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Health Assessment > Week 2: Head & Neck Eyes, Ears, Nose & Throat > Flashcards

Week 2: Head & Neck Eyes, Ears, Nose & Throat Flashcards

1
Q

What is a Migraine Headache

A

Migraine headache: unilateral, atypical appearance, generalized or occipital and gets worst, throbbing (cant work)

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2
Q

What is a Tension Type Headache

A

Tension Type headache: around forehead, band like, pressure, not bad in the morning gets worse (not severe can work through them)

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3
Q

What is Cluster Headache?

A

Cluster headache: generally behind the eye- stabbing pain behind the eye, eyebrow, lacrimal tearing unilaterally (severe and last minutes, multiple times a day)

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4
Q

What is Sinus Headache?

A

Sinus headache: in between the eyes, and generalized

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5
Q

What are Headache Red Flags?

A

“Worst headache” of your life?
Thunderclap? : did you feel or hear thunder, aneurysm
Progressively worsening over 3+months: cancer magilency?
Recent head trauma
Hx of HIV, CA or Pregnant
Vision Changes?
New onset after age 50?
Worse with exercise/exertion or position changes?
Precipitated w/valsalva: pressure cause the headache to really get bad, vascular issues
Pulsatile tinnitus - indicate vascular issue - ringing or sound comes in and out
Neuro: Mental status change or speech changes? (stroke) Papilledema (servere HTN crisis, fundus exam), neck stiffness (menigitis issues) or focal neuro deficits on exam (stroke, seizures)** -

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6
Q

Where are all the lymph nodes

A 
Occipital
Post-auricular
Pre-auricular
Tonsillar
Maxillary
Submental
Posterior Cervical (Behind the SCM) - behinc sternalclavicar mastoid muscle 
Anterior Cervical (In front of the SCM)
Supraclavicular, Infraclavicular
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7
Q

What to assess when looking at nose?

A

Sinus Palpation: frontal, maxillary
Inspect and Palpate External Structures
External symmetry, bridge of nose, septal deviation

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8
Q

What to inspect when looking inside the nose?

A

Mucosa – color, swelling, bleeding, exudate, ulcers, or polyps “boggy” and pale?
Drainage- purulent, thick, watery (green/yellow mucus- doesn’t automatically indicate need for abx)
Septum – deviation, inflammation, or perforation
Turbinates – use otoscope to view middle and inferior turbinates

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9
Q

What are some ear consideration for older adults?

A

Presbycusis: normal hearing loss that occurs with age. Unable to hear distinct words, may sound muffled
Hearing aids? (do they have one and dont wear them? Run out of battery)
Cerumen impaction: common, how do we remove it?
Ear lavage
Hair: excessive, course, may contribute to cerumen
Vertigo: what causes this?
Tinnitus?

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10
Q

Ear Consideration for infants & children?

A

Infants: Examine while asleep
Infants TMs & inner ears may appear red after crying
Do they respond (startle) to loud noise such as clap
Do they turn when called by their own name
Are they allowed to drink a bottle in bed, while lying flat?

Children: Examine while against mom’s chest
Pull ear down
Screening around age 4
Behaviors that warrant concern? 
Intelligible speech by age 2?
Cleaning?  NO
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11
Q

What is the weber test?

A

Weber: Strike the tuning fork (512Hz)- place in middle of scalp
Conductive loss: sound lateralizes to affected ear
Sensorineural loss: lateralizes to normal ear

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12
Q

What is the Rinne test?

A

Rinne: Strike the fork and place on mastoid process, then near ear: time each
Once sound is not heard at mastoid, switch to air conduction
If air conduction is longer than bone conduction: normal
Conductive hearing loss if the sound is heard as long or longer than air

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13
Q

What is Sensorineural hearing loss ?

A

Sensorineural hearing loss occurs when sound waves are not processed correctly.

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14
Q

What is Conductive hearing loss?

A

Conductive hearing loss occurs when sound waves do not reach the inner ear.

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15
Q

How do you assess ear for child vs adult? How do you look in their ears?

A

Child is pull and down, adult, up and back

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16
Q

Mental status change or speech changes? indicates?

