Heent Exam

Front 1

describe the auricle

Back 1

cartilage based appendage, consists of: helix, antihelix, tragus, orifice of the canal, lobe

Front 2

what type of epithilium lines the external ear canal?

Back 2

stratified squamous

Front 3

describe the tympanic membrane.

Back 3

located between the external canal and middle ear, fxn is to vibrate.

Front 4

list the structures of the TM.

Back 4

umbo
cone of light reflex
pars flaccids
pars tensa

Front 5

how will auricular tophi present? caused by?

Back 5

one or more NONtender, yellow papules on the helix or antihelix. cause: gout

Front 6

describe presentation of otitis externa maligna. cause?

Back 6

diffuse, erythematous, exquisitley tender swelling of the entire auricle. cause: psuedomonas in immunocompromised patients.

Front 7

describe presentation of ear lobe keloids. cause?

Back 7

soft, NONtender nodules on the lobe. caused by trauma (ear piercing)

Front 8

describe presentation of cauliflower ear. cause?

Back 8

presents with significant loss of structure/fxn of auricle. caused by trauma or infection involving auricle.

Front 9

describe preauricular node enlargement. cause?

Back 9

manifests with palpable nodes anterior to the tragus. cause: infection/inflammation of periorbital structures.

Front 10

list 4 problems with the external ear canal.

Back 10

furuncle
cerumen impaction
otitis externa
squamous cell carcinoma

Front 11

describe presentation of a furuncle.

Back 11

erythmatous, tender nodule in the canal. may drain purulent material.

Front 12

describe presentation of cerumen impaction.

Back 12

presents with decreased hearing, sense of fullness. upon examination, complete blockage of canal precludes visiualization of TM.

Front 13

describe presentation of otitis externa. cause?

Back 13

decreased hearing, sense of fullness. swelling, erythema and serous discharge from canal. swelling may occlude canal.cause: foreign body, infection with staph or step spp.

Front 14

describe presentation of squamos cell carcinoma.

Back 14

painless ulcer of auricle, posterior auricular nodes may be involved.

Front 15

list 4 problems with the TM/middle ear.

Back 15

serous otitis media
purulent otitis media
tympanoplasty tube
perforation of TM

Front 16

presentation of serous otitis media. cause?

Back 16

loss of translucency of TM, prominence of underlying structures (umbo/malleus). speckled type light reflection pattern and airfluid patterns behind TM, decrease in hearing
popping with swallowing
sense of fullness.
cause: viral or atopic process.

Front 17

purulent otitis media. cause?

Back 17

TM marked with erythema, prominent vessels around periphery, bulging of TM and loss of umbo/malleus, loss of light reflex, decreased hearing, sense of fullness, earache.
cause: bacterial infection (streptococcus, h. flu, b. catarrhalis)

Front 18

tympanoplasty tube

Back 18

metal or plastic orifice in TM, dull TM, small amt of discharge.

Front 19

perforation of TM

Back 19

hole in the TM itself, loss of cone of light reflex, dull membrane. purulent discharge. bloody discharge and precipitous onset of severe otalgia if cause by barotrauma.

Front 20

external anatomy of the nose

Back 20

nasal bone (supports bridge), two nares separated by a septum.

Front 21

internal anatomy of the nose.

Back 21

inferior, middle, superior turbinates. inferior demonstrable upon inspection.

Front 22

list 6 problems with the nose

Back 22

rhinophyma
allergic rhinitis
nasal fracture
septal hematoma
septal deviation
nasal polyps

Front 23

describe rhinophyma

Back 23

painless increase in size of nose w/ telengiectasia, sebaceous gland enlargement, accompanied by rosacea

Front 24

describe allergic rhinitis

Back 24

diffuse swelling of nasal mucous membranes w/ serouos rhinorhhea, often concurrent conjuctivitis and sneezing.

Front 25

describe a nasal fracture.

Back 25

trauma related, painful swollen ecchymotic nose with anterior epistaxis

Front 26

septal hematoma

Back 26

complication of a nasal fracture, discrete purple colored swelling of the septum of the nose impacting on both nares

Front 27

septal deviation

Back 27

complication of nasal fracture, deviation of septum with resultant decrease in size of one nare and increase in size of the other

Front 28

nasal polyps. cause?

Back 28

soft, red, pedunculated nodules in nasal canal (usually hanging from a turbinate or the septum) cause: atopic rhinitis or foreign bodies (nose ring)

Front 29

list the 6 problems affecting the face/sinuses discussed.

Back 29

amyloidosis
myxedema
svc syndrome
basilar skull fracture
sinusitis
frontal sinusitis

Front 30

describe the presentation of amyloidosis

Back 30

presents with peri-orbital plaque like ecchymosis, macroglossia, findings of right heart failure (hepatomegaly, peripheral pitting edema)

Front 31

describe the presentation of myxedema

Back 31

coarsening of features, macroglossia, loss of lateral eye brow hair, delayed reflexes (relaxation phase)

Front 32

SVC syndrome

Back 32

macroglossia, diffuse NON-pitting edema of upper extremities and face, elevated JVP

Front 33

basilar skull fracture

Back 33

periorbital ecchymosis, decreased level of consciousness, "battle's sign" and hematotympanum.

