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Physical Dx > L3-4: HEENT > Flashcards

L3-4: HEENT Flashcards

1
Q

HEENT: ROS

A
  • Head
    • headache, vertigo, syncope, head trau
  • Eyes
    • visual acuity changes, blurred vision, diplopia, photophobia
  • Ears
    • change in acuity, discharge, pain, tinnitus, recurrent ear infections
  • Nose
    • obstruction, discharge, epistaxis, pain
  • Mouth
    • toothaches, bleeding gums, sore throat, dysphagia, hoarseness, change in taste
  • Neck
    • pain, stiffness, swelling/masses
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2
Q

Cranial Nerves

What cranial nerves are responsible for the following

  • Visual Acuity
  • Hearing
  • EOMs
  • Facial expression
  • Mastication, clench
  • Soft touch face
  • Soft palate/uvula “Ah”
  • Movement of Tongue
  • Head & shoulder movement
A
  • Visual Acuity (CN II)
  • Hearing (CN VIII)
  • EOMs (CN III, IV, VI)
  • Facial expression(CN VII)
  • Mastication, clench (CN V motor)
  • Soft touch face (CN V sensory)
  • Soft palate/uvula “Ah” (CN IX, X)
  • Movement of Tongue (CN XII)
  • Head & shoulder movement (CN XI)
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3
Q

Hair

Alopecia Areata

Androgenic Alopecia

Seborrheic Dermatitis

A
  • Alopecia Areata: autoimmune condition causing hair loss
  • Androgenic Alopecia: Receding/thinning hair
  • Seborrheic Dermatitis: “Dandruff”, Greasy, Yellow scales
    • Scalp, Nasolabial folds, Eyebrows, Forehead
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4
Q

Psoriasis

What is it?

Clinical presentation?

A
  • Autoimmune dermatologic condition
  • Silvery white sharply demarcated plaques and coarse scale
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5
Q

Tinea Capitis

What is it?

Clinical presentation?

What is a kerion?

A
  • Fungal scalp infection
  • Round scaly patches or plaques with or w/o inflammation
  • Kerion: raised boggy secondarily infected fungal lesion
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6
Q

Trigeminal Nerve (CN V) Sensory and Motor

How to test?

A
  • Sensory - Light touch in all 3 areas bilaterally using cotton-tip applicator
    • Ophthalmic
    • Maxillary
    • Mandibular
  • Motor - palpate masseter muscle, clench teeth
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7
Q

Facial Nerve

Which cranaial nerve?

How to assess?

A
  • Facial Nerve (CN VII)
  • Assess facial symmetry
    • Raise eyebrows
    • Frown
    • Squeeze eyes shut
    • Puff out cheeks
    • Smile
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8
Q

Acromegaly

What is it?

Cause?

A
  • Excessive Growth Hormone production
  • Large hands & feet
  • Excessive facial bone growth, enlarged jaw
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9
Q

Bell’s Palsy

Cause?

Clinical presentation?

A
  • Idiopathic facial (7th) nerve paralysis: muscle weakness on one side of face
  • Difficulty closing eye
  • Flattened nasolabial fold
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10
Q

Specialized Test: Assessing the Temporal Artery

What are you ascultating for?

A
  • Palpate
  • Auscultate for bruits
    • Giant Cell (Temporal) Arteritis
      • Adults >50
      • New HA
      • Jaw Claudication
      • Elevated ESR
      • Associated with condition called Polymyalgia Rheumatica (PMR)
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11
Q

Anatomy of the Eye

Tarsal plates

meibomian glands

bulbar conjuctiva

palpebral conjuntiva

A
  • Eyelids
    • Tarsal plates: firm strip of connective tissue
    • Meibomian glands: sebaceous glands
  • Bulbar conjunctiva
    • Covers anterior eyeball
  • Palpebral conjunctiva
    • Covers inner eyelids
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12
Q

Visual Acuity: Vital Sign of the eye

Snellen vs. Rosenbaum

What is each test measure?

A
  • Snellen Chart: Test central vision @ 20 feet
    • Screens for myopia (impaired far vision)
  • Rosenbaum pocket chart (@ 14 inch*)
    • Screens for presbyopia (impaired near vision)
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13
Q

Pupils

Miosis

Mydriasis

Anisocoria

Direct pupillary light reflex

Consensual pupillary light refle

A

Miosis: excessive constriction

Mydriasis: excessive dilation

Anisocoria: pupils are unequal size

Direct pupillary light reflex: pupil constricts on same side as light

Consensual pupillary light reflex: Constriction in opposite eye

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14
Q

Near Far Accommodation

What is the test?