A

(stroke)

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17
Q

Papilledema indicates what?

A

(servere HTN crisis, fundus exam),

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18
Q

neck stiffness can indiciate what?

A

(menigitis issues) or

focal neuro deficits on exam (stroke, seizures)** -

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19
Q

Temple area: pain upon palpation of temple area- important for older adults presenting with H/A– why?

A

Temporal arteritis - severe inflammation of temporal artery

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20
Q

older adults consideration

“new onset” of H/A or severe H/A in ≥50 years old is a RED FLAG for… what?

A

Giant Cell Arteritis (GCA) or Temporal Arteritis- assess temporal arteries and should be ruled out: ESR, C-Reactive Protein (not cardiac)

– look for
Jaw Claudication: pain after prolonged chewing (caused by inflammation of the temporal artery)
Vision changes

Could have PMR symptoms (Polymyalgia Rheumatica): whole body aches, perceived weakness of limbs (proximal), fatigued
Possible exam findings: unequal BPs in arms, Bruit of Carotid Artery, murmurs

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21
Q

Thyroid consideration for pregnancy woman

A

Pregnancy variations in thyroid function
Thyroid gland stimulation from human chorionic gonadotropin hormones

Subclinical or overt hyperthyroidism
Fetal dependence on maternal thyroid hormone for brain development
Generally in individuals trying to get pregnant or are pregnant are given higher dose of thyroid meds because higher usage during pregnancy, if not enough can be a risk of losing the pregnancy

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22
Q

What is amiodarone’s consideration for thyroid?

A

it causes potiential hypothyriodism due to iodine contents

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23
Q

T cells and B cells, birth and mature place?

A

Primary lymphatic organs: Red Bone Marrow & Thymus Gland
Red bone marrow: B & T cells originate (b-cells mature there)
Thymus: t-cells mature there

24
Q

What is the significance of Epitrochlear lymphadenopathy

A

Epitrochlear lymphadenopathy (nodes greater than 5 mm) is pathologic and usually suggestive of lymphoma or melanoma.

