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Health Assessment > HEENT > Flashcards

HEENT Flashcards

1
Q

Neck Pain

A

can be due to muscular or cervical spinal cord problems

stress and tension may increase neck pain

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2
Q

Sudden head and neck pain with elevated temperature and neck stiffness

A

may be a sign of meningeal inflammation

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3
Q

Sudden trouble with vision

A

Sudden trouble with vision in one or both eyes or sudden trouble walking, dizziness or loss of balance or coordination may be a sign of impending stroke

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4
Q

Lumps or lesions on head/neck

A

lumps or lesions that do not heal may be a sign of cancer

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5
Q

Goiter

A

an enlarged thyroid gland or swelling at the base of the neck

also experience a tight feeling in the throat, a hoarse voice, cough, hoarseness, difficulty swallowing, or difficulty breathing

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6
Q

Change in skin, hair, nails, energy levels, sleep, and emotional stability?

A

thyroid function

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7
Q

Hyperthyroidism vs Hypothyroidism

A

Hypo: constipation, Bradycardia, weight gain, pale dry skin, slowed reflexes, cold intolerance, coarse hair, skin feels cold, no goiter, constipation, puffiness in periorbital region

hyperthyroidism: diarrhea, tachycardia, weight loss, moist skin, heightened reflexes, heat intolerance, fine hair with hair loss, skin feels warm, goiter, frequent bowel movements, exophthalmos (protruding)

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8
Q

Most common type of headaches

A
  • Vascular (migraines)
  • Muscle contraction (tension)
  • traction or inflammatory causes
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9
Q

Sudden headache with unknown cause

A

stroke

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10
Q

Hormone fluctuations and headaches

A

women are more prone to migraines than men usually provoked by hormone fluctuations

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11
Q

Meningitis

A

severe headache with stiff neck, vomiting and light sensitivity

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12
Q

Headache following a head injury

A

slow bleed

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13
Q

Headaches with numbness or tingling in the arms or legs

A

stroke

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14
Q

headache lasting for more than 24 hours in someone without a history of headaches

A

ICP

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15
Q

Sinus headaches

A

deep, constant throbbing pain

pressure like pain in one specific area of face or head and is tender to touch

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16
Q

When does sinus headaches occur?

A

with or after a cold or acute sinusitis or febrile illness with purulent discharge from nose

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17
Q

Location of sinus headaches

A

one area of face or along eyebrow ridge and below the cheek bone

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18
Q

Duration, severity, and pattern of sinus headaches

A

Duration: last until associated condition improves

severity: moderately severe and not debilitating
pattern: gets worse when they change their position as well as sudden temperature changes

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19
Q

Associated factors with sinus headaches

A

nasal drainage, congestion, fever, foul-smelling breath

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20
Q

Cluster headache

A

Stabbing pain

may be accompanied by tearing, eyelid drooping, reddened eye or runny nose

may be precipitated by ingesting alcohol

walking and moving around makes it feel better opposite of migraine headaches

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21
Q

Location of cluster headaches

A

localized in the eye or orbit and radiating to the facial and temporal regions

pain is always unilateral and always on the same side

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22
Q

Cluster duration, severity, and pattern

A

Typically occurs in the late evening or night

severity is intense

pattern is movement or walking back and forth may relieve the discomfort

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23
Q

Associated factors of cluster headaches

A

occurs more in young males

occur in cyclical patterns or clusters

may have eye reddening, tearing and nasal congestion

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24
Q

Tension Headaches

A

Dull, tight, diffuse

occurs simultaneously with stress, anxiety or depression

usually located in the frontal, temporal or occipital region

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25
Q

Tension headaches duration, severity, pattern

A

Last days, months or years

the severity is aching

relief may be obtained by local heat, massage, analgesics, antidepressants and muscle relaxants

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26
Q

Associated factors of tension headaches

A

affect women more than men

is the most common type of headache

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27
Q

Migraine headaches

A

Accompanied by nausea, vomiting, and sensitivity to noise and light

onset: aura might occur before or during migraines , can be precipitated by emotional disturbances or follow ingestion of alcohol

location: around eyes, cheeks, or forehead
- may affect only one side of the face