What are you looking for?

A
  • Patient focuses on an object approximately 10cm away then focus on an object >6 feet away
  • Watch for pupillary constriction with near effort, and dilatation with distance.
    • Narrows (constricts) with Near
    • Dilates with Distance
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15
Q

Extraocular Muscles (EOMs)

Nystagmus

How to test?

A

Nystagmus: uncontrolled repetitive movements of the eyes; fine rhythmic oscillation

During “H” pause @ upward & lateral gaze to detect nystagmus

Nystagmus may be seen in a variety of neurologic conditions

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16
Q

Extraocular Movements: Cranial Nerves

what are the extraocuar muscles?

What are the cranial nerves assocaited with each?

A
  • Extraocular Movements (CN III, IV, VI)
  • LR6…SO4… AO3
  • Lateral Rectus (CN VI)
  • Superior Oblique (CN IV)
  • All Others CN III
    • Medial rectus
    • Superior rectus
    • Inferior rectus
    • Inferior oblique
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17
Q

Corneal Light Reflection

How to test?

What does it test for?

A
  • Shine light into the patient’s eyes
  • Corneal light reflection tests for conjugate gaze
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18
Q

Ptosis

What is it?

Which cranial n.?

A

Ptosis: drooping uppe reyelid

Cranial nerve: CN III (oculomotor n.)

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19
Q

Eyelid: Incomplete closure

What is it?

Which cranial n?

A

CN VII

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20
Q

Chalazion vs. Hordeoleum

What are they?

Location?

A
  • Chalazion
    • Nontender blocked Meibomian (sebaceous) gland; points inside lid
  • Hordeoleum
    • Tender, red infection at the inner or outer margin of eyelid; usually from Staphylococcus aureus
    • When located on inner lid margin usually from obstructed Meibomian gland
    • When located on outer lid margin usually from obstructed eyelash follicle or tear gland
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21
Q

Dacryocystitis

What is it?

A
  • Dacryocystitis (Lacrimal Sac Inflammation)
  • Infection/inflammation of the nasolacrimal sac usually secondary to blockage of the nasolacrimal duct
    • Swelling between base of nose and eye
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22
Q

Entropion vs. Ectropion

A
  • Entropion
    • Lid inversion: INWARD turning of the lid margin
    • Irritation of conjunctiva and cornea
    • More common in elderly
  • Ectropion
    • Lid eversion: OUTWARD turning of the lid margin exposes palpebral conjunctiva
    • Excessive tearing can occur as eye may not drain effectively
    • More common in elderly
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23
Q

Pingueculum vs. Pterygium

A
  • Pingueculum
    • Yellow, triangular growth on bulbar conjunctiva on either side of the iris
    • Harmless, vision WNL
  • Pterygium
    • Triangular thickening of bulbar conjunctiva that grows slowly across cornea
    • May interfere with vision
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24
Q

Scleral Icterus

What is it?

DDx?

A
  • Scleral Icterus: Yellow discoloration of sclera, frequently association with jaundiced skin
  • Elevated bilirubin
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25
Q

Xanthelasma

What is it?

DDx?

A
  • Xanthelasma: Raised, yellow, well-circumscribed cholesterol-filled plaques around eyelids
  • Commonly associated with hyperlipidemia
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26
Q

Conjunctivitis

What is it?

Types?

A
  • Inflammation of the transparent covering of the eye because of bacterial or viral infection or allergic reaction. The eye appears swollen, and red with itching sensation.
  • Viral, Bacterial, Allergic, Irritant Conjunctivitis
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27
Q

Thyroid related Orbitopathy

Exophthalmos

A
  • Exophthalmos: Abnormal protrusion of the eyeball, lid retraction
    • Seen in Grave’s Disease (Thyroid dysfunction)
  • Thyroid dysfunction (hypothyroidism) may also cause loss of the lateral 1/3 eyebrows
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28
Q

Subconjunctival Hemorrhage vs. Hyphema

A
  • Subconjunctival Hemorrhage
    • Asymptomatic, self-limited
    • Usually hx of cough, straining
  • Hyphema
    • Grossly visible blood in anterior chamber
    • Usually secondary to trauma
    • Vision threatening → refer
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29
Q

Corneal Abrasion (With Fluorescein Stain) vs. Corneal Chemical Burn

A
  • Corneal Abrasion (With Fluorescein Stain)
    • Foreign body sensation
    • Photophobia, increased lacrimation, pain
    • Does patient wear contacts?
    • Injury?
  • Corneal Chemical Burn
    • Usually hx of liquid or gas splashed in eye
    • Immediate, prolonged irrigation
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30
Q

Cataract

Cause

Risk factors

A
  • Clouding (opacity) of the lens
  • Causes painless progressive vision loss
  • Risk Factors: age, Smoking, DM, Corticosteroid Use, ETOH
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31
Q

What is the normal cup to disc ratio?

