no cough)
- 6-7 attacks in 1 year (5 per year over two years, 3 per year over three years)
- Disrupting daily activities
- More than 1 quinsy
Quinsy: inflammation of the throat, especially an abscess in the region of the tonsils.
