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GM Phys Di > Unit 3 Head And Neck > Flashcards

Unit 3 Head And Neck Flashcards

1
Q

What is a tracheal tug

A

Downward displacement of the cricoid cartilage with each ventricular contraction

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2
Q

What happens when a downward tug of the trachea is synchronized with systole

A

Reveals the presence of an aortic arch aneurysm

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3
Q

What is campbell’s sign

A

The downward displacement of the thyroid cartilage during inspiration due to COPD

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4
Q

What does campbell’s sign displacement correlate with

A

The severity of compromise of the FEV

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5
Q

What causes campbells sign

A

Due to strong diaphragmatic contractions of COP patients

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6
Q

What is craniotabes of infants

A

Softening of the outer table of the skull

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7
Q

What is transillumination used for

A

You transilluminate the skull of infants who have suspected intracranial lesions or a rapidly increasing head circumference

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8
Q

Why is transillumination performed less often today

A

Because the availability of computed tomograpy (CT) scan

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9
Q

What is macewen sign

A

Use percussion of the skull that results in stronger resonant sound when either hydrocephalus or a brain abcess is present

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10
Q

Children up to 5 years with anemia have what commonly

A

Bruits

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11
Q

When auscultating a patient with a goiter or findings of hyperthyroidism what can be present

A

A bruit can be heard indicating increased vascularity

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12
Q

Bruit found in someone exibiting hyperthyroidism is a strong. Indicator of what?

A

Grave thyrotoxemia

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13
Q

What is the upper limit of the thyroid gland

A

15-25 gm

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14
Q

Where are most people iodine deficient

A

Mountainous regions/away from the sea

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15
Q

What is a thyroid gland that has posterior extracapsular tissue extending superiorly from the posterior aspect of the tongue

A

Lingual thyroid and can extend into the mediastinum

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16
Q

Who exhibits false positives

A

Thin patients, long necklines (psuedogoiters), fat pad,

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17
Q

What causes false negatives

A

Inadequate exam, short/thick neck, atypical/ectopic placement of thyroid

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18
Q

What is a chronic enlargement of the thyroid

A

A goiter

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19
Q

What causes a goiter

A

Non neoplastic nor inflammatory process, it is result of hypertrophy or degeneration of the gland

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20
Q

When do fetal thyroid glands become functional

A

In the second trimester

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21
Q

What is a skin and tissue disorder usually due to severe/prolonged hypothyroidism

A

Myxedema

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22
Q

What is it called when autoimmune antibodies are sent to thyroid-stimulating hormone receptor, leading to overactive thyroid

A

Graves disease

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23
Q

What is an autoimmune antibodies against the thyroid gland causing hypothyroidism

A

Hashimoto disease

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24
Q

What happens to the rate of T4 production and degradation with aging

A

It gradually decreases because the thyroid gland becomes more fibrotic

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25
Q

What does unilateral salivary gland swelling mean

A

Ductal calculus due to infx or rarely a tumor

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26
Q

What is a congenital lesion formed by incomplete involution of branchial cleft

A

Branchial cleft cyst

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27
Q

What is a neural tube defect with protrusions of brain and membranes that cover it through openings in the skull

A

Encephalocele

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28
Q

What is a problem in the formation, flow, absorption, of CSF that leads to an increase in volume of the CSF

A

Hydrocephalus

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29
Q

What is a circumference of head that is smaller than normal because the brain has not developed properly or has stopped growing

A

Microcephaly

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30
Q

What is a premature closure of one or more cranial sutures before brain growth is complete and leads to a misshapen skull

A

Craniosynostosis

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31
Q

What abnormality is characterized by inflammation of one or more lymphatic vessels

A

Acute lymphangitis

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32
Q

What abnormality is characterized by infx and inflamm of a lymph node and may affect a single or localized group of nodes

A

Acute suppurative lymphadenitis

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33
Q

What abnormality is edematous swelling due to excess accumulation of lymph fluid in tissue caused by inadequate lymph drainage

A

Lymphedema

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34
Q

What abnormality is a malignant neoplasm of the lymphatic system and the reticuloendothelial tissues

A

Non-hodgkin lymphoma

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35
Q

What abnormality is a malignant lymphoma

A

Hodgkin lymphoma

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36
Q

What causes infectious mononucleosis

A

Epstein barr virus mononucleosis

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37
Q

What is a congenital malformation of dilated lymphatics

A

Lymphangioma/cystic hygroma

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38
Q

What is a massive accumulation of lymphedema throughout the body and the most common cause of secondary lymphedema worldwide

