Nose, Sinus, Mouth, and Throat Flashcards
What two conditions account for the majority of antibiotics prescribed in outpatient clinics even though they are usually self-limiting viral infections?
URIs and otitis media
What is the issue with the unnecessary and overuse of antibiotics?
Emergence of super strains of drug-resistant bacteria
What is the clinical term for the common cold?
Viral rhinitis
What are the signs and symptoms of viral rhinitis?
Symptoms: stuffy nose and sinuses with watery discharge, sneezing, post nasal drip, cough, itchy eyes, nose, and throat
Signs: swollen nasal tissues and cervical lymph nodes
What is the major difference between allergic and viral rhinitis?
Allergic rhinitis lasts longer and is recurrent
75% of those with what other condition will get sinusitis?
Asthma
What are the signs and symptoms of acute sinusitis?
Symptoms: stuff nose and sinuses with green purulent discharge with aggravated face, teeth, or eye pain while bending over
Signs: swollen nasal tissues and cervical lymph nodes
What two test findings can be seen indicating sinusitis?
Digital pressure eliciting aggravated pain
No transillumination due to thick discharge
What are the grape-like inflammatory swelling of the nasal linings called that are seen in adults who have had allergies or chronic sinus infections for years?
Polyps
What issue can nasal polyps cause?
Interference of nasal drainage
What is the most common cause of a deviated septum?
Trauma
What is the “nasal cycle”?
Normal cycle of mild congestion (unilateral blood vessel engorgement) and decongestion alternating between nostrils about every 4 hours to make it easier to breath out of one side than the other
What should be considered first when examining a children with a one-sided runny nose?
Foreign object
More than half of the reported cases of loss of smell are due to what causes?
1 head injuries
2 post URIs
3 nasal/sinus conditions
What are Mullin’s 5 “Ts” of the mouth and throat that are analyzed during examination?
1 teeth 2 tongue 3 tissues 4 tonsils 5 throat
What should be considered when viewing a patient with crowded teeth?
Cranial misalignment
What visible sign of the teeth appears due to asymmetrical forces being transmitted into the temporomandibular-cranial-cervical complex?
Malocclusions
What is the term for a red, swollen smooth tongue due to the loss of the papillae?
Glossitis
What is the form of glossitis where the papillae are temporarily lost leaving smooth, irregular patches with a white outline that can change location on a weekly, sometimes daily, basis?
Geographic tongue (aka migratory glossitis)
What is the term for a tongue that presents with grooves of varying depth and width?
Fissured tongue
Fissured tongue is frequently associated with what other condition of the mouth?
Geographic tongue
What is the timeline of onset and progression for a fissured tongue?
Starts in childhood and becomes more prominent with age
What causes a black, hairy tongue?
Long-term antibiotic use
What is the anatomical reason for the appearance of a black, hairy tongue?
Failure of the papillae to naturally fall off causing them to elongate allowing fungi or bacteria to attach to them and cause discoloration
What is the clinical term for a cankersore?
Aphthous stomatitis
What is unique about the healing process of the ulcers of aphthous stomatitis?
Heal without scarring
What is the condition of the mouth that is a noncancerous or precancerous oral lesion common to those who use tobacco daily that appears as while leathery ridges on the buccal mucosa?
Leukoplakia
What is the clinical term for red, swollen, sensitive, and bleeding gums?
Gingivitis
What is the order of progress of developing gingivitis?
Bacteria and saliva form plaque which hardens into tartar then causes gingivitis
What can prevent or reverse gingivitis?
Brushing and flossing
What are the common locations for an oral carcinoma?
Sides of tongue, lips, floor of mouth
What activities are associated with 70-80% of oral carcinoma cases?
Smoking and smokeless tobacco (another risk factor = alcohol)
What is the condition of benign exostosis of either the hard palate or mandible?
Torus palatinus and mandibularis
When do torus palatinus or mandibularis occur?
Around age 30
What is tonsillar debris?
Mucous, sulfur-producing bacteria, and debris condense into small particles and collect in the crypts on the surface of the tonsils
Which is more common: viral or bacterial pharyngitis?
Viral (60%)
What is the major difference in symptoms between viral and bacterial pharyngitis?
Bacterial is associated with a fever and purulent, colored exudate
What are the three forms of pharyngitis?
