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Head And Neck > Head And Neck - History Taking > Flashcards

Head And Neck - History Taking Flashcards

1
Q

What symptoms should be asked in a head and neck history?

A

Sore throat
Dysphonia- hoarseness
Dysphagia
Mouth/throat ulcer
Neck lump

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2
Q

What id a lifestyle factor to consider in history?

A

Smoking
Alcohol

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3
Q

What is another important aspect to history in head and neck?

A

Family history (thyroid problem)

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4
Q

Where should you examine for head and neck?

A

Neck
Oral cavity
Pharynx
Larynx
Nose/ears/salivary glands

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5
Q

What nodes are in level 1 of the neck nodes?

A

Submental
Submandibular

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6
Q

What nodes are in level 2, 3 and 4 of the neck nodes?

A

Nodes in the anterior edge of SCM

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7
Q

What nodes are in level 5 of the neck nodes?

A

Posterior triangle
Feel for posterior nodes
Include supraclavicular fossa

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8
Q

What nodes are in level 6 of the neck nodes?

A

Pretracheal

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9
Q

How should salivary glands be palpated?

A

Bimanual palpation
Feel gland and associated duct

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10
Q

What should you ausculatate for in head and neck?

A

Thyroid bruit (grave’s thyroiditis)
Carotid bruit (carotid stenosis)

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11
Q

What can be used for throat examination?

A

Indirect laryngoscopy
Fibre optic nasolaryngoscopy
Rigid larygoscopy

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12
Q

What investigations should be done for head and neck?

A

Fine needle aspiration cytology
CT/MRI/PET scan
Us scan
Plain X-ray
Contrast swallow
Endoscopy

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13
Q

What should be considered when a patient present with a neck lump?

A

How long?
Site?
Fluctuates?
Sore?
H&N symptoms?
B symptoms
Travel?

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14
Q

What should be examined for in neck lumps?

A

Site
Size
Shape
Sore
Skin
Stuck
Soft

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15
Q

What would a reactive lymph node feel like?

A

Oval
Soft
Smooth
Mobile
Tender

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16
Q

What can be causes of salivary gland swelling?

A

Tumour eg benign pleomorphic adenoma
Inflammation- parotitis

17
Q

What should be asked in history of hoarseness?

A

How long?
Recent URTI?
Persistent or intermittent?
Pain?
Cough/ choking/ swallowing?
Asthma/ rhinosinusitis/ reflux?
Voice use?
Smoker?
Medication?

18
Q

What are benign causes of hoarseness?

A

Nodules
Cysts
Vocal abuse
Laryngitis
Infection
Smoking
Reflux

19
Q

What can be a non benign cause of hoarseness?

A

Laryngeal carcinoma

20
Q

What should be asked with dysphagia?

A

What is difficult?
Persistent/ intermittent?
Pain?
Where?

21
Q

What is a cause of dysphagia in the lumen?

A

Foreign body

22
Q

What is a cause of dysphagia in the wall?

A

Tumour
Stricture
Neuromuscular
Pouch

23
Q

What is a cause of dysphagia that is extra luminal?

A

Thyroid
Heart
Mediastinal mass

24
Q

What can be used to investigate the cause of dysphagia?

A

Barium swallow

25
Q

What is FOSIT?

A

Feeling of something in throat
Globus pharyngeus

26
Q

Does FOSIT present with dysphagia?

A

No

27
Q

Is FOSIT a red flag symptom?

A

No

28
Q

What can FOSIT be caused by?

A

Acid reflux “silent” (laryngopharngeal reflux)
Stress/ anxiety

29
Q

Where are common sites of head and neck cancer?

A

Oral cavity
Larynx
Oropharynx
Nasopharynx
Hypopharynx

30
Q

What does a malignant neck node feel like?

A

Round
Firm
Irregular
Fixed
Non-tender

31
Q

What is the symptom of airway obstruction?

A

Difficulty breathing

32
Q

What are the signs of airway obstruction?

A

Stridor
-inspiratory = obst above vocal cord level)
- expiratory = wheeze
- biphasic = below vocal cords and above trachea

33
Q

What are causes of airway obstruction?

A

Infection
Tumour
Foreign body

34
Q

How should airway obstruction be treated?

A

ABC
Humidifies O2
Steroids
Adrenaline nebuliser
Secure the airway (intubate; FONA - cricothyroidotomy, tacheostomy)

35
Q

How does bacterial tonsilitis present?

A

Pus covering
Neck nodes
Fever
No cough

36
Q

When should tonsilectomy be offered?

A

6-7 attacks in 1 year
Disrupts daily activities
More than 1 quinsy

Head And Neck (9 decks)

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