A

Lymphatic filariasis (elephantiasis)

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39
Q

What is among the most common causes of subacute or chronic lymphadenitis in children

A

Cat scratch disease

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40
Q

What is a dysfunx of cell mediated immunity

A

Acquired immune deficiency syndrome

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41
Q

What type of hypersensitivity is serum sickness

A

Type 3 hypersensitivity reaction

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42
Q

What is an allergic contact dermatitis that involves the immunne system and is caused by chemicals in latex products

A

Immune complex disease latex allergy

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43
Q

What type of hypersensitivity is immune complex disease latex allergy

A

Type 4 (delayed hypersensitivity)

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44
Q

What type of reaction is a true allergic reaction caused by protein antibodies of latex

A

Latex allergy type 1 reaction

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45
Q

When the immunce system fails the individual may experience a variety of illnesses like

A

Allergic reaction or immunodeficiency (congenital or acquired)

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46
Q

The lymphatic system supports a network of defenses against what

A

Microorganisms

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47
Q

Except for what 2 structures, every tissue supplied by blood vessels has lymphatic vessels

A

Placenta and brain

48
Q

Without lymphatic drainage where would lymph build up

A

Interstitial spaces due to more fluid leaving capillaries than absorbed

49
Q

The lymph nodes recieve lymph from collecting ducts and pass them through what vessels

A

Efferent

50
Q

Ultimately the large ducts of the lymph system merge into what and where

A

The venous system at the subclavian veins

51
Q

What is the drainage point for the right upper body

A

Lymphatic trunk that empties into the right subclavian vein

52
Q

What is the major vessel of the lymphatic system

A

The thoracic duct

53
Q

What drains lymph from the rest of the body into the left subclavian vein

A

The thoracic duct.

54
Q

Where does the lymph fluid return fluids/proteins to in order to form a closed but porous circle

A

The cardiovascular system

55
Q

What does the lymphatic system rely on for movement

A

The cardiovascular system, it is more sluggish

56
Q

As lymph fluid volume increases what happens

A

It flows faster in response to mounting capillary pressure, increased metobolic activity, mechanical compression

57
Q

What is central to the body’s response to antigenic substances

A

Lymphocytes

58
Q

Where are lymphocytes primarily produced

A

In the bone marrow

59
Q

Where do marrow derived lymphocyte cells first flow

A

To the thymus where it can be differentiated as a T lymphocyte

60
Q

What type of immunity involves the anitbodies produced by B cells

A

Humoral

61
Q

What type of immunit involves attacks on invaders by the cells themselves

A

Cellular

62
Q

Which has a longer life span b or t cells

A

T cells

63
Q

What does an increased number of lymphocytes in the blood represent

A

Systemic response to most viral infections and to some bacterial infection

64
Q

In early life what is the thymus’ role

A

Development of protective immune function

65
Q

What is the white pulp of the spleen

A

Made up of lymphatic nodules and diffuse lymphatic tissue

66
Q

What is the red pulp of the spleen

A

Made up of venous sinusoids

67
Q

What are spleens functions

A

Destroy and store RBC’s, produce antibodies, filter microorganisms from the blood

68
Q

Defensive responses to inhaled and intranasal antigens are activated in what tissues

A

Tonsils/adenoids

69
Q

When enlarged what is the problem with adenoids and tonsils

A

They can obstruct the nasopharyngeal passageway

70
Q

When does the immune and lymphoid system begin developing

A

20 weeks of gestation

71
Q

When does the mass of lymphoid tissue increase

A

Between ages 6-9 years and regress by puberty

72
Q

When does the umbilical cord drop off

A

By 1-2 weeks after birth, delayed is associated with leukocyte adhesion defect

73
Q

When is the thymus largest relative to rest of body

A

Shortly after birth, reaches greatest absolute weight at puberty

74
Q

What type of nodes are more common in older children compared to first year

A

Cervical and submandibular

75
Q

What type of node when present in children associates with high incidence of malignancy and is always cause for concern