INTENSE PAIN

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28
Q

Migraine duration, severity, and pattern

A

Duration lasts up to 3 days

Severity is throbbing and severe

Rest may bring relief

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29
Q

Associated factors of migraines

A

Occurs more often in women

headaches especially migraines tend to run in families

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30
Q

Tumor-related headaches

A

Aching and steady. Neurologic and mental symptoms as well as nausea and vomiting may develop

may develop when coughing, sneezing or sudden movement of the head

location varies with location of the tumor

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31
Q

Tumor related headaches duration, severity, and pattern

A

duration is commonly occurs in the morning and last for several hours

severity is different in tensity

pattern usually subsides later in the day

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32
Q

Microcephaly

A

an abnormally small head

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33
Q

Acromegaly

A

Skull and facial bones are larger and thicker

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34
Q

Paget disease

A

Acorn shape, enlarged skull and bones

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35
Q

Neurological disorders

A

may cause horizontal jerking movement

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36
Q

Involuntary nodding movement

A

may be seen with aortic insufficiency

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37
Q

Head tilted to one side

A

may indicate unilateral vision or hearing deficiencies

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38
Q

Drooping, weakness, or paralysis on side

A

may result from a stroke and is usually seen with paralysis or weakness of other parts of the body

can be a result of bell palsy

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39
Q

Mask-like face

A

can be seen with Parkinson

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40
Q

Sunken face with depressed eyes and hollow cheek

A

typical of cachexia (emaciation)

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41
Q

Tightened-hard face

A

with thinning facial skin seen in scleroderma

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42
Q

Temporal arteritis

A

When the temporal artery is hard, thick, and tender

can lead to blindness

acute and urgent

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43
Q

Swelling, enlarged masses

A

may indicate an enlarged thyroid gland, inflammation of the lump nodes or a tumor

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44
Q

Palpating the trachea

A

find the sternal notch and verify the trachea is midline

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45
Q

Trachea pulled to an affected side

A

Large atelectasis

fibrosis or pleural adhesions

Pneumonectomy

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46
Q

Trachea pushed to the unaffected side

A

in case of: tumor

enlarged thyroid lobe

pneumothorax

aortic aneurysm

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47
Q

Palpating the Thyroid

A

Usually not palpable

if rapid enlargement of a single nodule-consider malignancy

diffuse enlargement think hyperthyroidism

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48
Q

Auscultate Thyroid

A

bruit over the thyroid lobes is often heard with hyperthyroidism

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49
Q

Lymph Nodes

A

enlarged nodes are abnormal

swelling, tenderness, hardness and immobility are abnormal

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50
Q

Metastasis from a malignancy in the abdomen and thorax

A

an enlarged, hard, contender node in the supraclavicular area

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51
Q

Hodgkin Lymphoma

A

cancer of the lymphatic system

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52
Q

Preauricular

A

in front of the ear

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53
Q

Posterior auricular

A

(mastoid)

superficial to mastoid process behind the ear

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54
Q

Occipital

A

at the base of the skull

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55
Q

Submental

A

midline, behind the tip of the mandible

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56
Q

Submandibular

A

halfway between the angle and the tip of the mandible

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57
Q

tonsillar

A

under the angle of the mandible

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58
Q

Superficial cervical

A

overlies the sternomastoid muscle

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59
Q

deep cervical

A

deep under the sternomastoid muscle

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60
Q

Posterior cervical

A

in the posterior triangle along the edge of the trapezius muscle

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61
Q

supraclavicular

A

just above and behind the clavicle at the sternomastoid muscle

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62
Q

Red flags for Lymph Nodes

A

have appeared for no apparent reason

continue to enlarge or have been present for two to four weeks

feels hard or rubbery, or doesn’t move when you push on them

accompanied by persistent fever, night swears or unexplained weight loss

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63
Q

Sudden changes of vision

A

are associated with acute problems such as head trauma or increased intracranial pressure

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64
Q

Gradual changes of vision

A

may be related to aging, diabetes, hypertension or neurologic disorders

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65
Q

Scotoma

A

blind spot that is surrounded by either normal or slightly diminished peripheral vision and may be a sign of glaucoma

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66
Q

Intermittent blind spots

A

can be associated with vascular spasms (ophthalmic migraines), pressure on the optic nerve from a tumor or increased ICP

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67
Q

Consistent blind spots

A

may indicated retinal detachment

MED EMERGENCY

report of blind spots is an immediate referral

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68
Q

Most common causes of decreased vision in older adults

A

Cataract formation (lens opacity)

glaucoma from increased intraocular pressure

macular degeneration

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69
Q

Macular degeneration

A

breakdown of cells in macula of retina

irreversible central vision loss

most common cause of blindness

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70
Q

Halos or rings around lights?

A

associated with narrow angle glaucoma

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71
Q

Do you have trouble seeing at night?

A

night blindness is associated with optic atrophy, glaucoma and vitamin A deficiency

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72
Q

DO you experience double vision ?