What is the normal AV ratio?

A
  • CD Ratio: 1:2
  • AV ratio: 2/3
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32
Q

What is the Macula/fovea responsible for?

A

Responsible for central vision

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33
Q

Hypertensive Vascular Changes

Copper wire

Silver wire

A-V nicking/crossing

A
  • Copper wire
    • oVessels get full and tortuous with increased light reflex with coppery luster
  • Silver wire
    • Vessel wall becomes opaque. Blood inside cannot be seen
  • A-V nicking/crossing
    • Appearance of breaks in vein when artery and vein cross
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34
Q

Hypertensive Retinopathy

Cotton Wool Patches

Hemorrhages

What are they?

Cause?

A
  • Cotton Wool Patches: (aka. Soft exudates)
    • White, gray, ovoid lesions with irregular (soft) borders
    • Caused by infarcted nerve fibers
    • Also seen in DM
  • Hemorrhages:
    • Caused by microaneurysms
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35
Q

Diabetic Retinopathy

What is it?

Neovascularization?

A
  • Hemorrhages can be seen along with hard exudates
  • Hard (well-defined borders) exudates are creamy/yellow, appear bright
  • These are common with DM and HTN
  • Neovascularization: development of new blood vessels arising from the disc and extending to the margins
    • Caused by abnormal permeability and vascular occlusion
    • More numerous and tortuous
36
Q

Glaucoma with Cupping

What is glaucoma?

What does glaucoma do to the cup to disc ratio?

How is the anterior chamber depth related to galucoma?

A
  • Increased pressure w/i eye results in abnormal cupping (backward depression of the disc)
    • Represents optic nerve damage
  • Normal Cup to Disc ratio < 1:2.
    • In Glaucoma, cup to disc ratio is > 1:2 due to increase intraocular pressure
    • May have abnormal Anterior Chamber Depth on exam (crescent shadow coming soon…)
37
Q

Papilledema

What is it? Cause?

Symptoms?

A
  • Optic disc swelling caused by increased intracranial pressure
  • Sharp borders of the disc are no longer present
  • Pt may have severe HA, nausea, vomiting
38
Q

Macular Degeneration

A
  • LAST STEP of eye exam is to ask pt to look directly at light
    • Macula: Area of the retina that absorbs the most light
  • Normal: Reflection of light from macula
  • Degeneration of macula is due to build up of drusen (cellular debris)
    • As degeneration occurs, the light reflection decreases
39
Q

Specialized Test: Checking Visual Fields

What is it?

How to test?

A
  • Area seen by pt when they look at a central point
  • Check with fingers in each quadrant
40
Q

Normal Vision

Where is the lesion/defect for the following, cause?:

Blind eye

Lesion at the Optic Chiasm

Lesion on Optic tract behind chiasm

A
  • What I see on the nasal side hits the opposite (temporal) side of the retina and stays on the same side
  • What I see on the temporal side hits the opposite (nasal) side of the retina and crosses at the optic chiasm
  • (2) Blind eye = Defect at the optic nerve before optic chiasm (neither the nasal or temporal sight will make it to the brain)
  • (3) Lesion at the Optic Chiasm
    • Causes defect in both temporal fields (bitemporal hemianopsia) Ex. Pituitary tumor
  • (4) Lesion on Optic tract behind chiasm (Ex. stroke, tumor) produce defects on opposite side:
    • Defect at R optic tract causes L homonymous hemianopsia
    • Defect at L optic tract causes R homonymous hemianopsia
41
Q

Specialized Test: Cover-Uncover Test

When to perform?

How to test?

What does it test?

A
  • When to perform:
    • If abnormal corneal light reflection
  • How to test:
    • Occlude each eye in alternating fashion
    • Observe for change in fixation of the uncovered eye.
    • Observe for movement of covered eye after cover is removed.
  • May reveal muscle imbalance not seen on general eye exam
42
Q

Strabismus

What is it?