Front 34

sinusitis

Back 34

green nasal discharge, tenderness to percussion, decreased transillumination

Front 35

frontal sinusitis

Back 35

green nasal discharge, tenderness to percussion decreased transillumination

Front 36

list 4 problems with the neck

Back 36

goiter
cervical lymph node enlargement
Ludwig's angina
parotid gland enlargement

Front 37

goiter

Back 37

visible palpable mass on anterior neck. cause: enlargement of thyroid.
MAY have sx of hypo/hyper thyroidism or may be asymptomatic

Front 38

cervical lymph node enlargement

Back 38

one or more nodule in neck.
multiple causes:
can be due to metastisis: hard, stoney.
lymphoma: rubbery
infection-related: tender, swollen

Front 39

Ludwig's angina

Back 39

presents with tender, erythematous swelling in anterior neck (esp. submental area) may develop airway compromise and stridor

Front 40

parotid gland enlargement

Back 40

presents with lateral neck swelling can be tender or non tender. cause: mumps, bulimia, sialolithiasis

Front 41

gingival hypertrophy. cause?

Back 41

diffuse gingival thickening and enlargement, tender or non tender. cause: often due to medication - phenytoin, cyclosporin A

Front 42

gingivitis vulgaris

Back 42

diffuse tender swelling, tartar and calculus at gingiva/tooth interface and mild bleeding. varying severity: can uncover roots of teeth, purulent discharge may be present

Front 43

acute non-lymphocytic leukemia,M5 subtype

Back 43

manifests with diffuse gingival hypertrophy. cause: infiltration of leukemic cells into gingiva

Front 44

epulis

Back 44

manifests with hypertrophic interdental papilla. cause: irritation (flossing, being pregnant)

Front 45

torus mandibularis

Back 45

mucosa covered bony nodules usually on lingual side of mandible, benign.

Front 46

herpes simplex stomatitis

Back 46

clusters of vesicles, become painful erosions and ulcers on gingiva, mucosa, lip and skin

Front 47

coxsache stomatitis

Back 47

diffuse vesicles that become painful erosions and ulcers on the gingiva, mucosa, lip and posterior pharynx. DOES NOT CROSS VERMILLION BORDER OF LIP. may involve palms and soles

Front 48

thrush

Back 48

white papules and plaques on mucosa, pharynx tongue and gingiva

Front 49

aphthous stomatitis

Back 49

one or more tender erosions on the buccal mucosa. idiopathic.

Front 50

caries

Back 50

disruption of tooth enamel, brown or black discoloration. adjacent to sites of restoration or the interfce between gingiva and tooth.

Front 51

tooth attrition

Back 51

wearing down of incisural surfaces of the teeth, cause: wear and tear.

Front 52

herpes simplex labialis

Back 52

one or more clusters of vesicles on the lip OUTSIDE the vermillion border

Front 53

coxsachie A

Back 53

multiple vesicles and erosions on lip, gingival surface, mucosa of the mouth DOES NOT CROSS THE VERMILLION BORDER

Front 54

cheilitis

Back 54

one or more transverse fissures in the lip. casue: dryness or UV exposure

Front 55

cheilosis

Back 55

crusty fissures on the angles of the mouth. cause: candida or Fe deficiency

Front 56

macroglossia

Back 56

enlarged tongue with peripheral indentations, i.e. serratoglossia. cause: amyloidosis, acromegaly, hypothyroidism

Front 57

atrophic glossitis

Back 57

smooth tongue w/ loss of all fungiform and filliform papilla, appears shiny, prominence of circumvillate papilla on posterior surface.
cause: vit B12/ folate deficiency

Front 58

geographic tongue

Back 58

red patches of denuded tongue epithelium, surrounded by rims of white and normal epithilium, changes day to day.
cause: idiopathic

Front 59

black tongue

Back 59

black color, specifically fungiform/filiform papilla.
cause: colonization with aspergillus niger, bismuth, charcoal.

Front 60

sublingual varicosities

Back 60

purple vessles on sublingual surface. generally benign.

Front 61

squamos cell carcinoma

Back 61

painless red or white exophytic papule, plaque that ulcerates on the tongue.

Front 62

torus palatinus

Back 62

non-tender nodule in the hard palate, covered with mucosa.
cause: benign bony exostosis

Front 63

non-exudative pharyngitis

Back 63

erythema and swelling of tonsils and posterior pharynx, accompanied by cervical node enlargement, serous rhinorrhea, serous otitis media

Front 64

exudative pharyngitis

Back 64

swelling, erythema and exudates on posterior pharynx and uvula. accompanied by:
(if strep. etiology) enlarged jugulodigastric nodes.
(if mono) diffuse lymphadenopathy and all areas and splenomegaly

Front 65

quinsy

Back 65

smooth nodule or mass in the posterior pharynx adjacent to tonsil.
cause: strep abscess in peritonsillar area

Front 66

problems assoc with goiter

Back 66

hyper AND hypothyroidism

Front 67

hypothyroidism

Back 67

sx of cold, weight gain, depression, patchy (diffuse) alopecia, loss of lateral eyebrows. delayed relaxation phase for reflexes, bradycardia, thickened skin, proximal muscle weakness

Front 68

hyperthyroidism

Back 68

sx of weight loss, heat intolerance, hyperdefecation, bi-lateral or unilateral lid lag, active lid lag, active lower lid lag, bruit over goiter, bruit over the eyes, systolic rub, brisk deep tendon reflexes, tremor, thin skin, proximal muscle weakness, distal onycholysis.
GRAVES DISEASE MANIFESTS WITH SX OF HYPERTHYROIDISM. also, pretibial myexedema and proptosis/exophthalamus.