Head & Neck Flashcards
Yellow eyes and skin
Sclera: white part of the eye
Jaundice: increase biliirubin in blood, liver, bile duct problems or increased breadown rbc
1 half of the face paralized
Bell’s palsy
Central and peripheral facial paresis
inability to wrinkle eyebrow, drooping eyelid: cant close eye, inability to puff cheek: no muscle tone, drooping mouth: inability to smile or pucker
Inspection oral cavity
Lips : color, shape, symmetry, scars, ulceration, swelling, hemorrage, moistness
Buccal mucosa: open mouth as widely as possible, tilt head back, spatula to inspect oral cavity, use penlight and wear gloves, oropharynx, gum. Color, swelling, ulceration (white discoloration on gum: aphtae), coating
teeth (number 32 or 28: wisdom, condition, dental caries(brown), tartar,etc), gingiva (gum), palate(soft hard: symmetry, mobility, swelling ulcer), tongue, floor mouth, paletal arches, uvula, tonsils ( on the side of uvula), excretory ducts, salivary glands
hole in palate
cleft palate
can also have cleft lips
part of orofacial development in the 1st weeks: not proper closure
Inspection tongue and floor of the mouth
Patient stick out tongue with mouth open. Inspect superior side and edges of tongue. Press down tongue with spatula to see the base
Patient press tongue on palate. Inspect floor of mouth, inferior side of tongue, frenulum (elastic band tongue). Assesss: smoothness, color, swellings, ulcerations, hemorrage, coating
Red and white spots tongue
geographic tongue. Benign condition and cause unknown.
Palatal arch, uvula, tonsil
Spatula on base of the tongue (might triger gag reflex)
Look at tonsil on sides of arch: reddish. Assess if inflammed.
Look if uvula centered
Look at pharynx,oropharynx: color, swelling, discharge (nasal drip)
Ask to say “ah” look at movement arch and uvula
Excretory ducts of salivary glands
Parotid duct on cheek wall : look with spatula
Ask to lift tongue up
Sublingual ducts on the floor of the mouth
submandibular duct at the center on either side of frenulum
Palpation oral cavity
One hand glove another no glove
palpate with one hand outside and other inside
Feel difference in consistency
Inspection Neck
Patient sits and clavicles visible
Look while facing, then ask to turn head on right and left
Check for any swelling of the lymph nodes and thyroid gland
Check relative position clavicle, trachea centered, skin color, scars, etc
Palpation lymph nodes
stand behind patient. Patient sits
Palpate with small circular movements. Very small elastic beans, well defined borders: not always palpable.
Start at the chin: submental nodes
move to the side of the jaw: submandibular nodes
Front of ear: preauricular lymph node
Back of ear: retroauricular lymph node
Occiptal region, beside trapezius muscle: suboccipital lymph node
High on neck, anterior to sternocleido mastoid muscle, follow muscle: high,mid,low cervical lymph nodes. Can ask patient to push head away of examined side against hand to locate muscle. Then relax again for examination
Tilt head forward (to relax), grab on sternocleidomastoid muscle with thumb on one side and other fingers: deep cervical lymph nodes
Tilt head slightly to right to relax, palpate deeply above cervical: supraclavicular lymph node
Palpate deeply under clavicles: subclavicular lymph nodes
Thyroid gland
Inspect neck: cartilage structure larynx, symmetry, shape, swelling. Can ask to swallow
Palpation: take larynx sideways with both hands. Palpate contours with fingers (do some small tapings), assess tenderness, symmetry, swellings. Thyroid gland is at bottom of the neck
Stand behind and palpate thyroid cartilage(sideway laryngeal prominence) and cricoid cartilage (under laryngeal prominence, can feel a ring)
palpation thyroid gland: place finger on either side of trachea, upper finger on cricoid ring.
place the index fingers of both hands around the lower poles of the thyroid cartilage and ask the patient to swallow. In this way you will be able to feel whether the thyroid gland is enlarged because swallowing moves the larynx upwards and thyroid is attached so moves up as well.
Inspection Head
Patient stands and turn around for general overview: Shape skull, ears, nose, jaws and neck. Both sit and observe following: ill / not ill old, young facial expression postion head neck relative to trunk shape, symmetry, skull and face position eyes ears nose skin color, eyes color
foetal alcohol syndrome
(alcohol exposure during the mother’s pregnancy)
Epicanthal folds: skin fold of the upper eyelid covering the inner corner of the eye.
Railroad track ears: The top part (curve) of the outer ear is underdeveloped, folded over, and parallel to the curve beneath it, giving the appearance of a railroad track.
upturned nose: refers to a nose in which the tip is angled upward
Philtrum: or medial cleft, is a vertical indentation in the middle area of the upper lip
Palpebral fissures: the elliptic space between the medial and lateral canthi of the two open lids.