A

Diplopia

may indicated increased ICP due to injury or a tumor

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73
Q

Burning or itching pain

A

associated with allergies or superficial irritation

74
Q

Throbbing, stabbing or deep aching pain

A

suggests a foreign body in the eye

most eye disorders are not associated with pain

75
Q

Redness or swelling in the eye

A

An inflammatory response to allergy, foreign body or bacterial/viral infections

76
Q

Eye discharge

A

discharge from one or both eyes suggest a bacterial or viral infection

77
Q

Eye exam recommendations

A

Thorough eye exams are recommended every 2 years for people 18-60 years of age

annual examinations are recommended for people over 60

78
Q

Family history of eye problems

A

many eye disorders run in families

glaucoma, refraction errors, macular degeneration

79
Q

Pink eye

A

Pink eye conjunctivitis

tearing of the eye causing it to stick shut

pain, itchy, and burning. complaints of feeling scratchy and crusting on the eye lash

sensitive to bright lights (photophobia)

enlargement of the lymph node

80
Q

Allergic Conjunctivitis

A

Is more common in people with seasonal allergies

symptoms are intense itching, tearing and inflammation of the eye . As well as sneezing and watery nasal discharge

treatment OTC eye drops or prescription drops

81
Q

Chemical conjunctivitis

A

irritation caused by a chemical splash or foreign object in the eye

S&S include watery eyes and a mucous discharge, usually clear up on their own within about a day

82
Q

Severe chemical injuries to the eye

A

alkali burns are medical emergencies and can lead to scarring, damage to the eye or the sight, or even the loss of the eye

83
Q

Bacterial Conjunctivitis

A

often spreads to both eyes while viral only affects one eye

has heavier discharge than viral and its thick and greenish in color

treated with antibiotic eye drops or ointment

may improve after 3-4 days of treatment, but need to take the entire course of antibiotics to prevent recurrence

84
Q

Viral Conjunctivitis

A

characterized by excessive watering, rather than heavy discharge

sticky upon awakening but does not have the crust that makes it difficult to open the eye

associated with common cold and runny noses and sinus congestion

lymph nodes around ear and neck are associated with viral conjunctivitis

85
Q

Treating viral conjunctivitis

A

antibiotics will not work against viruses

no eye drops or ointments are effective against the common viruses that cause viral conjunctivitis

is self limited, which means it will go away bu itself after a short time

86
Q

20/200

A

legally blind

87
Q

20/30

A

referral should be for any assessment over 20/30

88
Q

Ishihara test

A

test for color bindness

rare in female

test between ages 4 and 8

89
Q

optical illusions

A

information gathered by the eye is processed by the brain, creating a perception that does not match the true image

90
Q

External (outer) ear

A

contains ear flap known s the auricle or pinna

91
Q

Middle Ear

A

Tympanic membrane (eardrum) separates the external and middle ear

contains the auditory ossicles: stapes, incus, malleus

conductive hearing problems happen in the middle ear

92
Q

Inner Ear

A

CONTAINS THE BONY LABRYINTH WHICH INCLUdES:

the vestibule, the semicircular canals and cochlea (central hearing apparatus)

93
Q

Function of inner ear

A

receives vibrations from the middle ear the stimulates nerve impulses

these impulses travel to the brain and the cerebral cortex interprets the sound

94
Q

AC

A

The normal pathway of hearing is air conduction and is the most efficient

95
Q

BC

A

an alternate route of hearing is by bone conduction (BC)

here the bones of the skull vibrate (vibrations are transmitted directly to the inner ear and CN VIII)

96
Q

Conductive hearing loss

A

involves a mechanical dysfunction of external or middle ear

will be able to hear sound if amplitude is increased

97
Q

What is conductive hearing loss caused by?

A

impacted cerumen

foreign bodies

a perforated TM

pus or serum in the middle ear

otosclerosis: which is a decrease in mobility of ossicles

98
Q

SENSORINEURAL

A

(or perceptive) hearing loss

cannot hear you no matter how loud you are

pathology of inner ear, cranial nerve VIII, or auditory areas of cerebral cortex

99
Q

Presbycusis

A

may be the cause of sensorineural hearing loss which is a gradual nerve denigration that occurs with aging and by ototoxic drugs which affect hair cells in cochlea.

