HEENT (Exam 2) Flashcards

Question

_________ of the thyroid cartilage happens during adolescence

Answer 1

enlargement

Answer 2

increased vascularity

Answer 3

• tension • sinus • cluster • migraine

Answer 4

if the patient doesn’t usually have headaches

Answer 5

concussion or blunt trauma and a change in LOC (OLDCARTS!!)

Answer 6

• presyncope • vertigo (objective v. subjective) • disequilibrium (shaking when walking)

Answer 7

acute infection; possible malignancy

Answer 8

head and neck cancer

Answer 9

• headaches • head injury • dizziness • history of head or neck surgery • lumps or swelling • neck pain/limitation of motion • PCC

Answer 10

any associated upper extremity numbness or tingling?

Answer 11

• acute onset stiffness • headache • fever

Answer 12

helmet use? stress? coping mechanisms?

Answer 13

• musculoskeletal origin • most common (39-78%) • 3 times more common in WOMEN than MEN • 3 categories (episodic infrequent, episodic frequent, chronic)

Answer 14

<1 day a month

Answer 15

<15 days a month for 3 months

Answer 16

>15 days a month for 3 months

Answer 17

variable, patient dependent

Answer 18

usually both sides; forehead, sides and back of head

Answer 19

30 minutes-7 days

Answer 20

band-like tightness, viselike non-throbbing

Answer 21

stress, anxiety, depression, poor posture, poor sleep

Answer 22

NSAIDS, tricyclic antidepressants, reducing stress, applying ice or heat to sore muscles, cognitive behavioral therapies, physical therapy, massages

Answer 23

situational; in response to overwork, posture

Answer 24

mild-moderate pain (Pain rating 1-5)

Answer 25

• trigeminal nerve/vascular origin • 15% prevalence • recurrent HA of moderate-severe intensity (5-10), lasting 4-72 hours • 3 times more common in WOMEN than MEN • 3 categories (migraine WITH AURA, migraine W/O AURA, chronic)

Answer 26

variable, patient dependent

Answer 27

commonly one sided, pain often being the eyes, temples or forehead

Answer 28

rapid onset, peaks 1-2 hr, lasts 4-72 hours

Answer 29

throbbing and pulsating

Answer 30

premenstrual hormonal fluctuations, drinks (alcohol and caffeine), foods (cheese, chocolate, salty/processed), additives (MSG, aspartame)

Answer 31

lie down, darken room and sleep; NSAIDS and preventative medications

Answer 32

4 stages: prodrome, aura, migraine attack (4-72 hours), postdrome (24-48 hours; fatigue and irritability)

Answer 33

hours-days before migraine; change in mood, sensitivity to light/sound/smell, fatigue

Answer 34

5-60 min; visual changes, tingling in extremities, vertigo, speech change

Answer 35

• rare • 3 times more common in MEN than WOMEN typical starts in 20s-40s

Answer 36

variable; can occur multiple times a day in clusters that last weeks

Answer 37

always one sided, around eye or temple

Answer 38

abrupt onset, peaks in minutes, lasts 15 min-3 hours

Answer 39

continuous, sharp, burning, piercing, excruciating

Answer 40

alcohol, nitroglycerin, histamine, organic compounds (paint, perfume…)

Answer 41

inhaled oxygen (high dose and flow rate), corticosteroids, calcium channel blockers

Answer 42

1-2 a day up, to 8 a day for weeks/months; then remission for months or years; often occurs at night or waking from sleep

Answer 43

very severe, 7-10

Answer 44

• maternal alcohol or drug use • type of delivery • growth pattern of the head

Answer 45

• dizziness (assess for injury) • neck pain • can they drive?

