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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
Q

What is the Cushing’s Syndrome facies (i.e. Cushoid Facies)

A

Round face, double chin, increased cheek fat deposits, and facial flushing

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26
Q

What are the signs of FAS

A

Low nasal folds, flat face, Shorter nose, Underdeveloped jaw, & thin upper lip with smooth filtrum (most characteristic)

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27
Q

What is the most common cause of acromegaly?

A

pituitary adenoma secreting GH

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28
Q

What are the signs of acromegaly

A 
Enlargement of hands, feet, and head
Frontal bossing
Palmar thickening
Coarse features
Prognathism (large, protruding jaw)
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29
Q

What is a pituitary issue called when it occurs before puberty? What about after puberty?

A

Pituitary issue before puberty = giantism

Pittuitary issue after puberty = acromegaly

30
Q

What are possible causes of parotid enlargement

A

Sjogren’s Syndrome
Mumps
Chronic disease (DM, obesity, liver cirrhosis, etc)
Neoplasm

31
Q

What is Sjogren’s?

A

It is an autoimmune disorder that attacks saliva secreting glands/cells in the body

32
Q

What are some signs Sjogren’s is associated with

A

Associated with dry eyes, dry mouth, and arthritis leading to 40% increased chance of lymphoma

33
Q

How is Sjogren’s diagnosed? How is it treated?

A

Dx with +SSA/SSB antibodies

Rx of cyclophosphamide and/or corticosteroids

34
Q

If the parotid enlargement is unilateral it is most likely due to…

A

A neoplasm

35
Q

What would a parotid enlargement due to neoplasm feel like

A

It would be hard and nontneder

36
Q

If the parotid enlargement is bilateral it is most likely due to…

A

An infection

37
Q

What is an infection in the parotid gland called

A

Parotitis

38
Q

What is the most common cause of parotitis

A

Infection by Staph aureus

39
Q

What would you notice upon palpation with parotitis

A

Pus from stenson’s duct, warm, & tender

40
Q

What is enlargement of the thyroid called

A

Thyromegaly

41
Q

What is the most common cause of thyromegaly world wide

A

Iodine deficiency

42
Q

Multinodular goiter characteristics are…

A

Rough, uneven, large

43
Q

In Hashimoto’s the thyroid enlargement is due to…

A

Hypothyroidism

44
Q

In Grave’s thyromegaly is due to…

A

Hyperthyroidism

45
Q

Some signs/symptoms of thyromegaly include…

A

Horseness, SOB, stridor, and dysphagia (from compression on trachea)

46
Q

Besides thyromegaly, the main characteristic of Grave’s disease is…

A

Exopthalmous (bulging eyes due to autoimmune response to the soft tissue around the eyes)

47
Q

Solitary nodule upon palpation should raise the flags for…

A

A malignancy

48
Q

A malignant nodule is… (characteristics)

A

Fixed, hard, non-tender, solitary

49
Q

The chance of malignancy is much more common in what type of patient (age)

A

Chance in a pediatric Pt is much more common than in an adult

50
Q

What structures make up the anterior triangle of the neck? What about the posterior triangle?

A

Posterior – trapezius, SCM, and clavicle

Anterior – SCM, mandible, neck midline

51
Q

What is lymphadenopathy (LAD)

A

Swollen, palpable, irregular lymph nodes

52
Q

LNs that are solitary, hard, fixed, non-tender, and growing are characteristic of…

A

A malignancy

53
Q

LNs that are solitary, erythematous, tender, fluctuant, and growing are characteristic of…

A

An infection (local)

54
Q

LNs that are diffuse, symmetric, nodular, and static are characteristic of…

A

A systemic disease

55
Q

LNs that are solitary or grouped, tender, and mobile are characteristic of…

A

A regional infection (such as sarcoid or lymphoma)

56
Q

What are shotty nodes? What are their characteristics?

A

They are hard LNs due to hyperplastic lymph from previous inflammatory process. They should be static and mobile

57
Q

Enlargement of supraclavicular nodes, especially on L, suggests…

A

mets from thoracic or lung malignancy

58
Q

Supraclavicular adenopathy is…

A

swelling of the supraclavicular nodes; should NEVER be present; may be indicitative of thoracic, lung, or gastric cancer

59
Q

Tinia capitus is…

A

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
Q

Excessive scaling on scalp may be…

A

Cellulitis or may be subarachnic dermatitis;Tx is with selenium sulfide

61
Q

With polysistic ovarian syndrome a patient may have…

A

Excess facial hair due to excess testosterone

62
Q

Roasia in elderly exhibits as…

A

Redness in face

63
Q

What are the headache warning signs?

A

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
Q

What is the main reason we palpate the retinal arteries?

A

To make sure there is adequate blood flow to the retinas

65
Q

What is a condition that may cause irregular temporal pulses?

A

Giant cell arteritis

66
Q

If the pt has more pain in their sinuses when bending forward what condition may they have?

A

Sinusitis

67
Q

Pt has unilateral facial pain that is tender to palpation, dull toothache, purulent nasal drainage (symptoms greater then 7 days). What might they have?

A

Bacterial sinusitis

68
Q

Tracheal deviation may be a sign of…

A

Pneumothorax, mediastinal mass, or atelectasis

69
Q

What type of curvature should the C-spine have

A

Lordotic

70
Q

What are the origins and insertions of the trapezius

A

Origin – nuchal line of occipital bone; sp of C7-T12

Insertion – lateral clavicle, acromion process, and scapular spine

71
Q

How many different directions can the neck move

A

6 directions

Physical Exam Midterm & Final (11 decks)

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