25
How to assess thyriod gland?
Flex neck slightly forward Place fingers of both hands with index fingers just below the cricoid cartilage Ask patient to swallow; feel for the thyroid isthmus rising up under your finger pads (not always palpable) Displace trachea to the right and palpate laterally for the right lobe of the thyroid; repeat on the left side Note the size, shape, and consistency Identify any nodules or tenderness If enlarged, listen over lateral lobes to detect a bruit
26
What do you do if you find nodule or tenderness upon assessment of the neck/thyroid?
Identify any nodules or tenderness | If enlarged, listen over lateral lobes to detect a bruit
27
Name the order of the anatomy of neck cartilage
hyoid bone throid cartilage cricoid cartilage thyroid gland
28
Cornea –
Anterior: allows light to enter eye and is responsive to touch, temperature, chemicals, and particlesAnterior:
29
Sclera
Posterior: Sclera – maintains shape of the eye
30
Headache? And/or N/V? can indicate what for the eye disease?
(acute glaucoma emergency - eye pain, headache, nausea vomit)
31
Strabismus disease is?
Light is reflecting on the pen to the same position on both eyes, then its negative - but if it isnt, then they have Strabismus indicates muscle weakness whne asymterical
32
Entropion
Entropion: lid flipped inward - cause abrasion on scalara, lashes are inward, eyelid are swollen
33
Extropion
Extropion: lid is lax and droops - more common with aging, pull eyelid, check for redness and pillar (anemia), allergy (cobblestone like)
34
redness and pillar inside the eye indicates
redness and pillar (anemia),
35
allergy in the eyes you will see
allergy (cobblestone like in palpebral fissue)
36
what is Pseudostrabismus
Pseudostrabismus | The medium campus have thicker skinfold, making the infant look crossed eye but isnt
37
what is Anisocoria?
Anisocoria - difference in pupillary size is visible in 35% of healthy people. If pupillary reactions are normal, considered benign.
38
EOMs Controlled by what 3 nerves
CN III, IV, & VI
39
What is Papilledema
Papilledema Blurred margins of the optic disc Swollen appearing vessels Cant see clear line of optic disk, often due to hypertension for prolonged periods of time
40
What is Presbyopia
Presbyopia: need magnification of smaller printed images
41
What is Cataracts?
Cataracts: by 70- many older adults begin forming (fibers of the lens begin to thicken and yellow) Can be caused by htn and dm
42
What is Glaucoma
Glaucoma: Optic nerve neuropathy, loss of peripheral vision
43
What is AMD (Age-related macular degeneration):
AMD (Age-related macular degeneration): loss of central vision caused by plaques
44
Pinguecula vs Pterygium
Pinguecula (yellow plaque like structure, benign will just stay there) & Pterygium (will cross lymbic line and lead to obstruction of vision and need treatment eventually)
45
Hordeolum vs Chalazion
Hordeolum & Chalazion Hordeolum: stye; pustular infection of the eyelid margin (external); usually infected hair follicle Chalazion: internal hordeolum/stye- inside the eyelid; usually infected oil gland warm compresses no antibiotics
46
What is Blepharitis
Blepharitis Inflammation of the eyelids near lashline- causes scaling/sloughing of skin- they can become irritated, red, itchy and may cause crusting/flaking occurs when the tiny oil glands of the inner eyelid become inflamed. It often occurs along with other skin conditions or allergies.
47
Bacterial vs Viral conjunctivitis
``` Bacterial Bilateral involvement 50% Discharge- mucopurulent Thick, pus like, yellow or green tint Conjunctival Erythema No pruritus ``` ``` Viral Bilateral involvement- 25% Discharge- watery Maybe yellow tint but mostly watery Conjunctival Erythema No pruritus ```
48
Orbital vs Periorbital Cellulitis
Orbital vs Periorbital Cellulitis The difference is serious- one can threaten vision & lead to sepsis if untreated Periorbital cellulitis is an infection of the eyelid and area around the eye; orbital cellulitis is an infection of the eyeball and tissues around it.
49
Considerations for Older Adults for hearing and ear
Presbycusis: normal hearing loss that occurs with age. Unable to hear distinct words, may sound muffled Hearing aids? (do they have one and dont wear them? Run out of battery) Cerumen impaction: common, how do we remove it? Ear lavage Hair: excessive, course, may contribute to cerumen Vertigo: what causes this? Tinnitus?
50
Presbycusis
normal hearing loss that occurs with age. Unable to hear distinct words, may sound muffled Hearing aids? (do they have one and dont wear them? Run out of battery)
51
Geographic Tongue: Benign Migratory Glossitis | What is it?
``` Geographic Tongue: Benign Migratory Glossitis A “map like” appearance on tongue Benign condition May have some slight burning or stinging Red patches w/out papillae Approx 3% of people have it ```
52
Consideration for older adults for throat and mouth
``` Considerations for Older Adults Sense of taste: may decline>>affects appetite (taste sweets the best) Oral health is important! Dentures: How do they fit? Gum disease: Bleeding? Dehydration: Dry mucous membranes Angular Chelitis: skin breakdown at corners of the mouth Coughing w/drinking or eating? ```
53
Considerations for Infants & Children
``` Tonsils are not visible in newborns Use gloved finger to check for tooth eruption and suck reflex Open your mouth “as big as a lion” Stick out your whole tongue, “pant like a doggie” Toddlers: in parents lap Play a game? Make noises? Always stabilize the head while inspecting nose, mouth, throat, ears Do they visit dentist regularly? Recurrent strep throat? Cleft Lip and/or Palate or other congenital malformations Feeding difficulties? Formula type? Thrush? Food allergies? Exposures? Daycare? To bed with a bottle? Smoke/tobacco exposure? Lead exposure? ```
54
Cobblestone appearance: indicates?
think Allergies
55
Indicator for strep throat?
fever, anterior cervial lymphadenopathy, tonsilar exudate, absence of cough 3 or greater points complete a rapid strep, score less than 3 do not require strep test
56
What is a control wool spot
Feature of both mild and severe diabetic retinopathy

Health Assessment (9 decks)

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