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5031 > HEENT > Flashcards

HEENT Flashcards

1
Q

What gland drains into the mouth and throat?

A

tonsillar, submandibular, and submental glands

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2
Q

Enlarged or tender lymph nodes?

A

Look for nearby drainage

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3
Q

Neck mass questions

A

How did you notice the lump? painful? >40 think malignancy. enlarged, tender think pharyngitis

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4
Q

hair

A

fine-hyperthyroidism
coarse-hypothyroidism

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5
Q

Scalp

A

scaliness and lesions: seborrheia dermatitis, psoriasis
soft lumps-pilar cyst (wens)
pigmented neri-melanoma

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6
Q

skull

A

deformities, depressions, lumps, tenderness
enlarged-hydrocephalus, paget disease

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7
Q

face

A

facial expressions, contours, assymetry, edema, mass

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8
Q

skin

A

color, pigment, texture, thickness, hair distribution, lesions
Hirutism-facial hair-PCOS

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9
Q

lymph

A

note size, shape, delamination (clumped together), mobility, consistency, and tenderness. enlargement of a supraclavicular node- left virchow’s node-metastasis from thoracis or abdominal malignancy. Generalized multiple infection-HIV, mono, lymphoma, leukemia, and sarcoidosis

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10
Q

trachea

A

midline-pneumothorax, mediastinal mass, atelectasis

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11
Q

Pemberton sign

A

check thyroid: neck hyperextension and arm elevation- get flushing from compression of thoracic inlet from gland

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12
Q

Thyroid retrosternal goiter

A

hoarseness, SOB, stridor, dysphagia

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13
Q

Graves disease

A

thyroid soft and nodular-U/S.
eyes-lid lag, exophtalmos

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14
Q

hashimotos

A

firm thyroid-U/S

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15
Q

Risk of hypothyroidism

A

autoimmune thyroiditis, older, caucasian, DM1, down syndrome, goiter, external beam radiation to head/neck, family history

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16
Q

Risk of hyperthyroidism

A

female, older, African, insufficient iodine intake, family history, medications-amiodarone

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17
Q

Hyperthyroidism s/s

A

nervousness, weight loss, increased appetite, sweating, heat intolerance, palpitation, increased BMs, tremor, proximal muscle weakness.
warm, smooth, moist skin. exophtalmos, increased SBP, decreased DBP, hyperdynamic cardiac pulsation, accentuated S1

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18
Q

hypothyroidism s/s

A

fatigue, modest weight gain, anorexia, dry coarse skin, cold intolerance, swelling of face hands legs, constipation, weakness, muscle cramps, arthralgias paresthesias, impaired memory, skinn yellowish from carotene, nonpitting myxedema, low pitch speech, decreased SBP, increased DBP, bradycardia, hypothermia, prolonged ankle reflex, hearing loss, peripheral neuropathy, carpel tunnel

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19
Q

conjunctiva

A

transparent protective lining over the sclera and inside of the eyelids. functions to lubricate and protect.

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20
Q

tarsal plate

A

connective tissue on eye. each plate has rows of meibomian glands for oily lubrication.