Answer 46

• size and shape (normocephalic v. micro/macrocephalic) • normal bone protrusions w/o tenderness (note any lumps, depressions or protrusions • palpate temporal artery and temporomandibular joint (note crepitation, limited ROM, tenderness)

Answer 47

• symmetry • any enlargements? • ROM • trachea (palpate for midline positioning)

Answer 48

• palpate with gentle pressure in circular motion in drain areas • should be soft, movable and non-tender

Answer 49

• enlargements/masses (infection, chronic inflammation, HIV, neoplasms, lymphoma?) • lymphadenopathy (>1cm lymph node enlargement from infection, allergy or neoplasm

Answer 50

• difficult; can have patient tilt head back and take a sip of water and inspect how patient swallows

Answer 51

•inspect sternomastoid and trapezius muscle for equal size and bilateral movement • assess motor function and strength

Answer 52

carries visual data; protected by orbital socket, eyelashes and eyelids

Answer 53

covers and protects the iris and pupil

Answer 54

transparent protective cover

Answer 55

produces tears and keeps the eyes moist

Answer 56

4 straight (rectus) muscles, 2 slanting (oblique) muscles

Answer 57

• superior • inferior • lateral • medial

Answer 58

• superior • inferior

Answer 59

when both eyes move, their axes remain parallel

Answer 60

binocular and single-image

Answer 61

• CN III (oculomotor) • CN IV (trochlear) • CN VI (abducens)

Answer 62

superior, inferior, and medial rectus and inferior oblique

Answer 63

superior oblique

Answer 64

lateral rectus, abducts the eye

Answer 65

the protective white covering; outer layer

Answer 66

transparent and sensitive, important for light refraction; outer layer corneal reflex

Answer 67

• highly vascularized to supply retina; middle layer • dark pigment to prevent light reflection • iris and pupil

Answer 68

• contracts pupil for bright light and near vision accommodation • dilates pupil for dim light and far vision

Answer 69

visual receptive layer; inner layer • optic disc, retinal vessels, macula

Answer 70

• vision difficulty • pain (foreign bodies, scratches, light sensitivity) • history of strabismus (misaligned eyes) • history of diplopia (seeing double) • redness or swelling? • watery or discharge? • history of eye issues • glaucoma family or personal history • use of glasses and last eye exam • PCC (how do you care for your eyes?)

Answer 71

• inspect for tremors • no ptosis (lid lag), discharge or crusting • check for ability to open and close • observe for flakiness and redness • note eversion/inversion of lids

Answer 72

• clear, moist, white sclera (no icteric aka yellowness, exudates, or lesions) • no conjunctivitis or pterygium • inspect cornea and lens for transparency (glaucoma?)

Answer 73

abnormal growth of conjunctiva, can impair vision

Answer 74

• color and shape • inspect CN III (oculomotor): size, shoe, equality of pupils • direct and consensual response of light • convergence test

Answer 75

moving your finger closer to a patients face, noticing the whole pupil moves toward the nose and pupils will constrict (cross eyed)

Answer 76

motor movement of the pupil

Answer 77

change in size of the pupil in response to a closer object

Answer 78

Pupils Equal Round Reactive Light Accommodation

Answer 79

snellen chart: • legal blindness (20/200) • numerator: distance of patient from chart • denominator: distance which average patient can read (20/20 is normal) near vision screening- 14 inches (rosenbaum)

Answer 80

nystagmus (oscillating movement), mild nystagmus ok in extreme lateral position corneal light reflex (Hirschberg test)

Answer 81

red glow filling patients pupil in response to the ophthalmoscope reflecting light off the retina optic disc appears as setting sun retinal vessels macula

Answer 82

confrontation test (peripheral vision)

Answer 83

• funnels sound waves into opening • has glands that produce ceremen for protection • lymphatic drainage flows to parotid, mastoid and superficial cervical nodes

Answer 84

•auditory ossicles •eustachian tube • conducts sound vibrations from outer ear • protects the inner ear by reducing amplitude of loud sounds • allows equalization of air pressure of each side of tympanic membrane to prevent rupture

Answer 85

malleus, incus, stapes

Answer 86

connects middle ear with nasopharynx and allows the passage of air

Answer 87

holds sensory organs for equilibrium and hearing vestibule and semicircular canals cochlea for central hearing

Answer 88

sound waves organ of corti (hair cells bend and turn vibrations into electrical impulses)

Answer 89

location and identification of sound CN VIII sends signals to brainstem

Answer 90

interprets meaning of sound to initiate a proper response

Answer 91

• middle/external ear • usually partial loss • impacted cerumen, foreign bodies, perforated tympanic membrane, pus, otosclerosis

Answer 92

• usually inner ear, CN VIII, or auditory areas of cerebral cortex • prebycusus • ototoxic drugs