Esotropia

Exotropia

Hypertropia

Hypotropia

Amblyopia

A
  • Strabismus: Misalignment of Eyes
  • Deviation of the eyes from their normally conjugate position
    • Congenital or acquired
    • Esotropia, Exotropia, Hypertropia, Hypotropia
  • One of the most common eye problems encountered in children (4% of children < 6YO)
  • Can result in amblyopia (vision loss) if not detected early and treated
    • Check visual acuity if strabismus detected and refe
43
Q

Asymmetric Corneal Light Reflection in Patient with Strabismus

Where is the light displaced in:

Esotropia

Exotropia

A

Esotropia: Light displaced laterally on affected eye

Exotropia: Lightdisplaced medially on affected eye

44
Q

Specialized Test: Anterior Chamber Depth

How to test?

What does this test for?

A
  • Tests for: increased intraocular pressure
    • Ex. glaucoma
  • How to test
    • Shine light from the temporal side of the patient’s eye (toward the nose)
    • Look for shadow on the medial aspect of the iris
      • “Crescent shadow”
45
Q

Specialized Test: Corneal Reflex

Which cranial nerves?

How to test?

A
  • CN V (sensory) and VII(motor)
  • Gently touch the edge of the cornea with a rolled cotton and observe for responsive blink

Note: Don’t confuse Corneal Reflex with Corneal Light Reflection: which checks for ocular alignment

46
Q

Specialized Test: Eversion of the Eyelid

How to test?

What does it test for?

A
  • Pull down upper eyelashes and evert eyelid over cotton applicator.
  • Used to rule out foreign body
47
Q

Gouty Tophi

A

Uric acid crystal deposit after years of chronically elevated uric acid

48
Q

Basal Cell Carcinoma vs. Squamous Cell Carcinoma

Clinical Presentations?

A
  • Basal Cell Carcinoma (BCC): Raised, pearly nodule with central telangiectasia
  • Squamous Cell Carcinoma (SCC): Crusted border, central ulceration, bleeding
49
Q

Assessment of Hearing

Which cranian nerve?

Conductive Loss vs. Sensorineural Loss

A
  • Assessment of Hearing (CN VIII)
  • If hearing reduced, distinguish conductive hearing loss vs. sensorineural hearing loss.
    • Conductive Loss: problem conducting sound waves (EAC, TM or middle ear). Abnormality usually visible
    • Sensorineural Loss: disorder of the inner ear, cochlear nerve (CN8) impairs transmission of nerve impulse to brain. Problem is NOT visible.
50
Q

Types of hearing conduction:

Air Conduction vs. Bone Conduction

What if:

AC > BC

BC > AC

AC > BC

A
  • Air Conduction: Sound transmitted through air (EAC, TM, middle ear) into cochlea
  • Bone Conduction: Sound transmitted though vibrations in bone. Bypass external & middle ear
    • Vibration of the skull stimulates the inner ear directly
  • AC > BC: Normal
  • BC > AC: Conductive hearing loss
  • AC > BC: Could also be sensorineural hearing loss
51
Q

Weber Test

How to test?

What does it test for?

What is normal? abnormal?

Conductive loss vs. Sensorineural hearing loss

Causes?

A
  • How to test:
    • Tuning fork on top of head
  • Tests for:
    • NORMAL: Sound heard equally in both ears
    • ABNORMAL: sound lateralizes
      • Conductive loss: Sound lateralizes to impaired (bad) ear
      • Sensorineural hearing loss (SNH): Sound lateralizes to good ear
        • Bad ear cannot transmit impulses
        • No signal is transduced by cochlea on affected side
  • Unilateral conductive loss lateralizes (sound is heard best) to impaired ear
    • Ex. Otitis media, perforation, cerumen, otosclerosis, etc.
  • Unilateral sensorineural loss lateralizes to good ear
    • Caused by damage to the inner ear
    • Ex. Presbycusis (age related hearing loss), noise exposure, head trauma
52
Q

Rinne Test

  • What does it test for?
  • What does it compare?
  • What is normal?
  • What would you expect with to see in:
    • Unilateral conductive loss
    • Unilateral sensorineural loss
A
  • Compares Air and Bone Conduction
  • How to test
    • Place tip of vibrating tuning fork on mastoid bone
    • Ask patient if they can hear it; have them tell you when sound stops
    • Move tuning fork in front of ear; ask if they can still hear it.
    • If they can still hear the sound, then AC>BC (NORMAL TEST)
  • Normal: AC>BC
    • Normally, sound is transmitted to cochlea most efficiently through air
  • Unilateral conductive loss: Sound heard through bone longer than through air (BC > AC)
  • Unilateral sensorineural loss: Sound heard longer though air (AC > BC) because AC and BC are reduced equally (normal pattern prevails)
53
Q

