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Adv. Health Assessment > HEENT > Flashcards

HEENT Flashcards

1
Q

the sinuses

A

frontal, ethmoid, sphenoid, maxillary

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2
Q

medications that increase nasal congestion

A

angiotensin-converting enzyme inhibitirs (ACE), beta blockers and OCP.

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3
Q

rhinorrhea

A

nasal discharge

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4
Q

unilateral nasal discharge indicates….

A

obstruction, polyp, tumor or foreign body

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5
Q

epistaxis

A

nose bleeds

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6
Q

herbal therapy that contributes to epistaxis

A

ginko biloba increases risk for bleeding related to anti platelet activity

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7
Q

common disorders of the nose

A

common cold, URI, sinusitis, allergic rhinitis, asthma

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8
Q

crepitus on palpation of the sinus indicates….

A

a large amount of exudates

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9
Q

transillumination of the sinuses

A

a red glow for air filled, when red is absent the sinus is filled with fluid or drainage

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10
Q

allergic rhinitis

A

bilateral clear discharge, boggy nasal mucosa, allergic shiners and nasal crease on exam. Often the patient and family have a history of seasonal allergies, eczema or asthma

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11
Q

sinusitis

A

thick green to dark yellow, often foul smelling discharge, absence of red glow upon transillumination. patient will report dull ache over the cheeks and above eyes that increases when bending over.

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12
Q

radioallergosorbent test (RAST)

A

a blood assay of the IgE antibodies which can indentify specific allergens.

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13
Q

intradermal sensitivity studies

A

suspected allergens are planted under the skin and the response is evaluated, a local reaction can occur

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14
Q

eosinophil count

A

a mucus smear from the nasal passage is assessed to gauge the degree of reaction but lacks specificity

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15
Q

Other condition that may affect nasal congestion

A

thyroid conditions

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16
Q

nasal/sinus considerations in the pregnant patient

A

increased congestion due to changes in hormones, circulating fluid volume.
increased vascularity due to changing hormones contribute to nosebleeds

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17
Q

nasal/sinus considerations of the geriatric patient

A

decreased hydration leads to increased frailty of the mucosa. Anticoagulant therapy can increase bleeding.

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18
Q

salivary glands of the oropharynx

A

parotid gland - in cheek anterior to ear, secretes via stensons ducts located in the cheek, sublinguial gland - secretes via whartons ducts located on either side of the frenulum, and submandibular gland - located under the tongue and secretes via the ducts on the floor of the mouth posterior to whartons ducts

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19
Q

nerve enervate of the mouth and tongue

A

IX and X - swallowing, rise of palate, gag reflex
V, VII, X and XII - modulate voice, speech
XII the tongue

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20
Q

dysphonia

A

disturbance of pitch

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21
Q

dysphagia

A

difficulty swallowing

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22
Q

dysarthria

A

disturbance of speech

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23
Q

differential of sore throat symptoms by etiology

A

bacterial are often abrupt, with severe pain and difficulty swallowing
viral are usually gradual (and can be post-bacterial) and not as severe in quality
allergic associated - often characterized as itchy, scratchy or irritated

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24
Q

nutritional deficiencies associated with bleeding gums

A

vitamin K or vitamin C deficiency

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25
Q

medications that increase risk for bleeding gums

A

oral contraceptives, hormone replacement therapy, anticoagulants, aspring, NSAIDS, ginko biloba

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26
Q

halitosis

A

bad breath

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27
Q

differential of halitosis based on odor description

A 
sweet and fruity - diabetes
fecal - large bowel obstruction
musty, sweet, or mousy hay odor - hepatic encephalopathy
musty or ammonia - end stage renal dz
musty - common cold or chronic sinusitis
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28
Q

tooth pain

A

often caused by tooth decay, loss of filling or development of carry, eruption of wisdom teeth

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29
Q

common mouth ulcerations

A

canker sores often occur in winter and spring, and have sudden onset, located in the mouth
impetigo - honey colored exudate, usually perioral
herpetic lesions have prodromal sx, perioral location
candida - white lesions that can be scraped off leaving shallow ulcerations, located within the mouth on palate bucal surfaces and tongue
white lesion that cannot be moved - consider cellular dysplasia or early squamous cell CA