Answer 93

age related nerve degeneration

Answer 94

labyrinth- feeds brain info about body’s position to determine verticality or depth misinformation may cause staggering gait or vertigo

Answer 95

• eustachian tube is shorter and wider, more horizontal (easier for pathogens to go to middle ear) • external ear canals shorter and opposite slope

Answer 96

conductive hearing loss between 20-40; bone formation and fixation impedes transmission

Answer 97

• cilia becomes course and stiff • hearing aids (cerumen impaction) • presbycusis

Answer 98

• earache (otalgia) • infections or history • discharge (otorrhea) • hearing loss • environmental noise and damage • tinnitus • vertigo • dizziness • PCC (hygiene, use of hearing aids, workplace ear protection, last ear check?) • past medical history/family history

Answer 99

• inspect auricles (size and shape, landmarks, consistent color and symmetry) • inspect external auditory canal (discharge) and meatus • check movement of auricle and tragus for tenderness

Answer 100

•audiometric most accurate • whispered voice test 2 ft behind • tuning forks (weber and rinne)

Answer 101

• CN I (Olfactory) • Turbinates (superior, middle, and inferior) warm, humidify, and filter air • sinuses drain into middle meatus • tears drain into inferior meatus

Answer 102

bone cartilage nares

Answer 103

• ciliated mucous membrane, easily occluded • 4 sets (maxillary, frontal, ethmoid, sphenoid)

Answer 104

• taste buds in the papillae at back and sides of tongue and soft palate

Answer 105

mastification swallowing teeth cleansing speech formation

Answer 106

parotid, submandibular, and sublingual • moisten and lubricate food • starts digestion • cleans and protects mucosa

Answer 107

adults have 32 crown, neck, root

Answer 108

separated from the mouth by bilateral tissue folds tonsils (lymphoid tissue)

Answer 109

above oropharynx and behind nasal cavity adenoids and eustachian tube openings rich lymphatic network

Answer 110

• salivation starts at 3 months old, drooling • 20 deciduous teeth (by 2.5 years old) • nose develops shape during adolescence (12-13 years old)

Answer 111

nasal stuffiness and epistaxis (nose bleeds) due to increased vascularity gums may be more sensitive

Answer 112

more prominent nose increased risk of malignant lesions receeding gums and tooth loss

Answer 113

• discharge (rhinorrhea) • frequent colds (infection?) • sinus pain • trauma • epistaxis (frequent, amount, which nostrils) • allergies • altered smell

Answer 114

sit, lean forward, and compress lower soft part of nose 15-20 minutes

Answer 115

• sores and lesions • sore throat • bleeding gums and toothache (heat v. cold sensitivity) • hoarseness and snoring • dysphagia • altered taste • smoking and alcohol consumption • PCC (dental care/dentures)

Answer 116

• inspect external nose (midline position, nasal flaring) • inspect internal nose (color, discharge/odor, masses/lesions, swelling of turbinates)

Answer 117

palpate frontal, maxillary sinuses and percuss for tenderness

Answer 118

• inspect mouth, lips, gums, teeth, mucosa (pink) with penlight • pharyngeal wall • bimanual palpation of mouth when indicated in adults

Answer 119

• inspect and grade tonsils (0-2+) • assess position of uvula • CN XII (hypoglossal): extension of the tongue, check for symmetry

Answer 120

• helmets • use of seatbelts • sunglasses-cataracts • vitamin a deficiency (night blindness) • routine screenings and exams • routine checkups • oral health • ear plugs/decrease music volume

Answer 121

sensory type; smell

Answer 122

sensory type; vision

Answer 123

mixed type; extraocular eye movement, opening of lids, pupil constriction, lens shape

Answer 124

motor type; down and inward movement of eye

Answer 125

mixed type; mastication muscles; face, cornea and mucous membrane sensations

Answer 126

motor type; lateral movement of eye

Answer 127

mixed type; facial muscles, speech, taste, saliva and tear secretion

Answer 128

sensory type; hearing and equilibrium

Answer 129

mixed type; pharynx, taste, parotid gland, carotid reflex

Answer 130

mixed type; pharynx and larynx, carotid reflex, general sensation from carotid body

Answer 131

motor type; movement of trapezius and stermomastoid muscles

Answer 132

motor type; movement of tongue