HEENT_king Flashcards
Fetal alcohol syndrome
mild microcephaly
Fragile x
broad nasal bridge
Hurler syndrome
low nasal bridge
frontal prominence
Treacher Collins
downward slant of palpebral fissures
low set ears
micrognathia
acromegaly
elongated head
coarsened facial features
bony overgrowth of forehead, nose, lower jaw
Cushing’s disease
Moon face
reddened cheeks
hirsutism
hypothyroidism
puffiness in the face
thinning and coarsening of the eyebrows and hair
ear height
top of auricle should be at or above a line bw the inner canthus and most prominent protuberance of the occiput
preauricular pit
developmental defect in the branchial arches
just anterior to the ear
can become infected
keloid
overgrowth of collagen in scar tissue
grow beyond the corders of original injury
cauliflower ear
d/t repeated blows to the ext ear in boxers and wrestlers
hematoma separates from the cartilage from the perichondrium
scar tissue fills the gap
otitis externa
painful when the ear is pulled
canal remains moist, most often d/t pseudomonas
PO abx not effective, ear drops and cleaning must be used
irrigate with any sort of acid
can become malignant OE, especially in DM
otitis media
bacterial infection of the middle ear
many resolve w/o tx
rarely can progress to mastoiditis, meningitis, or encephalitis….
glue ear
the middle ear becomes filled with glue-like fluid after repeated bouts of OM!!!!!!!!!!!!!!
glue ear is common, unk mech
dampens vibrations of eardrum= dec auditory acuity
surgically lance and drain w/ myringotomy tube
hemotympanum
collection of blood int he middle ear that is visible thru the TM
usually d/t head trauma
TM retraction
sequelae of glue ear
portion of the TM is weak and retracts into middle ear d/t relative negative pressure
decreased auditory acuity
epistaxis-anterior
anterior is most common, visible w/ inspection in area of Kesselbach’s plexus
arid climates, irritants, HTN, coagulopathies, cocaine
epistaxis- posterior
older patients with fragile vessels d/t HTN etc….
profuse bleeding from sphenopalatine a.
Emergent! `
basal cell carcinoma
most common
slow growing, exposed areas in fair-skinned individuals
over-exposure to radiation, solar, x-rays
overgrowth of tissue, does not ulcerate until later
squamous cell carcinoma
more aggressive and mets early
scaley, crusting patch
Herpes simplex of lip
HSV1 accounts for about 80% of cases
goes from asx–>latent stage that migrates to the DRG–>re-activated by physical or emotional stress at site of original infection
peutz-jeghers syndrome
AD disease
melanin deposits of mucous membranes
multiple intestinal polys
15x increased risk of GI cancer
thrush
oral infection d.t. candidia albicans
(infants, IS pts, abx therapy)
mouth irritation and altered taste
geographic tongue
loss of papillae causes this appearance
may be linked to vit B deficiency
no tx necessary
fissured tongue
probably genetic
often asx and noticed on routine exam
hairy leukoplakia
usually an early sign of HIV
pip smoking, chewing tobacco
resembles thrush
painless and rarely undergoes malignant transformations
tooth erosion
erosion of the posterior surface of the teeth
characteristic of bulimia nervosa
oral cancers
highly malignant
tx delayed, often d/t poor exmainations
tonsilar carcinomas
fairly rare
usually squamous cell
linked to HPV infection
often presents late in the course of the disease because there are few early sx
torus palatinus
hard body growth on the hard palate
normal, body exostosis
females>30, rarely need tx
pneumonia findings
auscultation: decreased breath sounds over affected ares, with bronchial sounds, rhonchi, wheezing
dullness to percussion
increased bronchophony and TF
COPD findings
Auscultation
Decreased breath sounds throughout ALL lung fields
wheezing but may have rhonci
Hyperresonance
Special Tests
Bronchophony-Decreased
Tactile fremitus-Decreased
CHF
Auscultation
Decreased breath sounds in dependent portions of the lung
Rales (crackles)
Percussion
May be unchanged or decreased over dependent portions of the lungs
Special Tests
Bronchophony-Usually unchanged
Tactile fremitus-Usually unchanged
Pneumothorax
Auscultation
Breath sounds decreased or absent on affected side
Percussion
Marked hyperresonance
Special Tests
Bronchophony-Decreased
Tactile fremitus-Decreased
Pleural effusion
Auscultation
Decreased or absent on affected side
Percussion
Dullness on affected side
Special Tests
Bronchophony-Unchanged
Tactile fremitus-Decreased
MCC is lung cancers (u/l)
Tonsillitis
most common is S. Pyogenes and other G+ bacteria
treat w/ abx to avoid RF or tonsillar abscess
