Head and Neck history taking Flashcards
what are common head and neck symptoms to cover in history taking?
sore throat
Dysphonia -Hoarseness
Dysphagia
Odynophagia
Mouth/Throat Ulcer
Neck Lump
smoker/alcohol intake
family history
what sites are important to cover in examination?
Neck
Oral cavity
Pharynx
Nasopharynx
Oropharynx
Hypopharynx
Larynx
Supraglottis
Glottis (vocal cords)
Subglottis
Nose/Ears/Salivary Glands
how many levels of the neck are there?
six commonly described levels in the neck
what is level one of the neck?
submental and submandibular area
what are levels two, three and four?
They follow the sternocleidomastoid and sit under the anterior edge of that muscle
what is examined within levels two, three and four?
deep cervical lymph nodes
what is felt for in posterior triangle/level 5?
posterior nodes
five also includes supraclavicular fossa
what is level 6 and when is it relevant in patients?
pretracheal, and it’s relevant in patients who might have thyroid conditions such as thyroid cancer
what major salivary glands are palpated for?
parotid gland, submandibular gland and the sublingual gland
how are salivary glands felt for?
the use of by manual palpation where one places the hand both inside and outside the patient’s mouth to palpate the glands and the associated ducts.
Just in case we might feel any swelling’s or indeed any stones or calculi within the ducts that drain these salivary glands.
note location of major salivary glands
what would cause a thyroid bruit?
A thyroid bruit is described as a continuous sound that is heard over the thyroid mass. (If you only hear something during systolic, think about a carotid bruit or radiating cardiac murmur.) A thyroid bruit is seen in Grave’s disease from a proliferation of the blood supply when the thyroid enlarges.
when would you perform auscultation?
Thyroid bruit (Grave’s thyroiditis)
Carotid bruit (carotid stenosis)
what would cause a carotid bruit?
A carotid bruit is a vascular sound usually heard with a stethoscope over the carotid artery because of turbulent, non-laminar blood flow through a stenotic area
what do these images show?
minor cleft palate, tonsillitis, mid tongue abscess following piercing
what are these images all examples of?
early oral cavity cancer, including lip cancer
what are different methods of throat examination?
Fibreoptic Nasolaryngoscopy
Indirect Laryngoscopy
(Obsolete)
Rigid laryngoscopy
what does this image show?
“Pearly white” normal vocal cords