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Physical Exam Midterm & Final > Head, Face, Neck, & Lymphatics > Flashcards

Head, Face, Neck, & Lymphatics Flashcards

1
Q

Vertex

A

Top of the head

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2
Q

Scalp

A

Calvarium

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3
Q

Parotid duct AKA…

A

Stenson’s duct, drains saliva into the mouth just behind 2nd molar

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4
Q

Worton’s duct

A

Submandibular duct

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5
Q

TMJ

A

Tempormandibular joint

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6
Q

Common or concerning symptoms of the head include…

A

Headache, history of head injury

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7
Q

Common or concerning symptoms of the eyes include…

A

Visual disturbances, spots (scotomas), flashing lights, use of corrective lenses, pain, redness, excessive tearing, double vision (diplopia)

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8
Q

Common or concerning symptoms of the ears include…

A

Hearing loss, ringing (tinnitus), vertigo, pain, discharge

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9
Q

Common or concerning symptoms of the nose include…

A

Drainage (rhinorrhea), congestion, sneezing, nose bleeds (epistaxis)

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10
Q

Common or concerning symptoms of the oropharynx include…

A

Sore throat, gum bleeding, hoarseness

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11
Q

Common or concerning symptoms of the neck include…

A

Swollen glands, goiter

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12
Q

What are the structures of the face

A 
Maxilla
Mandible
Zygomatic Arch
Nasal bones
TMJ
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13
Q

What is the TMJ

A

Joint where the mandible interacts with the temporal bone

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14
Q

What is unique about the zygomatic bone (think trauma)

A

It is often fractured when Pt is punched in the face (AKA orbital floor fracture)

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15
Q

What are the palpebral fissues

A

The space between the eye lids

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16
Q

What do the palpebral fissures look like in a downs pt? What about FAS pt?

A

They are upslanted in downs syndrome. They are shorter horizontally in fetal alcohol syndrome

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17
Q

What are the epicampful folds

A

Where the eyelids meet laterally (think palperbral commisure)

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18
Q

What are the nasolabial folds

A

The line from nares to the corner of the mouth

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19
Q

What do the nasolabial folds look like in Pts who have had a stroke

A

The pt will have facial droop due to damage to facial nerve so you won’t see the fold on the side effected by the stroke

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20
Q

What are the sinuses of the face

A

Frontal
Sphenoid
Ethmoid
Maxillary

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21
Q

What is the NLS?

A

The nasolacrimal sinus

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22
Q

Where does the NLS drain

A

Duct/sinus drains into the inferior meatus of the nose

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23
Q

Where are the frontal and maxillary sinuses

A 
Frontal = superior to eyebrows
Maxillary = inferior to orbits
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24
Q

What is the Down’s syndrome facies? What are other signs of Down’s?

A

Slanted palpebral fissues, flatened nasal bridge, prominent epicanthal folds, low set ears, large tongue, & brushfield spots on the iris