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21
Q

CNIII

A

raises eyelid with levator palpebrae superioris muscle

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22
Q

Lens

A

contracts and relaxes by ligaments for accomodation, project picture to retina

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23
Q

aqueous humor

A

in anterior and posterior chamber, produced by ciliary ody

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24
Q

vitreous humor

A

gelatinous fluid in vitreous chamber-maintains shape of eye

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25
opthalmoscope
see the posterior portion of the eyes called the optic fundus: retina, choroid, vitreous, retina vessels, macula, fovea, and optic disc.
26
blind spot
15 degrees temporal to the line of gaze
27
CNII
reaction to light-diverges in the midbrain
28
CNIII
when shifting focus to something close, the pupil constricts. called near reaction
29
superior rectus
lateral elevation, CNIII
30
lateral rectus
laterally away from nose, CNVI
31
inferior rectus
lateral depression, CNIII
32
inferior oblique
rotates top of eye away from nose CNIII
33
medial rectus
moves eye inward, CNIII
34
superior oblique
rotates top of eye towards nose, CNIV
35
yoked
conjugate gaze, if muscle is paralyzed one eye will deviate. trauma, nerve damage, lesions, congenital
36
thyroid
right lobe bigger than left, <2cm
37
concerning eye symptoms
blurred vision, loss of vision, floaters, flashing lights, pain, redness, tearing, diplopia-double vision.
38
vision question
hows your vision? one or both eyes? inflammatory signs? any surgery/eye drops/glasses?
39
loss of vision, one eye, no pain
think vitreous humor, DM, trauma
40
loss of vision, one eye, pain
MS, ulcer, change to anterior chamber HA-get neuro exam
41
bilateral loss of vision
no pain-stroke pain-intoxication, trauma, chemical or radiation exposure
42
gradual vision loss
cataracts, glaucoma, macular degeneration
43
floaters
lesions in retina, visual pathway, or brain. may see flashing lights
44
flashing lights with new floaters
retinal tears or detachment-immediate consultation
45
red painless eye
subconjunctival hemorrhage
46
red gritty eye
corneal abrasion, foreign body, ulcers, acute angle closure, glaucoma, herpes keratitis, fungal keratitis, hyphema (blood pooling between cornea and retina), uveitis (inflammation of middles eye)
47
diplopia
lesions in brainstem or cerebellum with weakness or paralysis of >1 extraoccular muscles
48
horizontal diplopia
palsy of CNIII or CNVI
49
vertical diplopia
palsy of CNIII or CNIV
50
20/40 vision
distance pt is away from chart/ how far a normal eye can see it
51
20/200 vision
legally blind
52
astigmatism
distortion while looking at near or far objects, imperfection in cornea or lens
53
persbyopia
focusing problem for near vision-holds farther away
54
color vision
test to rule out damage to optic nerve
55
upslanting eyelids
down syndrome sign
56
lagophthalmos
can't close eyelids-neuromuscular
57
increased tears
inflammation in lacrimal gland or sac
58
decreased tears
Sjogren syndrome
59
nystagmus
congenital, labyrinthitis, cerebellar disorders, and drug toxicity
60
absent red reflex
opacity of lens-cataract, detached retina. in kids-retinoblastoma
61
optic disc
note color and size-enlarged (glaucoma)
62
lens removal
magnification is lost
63
papilledema
swelling of optic disc and cup. meningitis, subarachnoid hemorrhage, trauma, and mass lesions
64
exophthalmos
protrusion of the eye. Get CT or MRI
65
swinging flashlight test
to each pupil shine a light. If damage to the optic nerve, they will conjugate constriction, and then when flashed in the affected eye, it will dilate.
66
POAG primary open angle glaucoma)
the leading cause of visual impairment and blindness in the US. >50% unaware.
67
external ear
auricle and ear canal
68
middle ear
3 ossicles: malleus, incus, and stapes. Tiny bones transform sound vibrations into mechanical waves that travel to the inner ear.
69
inner ear
cochlea (hearing), semicircular canals (balance), otolith organs (balance).
70
Conductive hearing loss (external)
cerumen impaction, otitis externa, trauma, squamous cell carcinoma, and benign bony growths (exostosis or osteoma)
71
conductive hearing loss (middle)
OTM, congenital, cholesteatomas, otosclerosis, tympanosclerosis, tumors, and perforations of TM.
72
Sensorineural hearing loss (inner ear)
congenital and hereditary conditions, presbycusis (age related hearing loss affecting both ears). Viral: rubella, cytomegalovirus. meneires disease, noise exposure, ototoxic drug, and acoustic neurons (benign tumor growing on the nerve)
73
air conduction
sound waves through air: middle to cochlea
74
bone conduction
bypasses external and middle ear, stimulates cochlea directly- tuning fork.
75
balance: rotational movement
semicircular canal
76
balance: linear movement
otolith organs
77
turbinates of nose
in charge of cleansing, humidification, and temp control
78
sinuses of physical exam
frontal and maxillary
79
meniere disease
tinitis with hearing loss and vertigo
80
vertigo
spinning causes: benign positional vertigo, labyrinthitis, vestibular neuritis, Meniere's disease, ataxia, diplopia, dysarthria (central neurologic causes in cerebellum or brainstem, cerebral vascular disease, or posterior fossa)
81
presyncope
passing out feeling (arrhythmia, orthostatic hypotension, or vasovagal response)
82
ear infection
fever, sore throat, cough, URI, yellow/green drainage.
83
drug induced rhinitis
topical decongestants, cocaine
84
acute bacteria sinitis
greater than 7 days, purulent drainage, and facial pain.
85
drugs that cause congestion
oral contraceptives, alcohol, and cocaine
86
epitaxis
trauma (nose picking), inflammation, drying and crusting of the nasal mucosa, tumors, and foreign body, chronic drug use of NSAIDs and anticoagulants, vascular malformations, and coagulopathies.
87
whispered voice test
hearing loss
88
failed whisper test
Do Weber and Rinne
89
weber
fork to the middle of the head or forehead, is it equal? No? conductive hearing loss
90
Rinne
fork to the back of ear, when sound stops put in ear. Do they hear it again? yes: conductive no: sensorineural loss
91
sore tongue
oral candidiasis, aphthous ulcers
92
aphthous ulcers
sore smooth tongue due to nutritional deficiencies
93
pharyngitis
Hx of fever, tonsillar exudates, swollen tender anterior cervical adenopathy, no cough. get rapid antigen testing or throat culture
94
speech hoarseness
acute: voice overuse, acute laryngitis over 2 weeks: refer to laryngoscopy: Possible reflux, vocal cord nodules, hypothyroidism, head/neck cancers, Parkinson's disease ALS, or myasthenia gravis.
95
Halitosis
poor hygiene, smoking tobacco, plaque, periodontal disease. systemic: sinusitis, tonsillitis, pharyngitis, foreign bodies, neoplasms, abscesses, and bronchiectasis.
96
Asymmetry of tonsils
lymphoma
97
pharynx
say "ah", note rise of sof palate. CN X. fails to rise and uvula deviates to unaffected side, possible lesion on nerve.

5031 (3 decks)

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