L2 - Head & Neck Exam Flashcards
head area
occiput to hairline
head exam
components and characteristics
hair
- color, texture, distribution, quantity, ant pattern loss
look at scalp
- lumps or lesions
skull
- generalized size and contour
the face
- what to note
note facial expression and contours
note assymetry, involuntary movements, edema and masses
the skin
- what to note
note color, pigmentation, texture, thicness, hair distribution, and lesions
nose
- what to note
asymmetry septum turbinates polyps assess pranasal sinuses smell
nose
- what to note
asymmetry septum turbinates polyps assess pranasal sinuses smell
implication of nose following the septum
may indicate any septation or not
implication of nose following the septum
may indicate any septation or not
describe upper third of nose
supported by bone
the lower 2/3rds is supported by cartialge
below the turbinates?
is a groove, or meauts, each is named according to the turbinate above them
below the turbinates?
is a groove, or meauts, each is named according to the turbinate above them
two sinuses to examine
frontla and maxillary is what we should focus on
two sinuses to examine
frontla and maxillary is what we should focus on
acute sinusitis
localized tenderness, along with pain, fever, and nasal discharge may suggest sinusitis
acute sinusitis
localized tenderness, along with pain, fever, and nasal discharge may suggest sinusitis
what to note on the face skin
tecture, pigmentation, lesions
what to note on the eyes
- examine?
visual acuity and visual fields eyelids lacrimal apparuatus conjunctiva, sclera, pupils extraocular muscle movement
what to note on the face skin
texture, pigmentation, lesions
skeletal structures to examine
facial bones and TMK
facial bones look for
fractures and asymmetry
TMJ examine?
range of motion (40-50 mm)
click/ pop?
dislocation?
main things to look out in oral examination
- mouth/ oropharynx
- lips
- tongue
- palate
- floor of mouth
- buccal mucosa
- buccal vestibule
- Teeth
- suggests always doing this last
lips look
observe color, moisture, any lumps, ulcers, or cracking
oral mucosa note
color, ulcers, white patches, and nodules
gingiva note
color, pigmentation, ulcerations
face consists of what (dimensional)
hairline to mandible
neck consists of (dimensional)
mandible to clavicle
fine hair seen in? thick?
fine hair – hyperthyroidism
thick – hypothyroidism
nits
tiny ovoid granules that adhere to hairs may be nits
signs of seborrheic dermatitis or psoriasis
redness and scaling on the scalp
pilar cysts
soft lumps on scalp
hydrocephalus?
enlarged skull may signify this or Paget’s disease of bone
signs of potential head trauma
palpable tenderness or step-offs
air enters nasal cavity by? then goes?
by the anterior naris – then passes into a widened area known as the vestibule and on through the narrow nasal passage to the nasopharynx
nasal septum covered with
mucous member
vestibule lined with?
hair-beeding skin NOT mucosa
laterally in the nasal cavity
turbinates are present
covering turbinates
highly vascular mucous membrane that protrude into the nasal cavity
the SA provided by the turbinates and the mucosal covering them help provide
- cleansing
- humidification
- temperature control of inspired air
draining into the inferior meatus *
nasolacrimal duct
draining into the middle meatus?*
most of the paranasal sinuses
nasal polyps
pale sacklike growths of inflamed tissue that can obstruct the air passages or sinuses
conditions conducive to polyps
- allergic rhinitis
- aspirin sensitivity
- asthma
- chronic sinus infection
- cystic fibrosis
pharynx examine?
symmetry, exudate?, swelling, ulceration, or tonsillar enlargement
palpate areas that are suspicious for evidence of induration or tenderness
common abnormalities
- malocclusion
- dentofacial deformities
- trauma
- masses
- pigmented lesions
- ulcers
common lesions on palate
- salivary gland pathology
- kaposi’s sarcoma (HIV pt’s) – darker
- traumatic ulcers
- torus
common swellings associated with the lips
- fibroma
- lymphangioma
- hemangioma
- mucocele
sensory disturbances in tongue originate what nerve
V and IX
taste problems - what nerves
VII and IX
common swellings on tongue
- hemangioma
- lymphangioma
- malignancy
Ranula
sublingual gland lesions - associated with floor of the mouth
whartons duct location? if pathology?
floor of mouth – can cause submandibular gland obstruction
buccal mucosa note?
a lot! check for any lesions - leukoplakic lesions - CA in-situ - malignancy - hyperkaratosis
wickham’s striae aka
lichen plaus
- buccal mucosa
stenson’s duct lesion where
parotid lesion– look on buccal mucosa
what to check in the buccal vestibule
- alveolar ridge height/ width
- frenum
- buccal / vestibular infections of odontogenic origin
when you find a swelling what do you note (6 aspects)
- size and shape
- tenderness
- consistency / texture
- fixation to structures
- rate of growth
- color/ pigmentation
charactieristics of inflammatory swelling
- short duration
- tender
- erythematous
- movable
try to localize source
characteristics of neoplastic swellings
- longer duration
- rate of growth (benign vs. malignant)
- fixed
- tender or non-tender
what to note when see an ulcer
- size
- shapre
- margins
- rolled, inverted, everted, etc
etiology if known
what to look at on neck exam
- lymph
- cervical spine
- range of motion
- trachea
- thyroid gland
- carotid pulse
lymph node examination
- note?
- size
- location
- texture
- tenderness
- movable vs fixed
true or false focus on CC with exam
no