A

Supraclavicular nodes

76
Q

What happens to lymph nodes as we age

A

They may diminsh in number and size more likely to become fibrotic and fatty

77
Q

Disorders of the lymph system can present with what three physical signs

A

Enlarged nodes, red streaks on overlying skin, and lymphedema

78
Q

What is a node that feels like it contains fluid

A

Fluctuant node

79
Q

What does a fluctuant node suggest

A

Suppuration from infection

80
Q

What characteristic is most common from fixation of a node to underlying tissue

A

Metastatic cancer, but also can occur with chronic inflamm

81
Q

What is found that is widespread and involves several lymph node regions indicating systemic disease/disorder

A

Lymphadenopathy

82
Q

What is the six step sequence of nodes on the head

A

Occipital, postauricular, preauricular, partoid/retropharyngeal, submandibular, submental

83
Q

What is the 4 step sequence palpating nodes down the neck

A

Superficial cervical nodes, posterior cervical nodes, cervical nodes deep to SCM, supraclavicular areas (virchow nodes)

84
Q

Where is the lymphatic drainage of the testes

A

Into the abdomen

85
Q

Nodes in the inguinal area enlarge if there are lesions of what

A

The penile and scrotal surfaces

86
Q

It is not unusual to find enlarged postauricular and occipital nodes in children younger than what age

A

2 yr old

87
Q

Past the age of 2 an enlarge postauricular and occipital node may be siginificant for what

A

Mumps/immune deficiency

88
Q

Cervical and submandibular nodal enlargement is less common in children younger than what

A

1 year of age

89
Q

Nodes smaller than ___ are not concerning and nodes with diameter of ____ or less in the cervical do not always indicate a problem

A

0.5 cm; 1 cm

90
Q

Excessive enlargement of the palatine tonsils if too enlarged can do what

A

Obstruct the nasopharynx, increase risk of sleep apnea, and rare but pulmonary HTN

91
Q

What is the largest endocrine gland in the body

A

The thyroid

92
Q

What hormones does the thyroid produce

A

Thyroxine (T4) and triiodothyronine (T3)

93
Q

When does ossification of infantile sutures begin

A

After completion of brain growth around age 6

94
Q

What happens to T4 as we age

A

T4 production and degradation gradually decreases with aging and the thyroid gland becomes more fibrotic

95
Q

Holding the head tilted to one side to favor something is usually what

A

Favor a good eye/ear

96
Q

Holding the head tilted to favor eye or ear can also be asymptom of what

A

Torticollis

97
Q

What is defined as an expression or appearance of the face and features of the head and neck that when considered together is a characteristic of a clinical condition or syndrome

A

Facies

98
Q

Percussion on the masseter muscle may produce what

A

Hyperactive masseteric reflex (the chvostek sign)

99
Q

What type of bruit is considered common in children

A

Intracranial bruits

100
Q

Individuals with ____ that hav a bruit over the orbit suggests an expanding cerebral aneurysm

A

Diplopia

101
Q

Nuchal ridigity, resistance to flexion of the neck may be associated with what

A

Meningeal irritation

102
Q

In an infant dilated scalp veins and a head circumference increasing faster than expected may indicate what

A

Increased intracranial pressure

103
Q

What is a subcutaneous edema over the presenting part of the head at delivery

A

Caput succedaneum

104
Q

What is the most common form of birth traua of the scalp and usually occurs over the occiput and crosses suture lines

A

Caput succedaneum

105
Q

What is a subperiosteal collection of blood and is therefore bound by suture lines

A

Cephalhematoma

106
Q

What can result from premature fusion of one of the sutures

A

Plagiocephaly

107
Q

Positional plagiocephaly is common among infants with what

A

Toriticollis

108
Q

A bulging fontanel with marked pulsations may indicate what

A

Increased intracranial pressure from space occupying mass or meningitis

109
Q

What indicates craniotabes and what is it associated with

A

Snapping sound; premature, rickets, hydrocephalus, syphilis, thalassemia

110
Q

What is indicative of fracture in a clavicle of newborns

A

A fracture during birth

111
Q

What do you do if you suspect intracranial lesions or rapidly increasing head circumference

A

Transilluminate

112
Q

Cranial bruits are common in children up to how old

A

5 years of age or in children with anemia, past that may present vascular anomalies

113
Q

What is a congenital lesion formed by incomplete involution of branchial cleft

A

Branchial cleft cyst

114
Q

What is a skin and tissue disorder due to severely prolonnged hypothyroidism

A

Myxedema

115
Q

What condition is an autoimmune antibodies against the thyroid gland

A

Hashimoto disease

GM Phys Di (3 decks)

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