Weber vs. Rinne

Normal

Conductive Hearing Loss

Sensorineural Hearing Loss

A
  • Weber
    • Normal:
      • No lateralization (equal Bilaterally)
    • Conductive Hearing Loss:
      • Lateralizes to impaired ear
    • Sensorineural Hearing Loss:
      • Lateralizes to Good ear
  • Rinne
    • Normal:
      • Air > Bone Conduction Bilaterally
    • Conductive Hearing Loss:
      • BC > AC in impaired ear
      • AC > BC in Good ear
    • Sensorineural Hearing Loss:
      • AC> BC in both ears
54
Q

Tympanosclerosis

A
  • Chalky white patch- Scarring of the TM
  • Seen in recurrent Otitis Media or hx of tubes or previous perforation
55
Q

Serous Effusion With Air Bubbles

Cause?

Symptoms?

A
  • Usually caused by viral URI or barotrauma
  • Eustachian tube dysfunction often involved
  • Sxs: Fullness or popping in ear
56
Q

Bullous Myringitis

What is it?

A
  • Painful, hemorrhagic vesicles
  • Landmarks obscured
  • Commonly conductive hearing loss during infection
57
Q

Otitis Externa

What is it?

Symptoms?

A
  • Infection of the external auditory canal
  • Discharge and edema of the canal
  • Tenderness with movement of tragus and pinna
58
Q

Specialized Test: Assessing the Sinuses

Sinus percussion

Sinus palpation

Frontal Sinus Transillumination

Maxillary Sinus Transillumination

A

Sinus percussion: Tap the frontal and maxillary sinuses assessing for tenderness

Sinus palpation: Apply pressure to the frontal and maxillary sinuses assessing for tenderness

Frontal Sinus Transillumination: Place light below brow and look for glow in frontal area (Normal finding)

Maxillary Sinus Transillumination: Place light against cheek bone below eye and look for glow on hard palate (Normal finding)

59
Q

Septal Deviation vs. Septal Perforation

Symptoms?

Cause?

A
  • Septal Deviation
    • Deviation is common and mild deviation often asymptomatic
    • Deviation seldom obstructs air flow
  • Septal Perforation
    • Seen with trauma, infection, cocaine, s/p surgery
    • Symptoms: crusting, epistaxis
    • Small lesions may whistle
60
Q

Nasal Polyps

A
  • Soft, pale growths commonly seen in allergic rhinitis, chronic sinusitis and other conditions
  • May cause nasal obstruction
  • Anosmia (loss of smell)
61
Q

Septal Hematomas

Cause?

Symptoms?

A
  • May occur after nasal trauma
  • More common in peds patients
  • Symptoms: Nasal obstruction, pain & tenderness
  • PE: Soft, tender swelling
  • Must rule out septal hematoma in all nasal trauma
  • Early diagnosis and treatment prevents abscess, deformity and other complications
62
Q

Epistaxis

What is it?

Where does it most commonly occur?

A
  • aka Nosebleed
  • Highly vascular region of anteroinferior nasal septum
  • 90% of all epistaxis occur in Kiesselbach plexus/area
63
Q

Rhinitis and Sinusitis

Symptoms?

A
  • Allergic Rhinitis (AR): Swollen, pale, blue, boggy turbinates, shiners, eye Sxs
    • Sinusitis and URI: Erythematous turbinates
    • Drainage—mucoid vs. clear vs. purulent
  • Sinusitis: Tenderness to palpation/percussion of sinuses, abnormal transillumination
64
Q

Salivary glands

What are the glands?

What are the ducts associated with the glands?

Where are they located?

A
  • Parotid
    • Stensen Ducts: Buccal mucosa lateral to molars
  • Submandibular
    • Wharton Ducts: Floor of mouth under tongue
65
Q

Examination of the Oropharynx

Bimanual Examination

Examination of the tongue

A
  • Bimanual Examination: Palpate oropharynx with gloved hand
    • Palpate wall of mouth between internal and external fingers (“bimanual”)
    • Palpate floor of mouth, tongue for masses, lesions
  • Examination of the tongue: With gloves and gauze, gently grasp tip of the tongue to inspect lateral margins
    • Especially important if tobacco use
66
Q

Carcinoma of the Lip

Common cause?