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25
What is the Cushing's Syndrome facies (i.e. Cushoid Facies)
Round face, double chin, increased cheek fat deposits, and facial flushing
26
What are the signs of FAS
Low nasal folds, flat face, Shorter nose, Underdeveloped jaw, & thin upper lip with smooth filtrum (most characteristic)
27
What is the most common cause of acromegaly?
pituitary adenoma secreting GH
28
What are the signs of acromegaly
``` Enlargement of hands, feet, and head Frontal bossing Palmar thickening Coarse features Prognathism (large, protruding jaw) ```
29
What is a pituitary issue called when it occurs before puberty? What about after puberty?
Pituitary issue before puberty = giantism | Pittuitary issue after puberty = acromegaly
30
What are possible causes of parotid enlargement
Sjogren’s Syndrome Mumps Chronic disease (DM, obesity, liver cirrhosis, etc) Neoplasm
31
What is Sjogren's?
It is an autoimmune disorder that attacks saliva secreting glands/cells in the body
32
What are some signs Sjogren's is associated with
Associated with dry eyes, dry mouth, and arthritis leading to 40% increased chance of lymphoma
33
How is Sjogren's diagnosed? How is it treated?
Dx with +SSA/SSB antibodies | Rx of cyclophosphamide and/or corticosteroids
34
If the parotid enlargement is unilateral it is most likely due to...
A neoplasm
35
What would a parotid enlargement due to neoplasm feel like
It would be hard and nontneder
36
If the parotid enlargement is bilateral it is most likely due to...
An infection
37
What is an infection in the parotid gland called
Parotitis
38
What is the most common cause of parotitis
Infection by Staph aureus
39
What would you notice upon palpation with parotitis
Pus from stenson's duct, warm, & tender
40
What is enlargement of the thyroid called
Thyromegaly
41
What is the most common cause of thyromegaly world wide
Iodine deficiency
42
Multinodular goiter characteristics are...
Rough, uneven, large
43
In Hashimoto’s the thyroid enlargement is due to...
Hypothyroidism
44
In Grave’s thyromegaly is due to...
Hyperthyroidism
45
Some signs/symptoms of thyromegaly include...
Horseness, SOB, stridor, and dysphagia (from compression on trachea)
46
Besides thyromegaly, the main characteristic of Grave's disease is...
Exopthalmous (bulging eyes due to autoimmune response to the soft tissue around the eyes)
47
Solitary nodule upon palpation should raise the flags for...
A malignancy
48
A malignant nodule is... (characteristics)
Fixed, hard, non-tender, solitary
49
The chance of malignancy is much more common in what type of patient (age)
Chance in a pediatric Pt is much more common than in an adult
50
What structures make up the anterior triangle of the neck? What about the posterior triangle?
Posterior – trapezius, SCM, and clavicle | Anterior – SCM, mandible, neck midline
51
What is lymphadenopathy (LAD)
Swollen, palpable, irregular lymph nodes
52
LNs that are solitary, hard, fixed, non-tender, and growing are characteristic of...
A malignancy
53
LNs that are solitary, erythematous, tender, fluctuant, and growing are characteristic of...
An infection (local)
54
LNs that are diffuse, symmetric, nodular, and static are characteristic of...
A systemic disease
55
LNs that are solitary or grouped, tender, and mobile are characteristic of...
A regional infection (such as sarcoid or lymphoma)
56
What are shotty nodes? What are their characteristics?
They are hard LNs due to hyperplastic lymph from previous inflammatory process. They should be static and mobile
57
Enlargement of supraclavicular nodes, especially on L, suggests...
mets from thoracic or lung malignancy
58
Supraclavicular adenopathy is...
swelling of the supraclavicular nodes; should NEVER be present; may be indicitative of thoracic, lung, or gastric cancer
59
Tinia capitus is...
Dermatafite infection of the scalp, can cause allopicia, often see exclamation point hairs; if untreated may turn into full blown kerion which is a full blown fungal infection; treat with systemic drugs
60
Excessive scaling on scalp may be...
Cellulitis or may be subarachnic dermatitis;Tx is with selenium sulfide
61
With polysistic ovarian syndrome a patient may have...
Excess facial hair due to excess testosterone
62
Roasia in elderly exhibits as...
Redness in face
63
What are the headache warning signs?
More frequent/severe over 3 months “Thunderclap” “Worst of my life” New onset after 50 Associated constitutional (fever, sweats, wt loss) Known Ca, HIV, or pregnancy Recent head trauma Focal deficits, vision change, neck stiffness (meningitis, neuro deficits, etc)
64
What is the main reason we palpate the retinal arteries?
To make sure there is adequate blood flow to the retinas
65
What is a condition that may cause irregular temporal pulses?
Giant cell arteritis
66
If the pt has more pain in their sinuses when bending forward what condition may they have?
Sinusitis
67
Pt has unilateral facial pain that is tender to palpation, dull toothache, purulent nasal drainage (symptoms greater then 7 days). What might they have?
Bacterial sinusitis
68
Tracheal deviation may be a sign of...
Pneumothorax, mediastinal mass, or atelectasis
69
What type of curvature should the C-spine have
Lordotic
70
What are the origins and insertions of the trapezius
Origin – nuchal line of occipital bone; sp of C7-T12 | Insertion – lateral clavicle, acromion process, and scapular spine
71
How many different directions can the neck move
6 directions

Physical Exam Midterm & Final (11 decks)

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