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HEENOT 2 > Phys Di > Flashcards

Phys Di Flashcards

1
Q

Nose ROS

A 
rhinorrhea
congestion
sneezing
itching
obstruction
nosebleed
change in smell
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2
Q

nose anatomy

A
  • glabella
  • root (right between eyes)
  • nasal sidewall (side of nose)
  • ala (lateral nare)
  • nasolabial fold (between nose and mouth)
  • dorsum (bridge of nose)
  • columella - between nares
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3
Q

where is the opening to the eustachian tube

A

nasopharynx

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4
Q

two palpable sinuses

A
  • frontal with thumb (under bony brow)

- maxillary with thumb or index & middle (under zygomatic process)

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5
Q

what size speculum to use in nose exam

A

largest avail ear speculum

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6
Q

what to avoid touching during inside of nare inspection

A

nasal septum

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7
Q

When perform transillumination of frontal and max sinus

A

palpation was tender or infection present

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8
Q

where place light source during frontal sinus transillumination

A

medial aspect of supraorbital rim

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9
Q

where place light source during max sinus transillumination

A

lateral to the nose, just beneath medial aspect of eye

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10
Q

Mouth/oropharynx ROS

A
  • sore throat
  • hoarseness
  • bleeding gum
  • lesions
  • change in taste
  • change in breath
  • recurrent infections
  • last dental exam
  • dentures
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11
Q

Philtrum

A

two lines between nose and upper lip

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12
Q

name of edge of lips

A

vermillion border

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13
Q

name for lateral edge of lips

A

lateral commisure

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14
Q

name for dry lips

A

Cheilitis

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15
Q

name for fissures at corner of mouth

A

angular cheilosis

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16
Q

where is Stenson’s duct

A

aligned with second upper molar - white/yellow or white/pink protrusion
- parotid gland

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17
Q

CN tested when stick tongue out

A

CN XII

18
Q

What ducts are found below the tongue

A

Warton ducts - submandibular duct

19
Q

colors/shape of hard and soft palate

A

Hard: pinkish-white, dome shape
Soft: more pink

20
Q

“Ahhh” and gag reflex test what CN

A 
CN IX (sensation)
CN X (motor)
21
Q

tonsil measurement system

A

1+ visible
2+ halfway between pillars and uvula
3+ nearly touching uvula
4+ touching each other

22
Q

Fordyce spots

A
  • expected variation
  • enlarge sebaceous glands appear on buccal mucosa and lips
  • numerous small, yellow-white raised lesions
  • asymptomatic
23
Q

Torus palatinus

A

bony protuberance at midline of hard palate

- expected variation

24
Q

normal lymph node characteristics

A
  • ovoid

- less than 1 cm short axis

25
Q

Affected areas of submental/submandibular nodes

A
  • oral cavity
  • face
  • salivary glands
  • thyroid
  • larynx
26
Q

reactive lymphadenopathy - characteristics

A
  • enlarged lymph nodes
  • tender
  • typically related to URI
27
Q

Deep neck abscess

  • def
  • from what usually
A
  • lymphatic infection with transition to abscess

- oral cavity and pharyngeal infections

28
Q

Deep neck abscess sx

A
  • pain
  • fever
  • toxic appearance
  • torticollis
  • hoarseness
  • odynophagia (painful swallowing)
29
Q

When to surgically incise and drain deep neck abscess

A

airway management

30
Q

lymphadenitis

A

inflamed lymph node

31
Q

when suspect lymph node malignancy

A

persistent adenopathy without any infectious cause

32
Q

Find a cancerous lymph node in neck - what else is happening

A

lymph is secondary malignancy, must find first, send to specialist

33
Q

How treat reactive lymphadenopathy?

A

don’t

- usually resolves on own

34
Q

Imaging methods to workup neoplastic neck mass

A
  • US: est. size and characteristics, no radiation, good to monitor growth
  • CT w/contrast: characterize extent and character, most common
  • MRI: alt to CT but less common, more time and money
35
Q

Ways to biopsy neck mass

A

fine needle aspiration

  • w/ or w/o US guidance
  • easily palpable masses

Open surgical

  • avoided if possible
  • use in lymphoma to best characterize tumor
36
Q

PET-CT imaging

A

tracks uptake of fluorodeoxyglucose (FDG)

  • radioactive isotope of fluorine attached to glucose
  • increased uptake in infected tissue, malignant neoplasms
37
Q

When is PET-CT imaging used

A
  • staging

- post-treatment f/u

38
Q

Squamous cell carcinoma

A
  • aways metastatic
  • most common ca head and neck
  • must determine source for adequate therapy
39
Q

Unknown primary squamous cell carcinoma

A
  • prim. source is unable to be determined

- entire pharynx from naso- to hypo- is treated with chemo/radiation

40
Q

Salivary malignancy

A
  • drain to level 1-3
  • surgical excision
  • radiation
41
Q

Lymphoma

A
  • present in any lymph group
  • FNA biopsy to determine malignant process
  • excisions biopsy usually needed for further classification
42
Q

Supraclavicular adenopathy

A
  • LEFT nodes should raise concern for visceral mal

- Thoracic duct

HEENOT 2 (7 decks)

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