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30
Q

social and family history components to oral cancer

A

increased risk with family history, smoking, oral tobacco use, and ETOH

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31
Q

leukoplakia

A

white patches which can be considered a precancerous lesion

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32
Q

bacterial pharyngitis, tonsillitis

A

actue onset, with family or colleguaes who’ve been ill, often in winter or spring.
erythem of the pharynx or tonsils with white to yellow exudate is seen, fever of 101 or greater
Dx with culture and sensitivity, quick beta strep test

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33
Q

viral pharyngitis, tonisilitis

A

rapid onset, with system sx, cough, rhinnorrhea, conjunctivitis, rarely exudate will be seen

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34
Q

irritation of throat r/t post nasal drip

A

seasonal allergies, in Hx, mild to moderate pain that increases when lying down per pt. On inspection, clear nasal discharge that drains to the posterior throat, congestion, and boggy nasal turbinates

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35
Q

common mouth findings in pregnancy

A

gingival hyperplasia and bleeding

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36
Q

mouth considerations for the older patient

A

problems assoc. with the loss of teeth, changes in taste, dental caries, dry mouth, varicose veins under tongue common

37
Q

palpebral fissure

A

the opening of the eyelids

38
Q

meiobian glands

A

glads along the tarsal plastes within the eyelids which secret an oily lubricating substance at the lid margin to prevent excessive evaporation of tears and provide a seal when eyes are closed

39
Q

levator palpebrae

A

muscle that controls the upper eyelid, innervated by the oculomotor nerve

40
Q

kerratitis sicca

A

dry eyes, caused by an imbalance between tear production and tear drainage via the nasolacrimal ducts

41
Q

aqueous humor

A

a fluid that circulations through the posterior changer through the pupil to anterior chamber and is produced by the ciliary body, drains out through the canal of Schlemm. Intraocular pressure should be 15 mmHg + or - 3mm

42
Q

macula lutea and fovea

A

fovea is a small depression in the retinal surface that marks the point of central vision, surrounded by darkened area which is the macula and distinguishes fine detail and colors

43
Q

optic disc

A

location of the optic nerve and retinal vessels

44
Q

ciliary body

A

controls the thickness of the lens to accomodate for a clear focused image to refracted onto the retina. it also produces aqueous humor

45
Q

rods and cones of the retina

A

translate the lith into electrical impuls

46
Q

convergence

A

the movement of the eyes inward, which brings images together. extraoccular muscles maintain the balance to hold two images parallel

47
Q

common causes of severe eye pain

A

corneal ulcer, uveitis, acute angle-closure glaucoma and endopthalmitis

48
Q

glaucoma sx

A

presents with eye pain, photophobia, and visualization of halos

49
Q

endocrine conditions with eye manifestations

A

diabetes - diabetic retinopathy, vascular disease

50
Q

cardiac conditions with eye manifestations

A

hypertension can result in ocular hemorrhage

51
Q

neurologic conditions with eye manifestations

A

headache - papilledema (increased ICP) and glaucoma (increased IOP)
nystagmus - congenital - hydrocephalus, diencephalic tumors, medication toxicity, Arnold-chiari malformation, brain tumor, anomalies
nystagmus - acquired- blindness, MS peripheral vestibular dz, cerebellar or brain stem disease, drug use

52
Q

Handheld near vision screaner

A

Rosenbaum or Jaeger

53
Q

Color vision plates

A

Ishihara or Hardy Rand Ritter

54
Q

proptosis

A

abnormal protrusion of the eye which may indicate graves disease

55
Q

ptosis

A

eyelid droop which can indicate 3rd nerve palsy or myasthenia gravis

56
Q

xanthelasma

A

creamy yellow plaques on teh eyelids indicating abnormal lipid deposits

57
Q

hordeolum

A

a style, or abscess in teh eyelash follicle

58
Q

chalazion

A

inflammatory granuloma of the meibomian gland

59
Q

blepharitis

A

crusting of the eyelids, thickening othe eyelids and plgugin gof the meibomian glands

60
Q

pterygia

A

tissue growth from the periphery toward the cornea, often develop in response to chronic irritation of he cornea, such as from wind

61
Q

arcus senilis

A

a white opaque ring around the limbus, may indicate hyperlipidemia in those under 40

