Head and neck - history taking, examination and investigation Flashcards
Symptoms of H&N problems
dysphagia, odynophagia, dysphonia, sore throat, lump, ulcer
What is dysphonia?
hoarseness
How are the salivary glands examined?
bimanual palpation
examination of the throat
indirect laryngoscopy
fibre optic nasolaryngoscopy
Auscultation findings of neck lumps
thyroid bruit eg grave thyroiditis
carotid bruit eg carotid stenosis
pseudoaneurysm
Investigations of head and neck
FNAC - not in pulsatile mass
CT/MRI/PET, US, contrast swallow, x ray, endoscopy
Presenting complaints of neck lump questions
how long, sore, site, fluctuates, other symptoms, travel, B symptoms - lymphoma
Examine neck lump - 7 S’s
site, sore, soft, shape, stuck, skin, size
Reactive lymph node characteristic
oval, soft, smooth, mobile, tender
Salivary gland problems
pleomorphic adenoma
cancer
duct calculus
Hoarseness - presenting complaint questions
how long, persistent or intermittent, pain, cough/choking/swallowing, voice use, asthma, rhinosinusitis, reflux, smoker, medication
Causes of hoarseness
vocal cord - nodules, vocal abuse, cysts
laryngitis, smoking, laryngeal cancer, infection, reflux, recurrent laryngeal nerve paralysis
Dysphagia questions
what is difficult eg solid/liuids
persistent or intermittent
pain, where
Causes for dysphagia - solid and liquid
solid = blockage, stricture, tumour liquid = neuromuscular problem
FOSIT
feeling of something in throat
eg acid reflux, stress, cricopharyngeus spasm
usually benign if no related dysphagia