Viral, bacterial, streptococcal
What progressive condition occurs in 1% of strep throat cases?
Rheumatic fever
What is rheumatic fever so rare?
Antibiotics are 90% effective at preventing strep throat from progressing
What condition is a progression of strep throat that is not prevented by antibiotic treatment?
Post-streptococcal glomerulonephritis
What part of the heart may get damaged via post-streptococcal glomerulonephritis?
Mitral valve
What conditions are considered upper respiratory conditions?
Common cold, allergic rhinitis, sinusitis, and pharyngitis
What is the “in between” condition of upper and lower respiratory conditions?
Laryngitis
What condition is inflammation of the mucous lining of the larynx and vocal cords resulting in a sore scratchy throat, hoarseness, or loss of voice?
Laryngitis
Laryngitis that last longer than what time span warrants consultation?
4 weeks
What cranial nerves can be assessed as part of the mouth and throat exam?
7, 9, 10, and 12
How can you test for cranial nerve 7 in the mouth and throat exam?
Sweet and salty tastes of the anterior 2/3 of the tongue
How can you test for cranial nerve 9 in the mouth and throat exam?
Sour and bitter tastes of the posterior 1/3 of the tongue
How can you test for cranial nerve 9 and 10 together in the mouth and throat exam?
Perform gag reflex
How can you test for cranial nerve 10 alone in the mouth and throat exam?
Have patient say, “coo la me”
How can you test for cranial nerve 12 in the mouth and throat exam?
Have patient press tongue into each cheek
What is another term for blackheads?
Comedones
What type of facial eruption are pimples?
Pustules and papules
What part of the body is usually affected by erysipelas?
Face and ears
Erysipelas is usually secondary to what type of condition?
Preexisting skin infection or wound
What causes erysipelas?
Type A beta hemolytic streptococcus (form of cellulitis)
How is cellulitis different from erysipelas?
Lacks sharp, raised borders and usually affects limbs
What is the mechanism of injury for cellulitis?
Enzymes produced by the organism break down cellular components that would normal contain the infection
What condition is a chronic inflammatory disorder resulting in new superficial blood vessels?
Rosacea
What population is more likely to be affected by rosacea?
Middle-aged women
What sign of rosacea may occur in males?
Rhinophyma (soft tissue hypertrophy of the nose)
What is the conventional treatment for rosacea?
Tetracycline
What condition presents as red, painful inflammation of the nail fold?
Paronychia
What pathogens can cause paronychia?
Bacteria or fungi (Candida)
Paronychia due to fungi is more present among children in adults that participate in what activities?
Children that suck their thumb
Adults whose hands are frequently in water
What kind of skin eruption is a verruca?
Benign papule
What are the common locations of verruca plana?
Face, neck, wrist, back of hands and knees
What condition is an eczema that affects hands and the sole and sides of the fingers?
Pompholyx (dyshidrotic eczema)
What color should the nail bed be?
Variations of pink
Vertical ridges of nails are a normal variation seen in what population?
Elderly
Pigment deposits or bands in the nail beds may be normal in what group of people?
Those with darker skin
White spots on the nails (leukonychia) are usually due to what?
Mild injury
What condition is a fungal infection of the nail plate and appears as a yellow-brownish discoloration even causing the nail to become brittle, bent, and thick?
Tinea unguium
What nail signs may occur in severe psoriasis?
Splinter hemorrhages and pitting
Splinter hemorrhages are often associated with what condition?
Endocarditis
What is the clinical term for nail spooning?
Koilonychia
What can cause koilonychia?
Trauma or iron deficiency anemia
What is the condition where the nail appears white except for a narrow zone at the distal tip?
Terry nails
Terry nails is associated with what underlying serious condition?
Cirrhosis of the liver
What condition presents with transverse, white depressions in the nail?
Beau’s line
Beau’s line can be caused by what things?
Malnutrition, coronary artery disease, maybe trauma
What is Schamroth’s technique?
Placing nails from each hand back to back and observing the space created (normal = diamond shaped due to 160 degree angle of nail base)
What nail condition caused the diamond shape observed in Schamroth’s technique to disappear due to abnormal enlargement of the distal phalanges?
Nail clubbing
Nail clubbing is associated with what kinds of underlying serious conditions?
Respiratory and cardiovascular diseases