A
  • Squamous Cell Carcinoma common cause
  • Thorough exam of lips, tongue and oral mucosa important
    • Sores that don’t heal
    • Newly formed lesion
  • Consider Risk factors
67
Q

Angular Cheilitis

What is it?

Cause?

A
  • Irritation, fissuring of skin at corners of the mouth associated with
    • Ill-fitting dentures
    • Vitamin deficiency
    • Excessive salivation
68
Q

Oral Candidiasis

A

Oral Candidiasis (Thrush)

  • White patches or plaques on the tongue or buccal mucosa
  • Uncommon among healthy adults
  • Thrush can Brush
69
Q

Leukoplakia

What is it?

How to differentiate from thrush?

A
  • Lesions in the mouth that present as thickened, white patches that cannot be rubbed off.
  • Potentially premalignant
  • Differentiated by thrush by the inability to remove white area
  • Referral for biopsy
70
Q

Oral Carcinoma

Main cause?

A
  • Thorough physical exam is essential!
  • Majority of oral Ca is Squamous Cell Carcinoma
71
Q

Torus Palantinus

A
  • Benign, midline mass in hard palate
72
Q

Gingivitis

Symptoms?

A
  • Causes changes to the Gums
    • Redness
    • Bleeding
    • Edema
    • Tenderness
73
Q

Gingival Hyperplasia

Causes?

A
  • Can be caused by:
    • Medications
    • Pregnancy
    • Puberty
74
Q

Tonsillar Hypertrophy

A
  • persistently enlarged tonsils
75
Q

Hairy Tongue

What is it?

Cause?

A
  • Benign Condition
    • Defect in desquamation of papillae
  • Many causes: Candida, poor hygiene, Abx, tea, coffee, tobacco use
76
Q

Fissured Tongue

A
  • Multiple small grooves on dorsal tongue
  • Benign
  • Increasing incidence with advanced age
77
Q

Geographic Tongue

A
  • Dorsum of tongue reveals smooth areas void of papillae
    • Benign
    • “Map-like”
78
Q

Group A Strep

Exudative Tonsillitis

Symptoms?

A
  • ST, fever, +/- known exposure
  • No cough, nasal congestion
  • Bilateral exudative tonsillitis, cervical lymphadenopathy (LAD)
  • Strep screen/culture +
79
Q

Mononucleosis

Symptoms?

Cause?

A
  • Mononucleosis (Epstein Barr Virus)
  • ST, fever, fatigue
  • Bilateral exudative tonsillitis
  • Tender cervical LAD, +/- splenomegaly
  • Mono screen +, strep screen negative
80
Q

Peritonsillar Abscess

Symptoms?

Clinical presentation?

A
  • Unilateral peritonsillar swelling & shifted uvula
  • Infection spreads into peritonsillar space
  • “Hot potato voice,” drooling
81
Q

Anatomy of the Neck

Anterior Triangle

Posterior Triangle

A
  • Anterior Triangle
    • Boundaries: mandible, sternocleidomastoid, midline neck
  • Posterior Triangle
    • Boundaries: sternocleidomastoid, trapezius, clavicle
  • Thyroid cartilage
  • Cricoid cartilage
  • Thyroid gland
  • Trachea
  • Carotid artery, jugular vein
82
Q

Lymph Nodes

What are the lymph nodes?

What is unique about one of the categories of lymphnodes?

A
  • Occipital
  • Post-auricular
  • Pre-auricular
  • Tonsillar
  • Submaxillary
  • (submandibular)
  • Submental
  • Anterior cervical - superficial & deep
  • Posterior cervical - superficial & deep
  • Supraclavicular
    • may suggest metastasis from lung or GI cancer
83
Q

What is bruits?

A

signs of turbulent arterial blood flow.

84
Q

Goiter

What is it?

A
  • Enlarged thyroid (Thyromegaly)
  • May be present in multiple forms of thyroid dysfunction
  • Palpate thyroid while patient swallows
85
Q

Tracheal Deviation

What is it?

Cause(s)?

A
  • Trachea may shift toward one side or another
  • Multiple causes
    • Ex. Pneumothorax, goiter, or tumor
86
Q

Jugular Venous Distension

What is it?

Cause?

A
  • Cardiac vs. pulmonary cause
  • Blood flows backward from right atrium into the jugular veins
  • Stay tuned to learn more about JVD in upcoming lectures

Physical Dx (11 decks)

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