62
Q

hyphema

A

blood in the anterior chamber is usually the result of trauma or surgery

63
Q

absence of red reflex

A

retinal detachment, chorioretinitis, retinostoma

64
Q

leukokoria

A

white retinal reflex

65
Q

soft contact lense wearers are at risk for this infection

A

Pseudomonas

66
Q

foreign body in eye

A

tearing, visualization of body, relief of pain after irrigation, Dx with flueorescein stain, examination with cobalt blue light, opthalmic or slit lamp examination

67
Q

corneal abrasion

A

accompanied by tearing, photophobia, corneal defect, Dx with Fluorescein stain, examination with cobalt blue light, otphtalmic or slit lamp examination

68
Q

herpetic lesions of eye

A

herpetic rash may be present, eye pain, no hx of trauma, vesicular rash may be sen, if nose is involved then ocular involvement is likely, epithelial dendrite stains green with fluorescein stain on eye.

69
Q

ossicles

A

malleus - hammer
incus - anvil
stapes - stirrups

70
Q

typanic membrane landmarks

A

cone of light, ?

71
Q

common causes of otalgia (ear pain)

A

primary - infections, inflammations of middle and external ear structures
secondary - TMJ problems, dental adn periodontal problems, infections in the sinuses and nasopharyngeal areas, lesions of the tongue, cervical MSK problems and neuralgias involving cranial nerves V, VII, IX and cervial cerves I, II, and III

72
Q

causes of gradual hearing loss

A

presbycusis, ototoxic drugs, chronic infection, otosclerosis, brain attack

73
Q

causes of sudden hearing loss

A

acute otitis media, nasophyringeal infections, meningitis, sudden occlusion of external ear canal, sudden accumulation of middle ear fluid or blood, acute performation of tympanic membrane

74
Q

tinnitus

A

originate in central auditory system and affect 10% of population

75
Q

gradual onsent tinnitus causes

A

advancing age, meieres disease, otosclerosis, metabolic conditions of diabetes and hypothyroidism, and TMJ

76
Q

acute onset tinnitus causes

A

acoustic and baro trauma, acute occlusion, allergies, sudden alteration of BP up or down, head and neck injury, acute ototoxic drug therapy and infections

77
Q

otorrhea

A

discharge from ear
clear mucoid - chronic otitis media with TM perforation
clear watery - CSF d/t basilar skull fx and TM perforation, eczema of external ear
white - fungal infection or term conditons of ext ear
bloody- chronic infection or trauma
brown/gray - liquefied cerumen

78
Q

vertigo

A

dizziness related to disorder of the inner ear

79
Q

breif vertigo

A

associated with benign paroxysmal positional vertigo

80
Q

veritgo that last hours

A

usually associated with menieres Dz, viral labrynthitis, perilymph fistula

81
Q

long periods of vertigo

A

assocated with vertibrobasilar insufficiency, other CNS conditions, systemic autiommune dzi like rheumatoid dz, systemic metabolic dz like DM or hypothyroid

82
Q

ototoxic drugs

A

aminoglycosides, salicylates, loop diuretics, nitrogen mustards, bleomycin, cisplatimun, vincristine, heavy metal exposure, and quinine derivatives.

83
Q

tinnitus related drugs

A

ACE inhibitors, macrolides, quinolones, slufa antibiotics, tricyclic antidepressants, antihistamines, beta blockers, CA channel blockers, some narcotics, and NSAIDS

84
Q

congential syndromes associated with inheritied ear conditions

A

down syndrome, usher syndrome, treacher collins syndrome, fetal alcohol syndrome, crouzon syndrome, alport syndrome, hemifacial microsemia, stickler syndrome, branchio-otorenal syndrome, Pendred syndrome, CHARGE association, neurofibromatosis type II, Waarden bur syndrome, congential rubella syndrome, pierr robine syndrome, trisomy 13, and cleft lip/palate

85
Q

bulging tympanic membrane

A

reliable indicator of acute otitis media

86
Q

presbycusis

A

age related hearing loss common in elderly

87
Q

Geographic tongue

A

Benign variation of smooth tongue and raised papillae, has a map like appearance

88
Q

Hairy tongue

A

Black hairy appearance, elongated darkened papillae, benign

Often due to staining or antibiotic treatment

89
Q

Nodes of the neck

A 
Preauricular
Post-auricular
Occipital
Tonsilar
Submaxillary
Submental
Superficial cervical
Deep cervical
Posterior cervical
Supraclavicular
Infraclavicular

Adv. Health Assessment (13 decks)

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