100
Q

Mixed hearing loss

A

is a combination of conductive and sensorineural types in same ear

101
Q

Sudden decrease in the ability to hear

A

associated with otitis media or cerumen impaction

102
Q

Sudden sensorineural hearing loss

A

sudden deafness may be a medical emergency

103
Q

Drainage of the ear

A

otorrhea usually indicates infection

104
Q

Purulent, bloody drainage in the ear

A

infection of the eternal ear

external otitis

105
Q

Purulent drainage associated with pain and a popping snesation

A

characteristic of otitis media with perforation of the tympanic membrane.

if they don’t complain anymore they could’ve ruptured the ear drum

106
Q

Clear draining in the ear

A

is a medical emergency and can signal spinal fluid

107
Q

Otalgia

A

earache that occurs with ear infections, cerumen blockage, sinus infections, teeth or gum problems

108
Q

Swimmers ear

A

pain that occurs with manipulating or wiggling, the pinna may suggest otitis externa (swimmer’s ear)

109
Q

Nausea and dizziness and the ear trouble

A

Patients with ear infections experience nausea and dizziness

110
Q

Ringing in the ears

A

Tinnitus is associated with excessive earwax buildup, high blood pressure or certain ototoxic medications as well as loud noises

111
Q

Vertigo

A

true spinning motion may be associated with an inner ear problem

the labryinth in the inner ear feeds information to the brain about body’s position in space

information of the labyrinth makes it feed wrong information to the brain, creating a staggering gait and strong spinning, whirling sensation (vertigo)

112
Q

Repeated infections of the ear

A

can affect the tympanic membrane and hearing

113
Q

Family history of hearing loss

A

age related hearing loss tens to run in families

114
Q

Misaligned or low set ears

A

is seen with genitourinary disorders or chromosomal defects

115
Q

Otitis externa or impacted foreign object discharge

A

Foul smelling, sticky, yellow discharge

116
Q

Ruptured tympanic membrane

A

Bloody, purulent discharge

117
Q

Skull trauma

A

cerebrospinal fluid which will be a bloody or watery discharge.

MEDICAL EMERGENCY

118
Q

Tympanic membrane

A

ear drum should be pearly gray, shiny, and translucent

no building or retraction

slightly concave smooth and intact

light reflex at “5” in the right ear and “7” in the left ear

119
Q

Abnormal findings in the tympanic membrane

A

Otitis media, serous otitis media, scarring

120
Q

Otitis media

A

red, buldging ear drum

diminished or distorted light reflex

the membrane does not move or flutter when the bulb is inflated

121
Q

Serous Otitis Media

A

Yellow, building membrane with bubbles behind it

122
Q

Scarring

A

White spots on membrane

123
Q

Otosclerosis

A

Age of 20 and 40 YEARS DISEASE OF THE YOUNG

cause of conductive hearing loss in young adults between ages of 20 and 40 years

gradual hardening that causes the foot plate of the stapes to become fixed in the oval window, impeding transmission of sound and causing progressive deafness

124
Q

Presbycusis

A

disease of the old

hearing loss that occurs with aging even in people living in quiet environments

caused by nerve degeneration

loss of higher tones occur first (woman’s voice)

ability to localize sound is impaired

can filter background noise and feel like people are mumbling

125
Q

Lesions in the mouth or tongue

A

Lesions that last for 2 weeks need a referral

126
Q

Painful, recurrent ulcers around the mouth

A

seen with apothous stomatitis (canker sores) and herpes simplex (cold sores)

127
Q

Warning signs of cancer for mouth and tongue

A

sores that do not heal, persistent red or white patches

a lump or thickening on the tongue or rough, crust, eroded areas are warning signs of cancer and need a referral

128
Q

Gingivitis

A

red, swollen gums that bleed easily occur in early gum disease which is gingivitis

129
Q

Destruction of the gums with tooth loss

A

occurs in advanced disease

130
Q

Periodontal disease

A

is highly correlated with cardiovascular disease

three times more prevalent in AA

131
Q

Pain, tenderness and pressure around the eyes, cheeks, nose or forhead

A

seen in acute sinusitis which is an infection of the sinuses

132
Q

Chronic sinusitis

A

the sinuses become inflamed and swollen but symptoms will last 12 weeks or long even with treatment

133
Q

Epistaxis

A

nose bleeds

local causes are trauma, mucosal irritation, inflammatory diseases or tumors

idiopathic causes which are (unknown cause)

134
Q

Kiesselbach area

A

located in the anterior part of the septum

is the most common site for nose bleeds

135
Q

Stopping a nose bleed

A

Have patient sit up with head tilted forward not back, pinch nose between thumb and forefinger to 5 to 15 minutes

136
Q

Thin, watery clear drainage

A

chronic allergies, but can also be CSF if associated with head injury

137
Q

Yellow or green drainage

A

is typical of a cold, rhinitis or a sinus infection

138
Q

Most upper respiratory infections are _____?

A

viral

139
Q

Family history of mouth, throat, nose or sinus cancer

A

genetic links to these types of cancer

140
Q

Smoking and drinking oral cancer

A

excessive use of alcohol increases the risk of oral cancer

141
Q

Poor fitting dentures

A

may lead to poor eating habits

reluctance to speak freely

mouth sores or leukoplakia (thick white patches of cells) which is a precancerous condition

142
Q

Pallor in the lips

A

seen with anemia and shock

143
Q

Bluish in the lips

A

cyanotic seen with being cold or hypoxia

144
Q

Reddish in the lips

A

seen with keto acidosis, carbon monoxide poisoning and COPD with polycythemia

145
Q

Swelling in the lips

A

seen with local or systemic allergies or anaphylactic reactions

146
Q

Red swollen gums

A

vitamin C deficiency

gingivitis

leukemia

147
Q

Buccal mucosa abnormalities

A

Leukoplakia and thrush

148
Q

Leukoplakia

A

chalky white raised patches that are precancerous

149
Q

Thrush

A

Whitish curd-like patches that snap off and bleed easily

150
Q

Fruity or acetone breath odor

A

diabetic ketoacidosis

151
Q

Ammonia breath odor

A

kidney disease

152
Q

Foul odor

A

oral or respiratory infection or tooth decay

153
Q

Fecal breath odor

A

bowel obstruction

154
Q

Sulfur breath odor

A

end stage liver disease

155
Q

Grading scale for tonsils

A

1+ visible

enlarged
2+ halfway between tonsillar pillars and uvula
3+ touching uvula
4+ touching each other

156
Q

Tonsillitis

A

when the tonsils are covered with exudate

157
Q

Dry tongue with deep longitudinal fissures

A

a sign of dehydration

158
Q

enlarged tongue

A

suggests hypothyroidism

acromegaly (pituitary gland produces too much growth hormone)

Down syndrome

159
Q

Small tongue

A

seen with malnutrition

160
Q

atrophied tongue

A

seen with damage of cranial nerve XII

161
Q

Bright red throat with yellow or white exudate

A

pharyngitis

162
Q

Yellow mucus in the throat

A

seen with postnasal sinus drainage

163
Q

Strep Throat

A

accounts for only a small portion of sore throats

if untreated it can cause complications such as kidney inflammation or rheumatic fever

has to be treated by antibiotics.

Should always come in if they have a sore throat because you don’t know if its strep

164
Q

Characteristics of strep throat

A

Erythematous posterior pharynx

palatal petechiae

white strawberry tongue

165
Q

Deviated septum

A

can interfere with the openness of air flow

crooked nose

166
Q

nasal mucosa (turbinates) that are swollen and pale pink or bluish gray

A

seen with chronic allergies

167
Q

Nasal mucosa that is red and swollen

A

seen with upper respiratory infection

168
Q

Small pale, round firm overgrowths or masses on the mucosa

A

are polyps

169
Q

perforated septum is seen with ___?

A

cocaine use

170
Q

Tender maxillary sinuses

A

if tender seen with chronic allergies or acute bacterial infection

patient will large amount of exudate in their sinuses crepitus will be felt on palpation of the maxillary sinuses

171
Q

Hypothyroidism on its one

A

sleepiness, muscle aches, menstrual irregularities

myxedema is a medical emergency

172
Q

Myxedema symptoms

A

low bp, decreased breathing, decreased body temp, unresponsiveness and even coma

173
Q

what comes along with aura with migraines ?

A

Aura might occur before or during migraines: visual disturbances, vertigo, tinnitus, numbness or tingling , difficulty speaking

May be precipitated by emotional disturbances
May follow ingestion of alcohol, cheese, chocolate or other foods and substances which patient is sensitive to.

174
Q

aura from migraines

A

Aura might occur before or during migraines: visual disturbances, vertigo, tinnitus, numbness or tingling , difficulty speaking

May be precipitated by emotional disturbances
May follow ingestion of alcohol, cheese, chocolate or other foods and substances which patient is sensitive to.

175
Q

Hypertensive headache

A

begins in the morning, decreases during the day

176
Q

temporal arteritis headache

A

typically occurs in older adults

177
Q

Myxedema

A

causes facial puffiness, extremity edema, and weight gain

hypothyroidism

178
Q

Graves disease

A

includes increased appetite, weight loss, nervousness, tremors, and thyroid enlargement (goiter)

Hyperthyroidism

179
Q

Miosis

A

Pupil constriction

180
Q

Mydriasis

A

pupil dilation

Health Assessment (9 decks)

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