N362 Midterm Terms Minus Skin, Hair, Nails, Eyes

Front 1

Sternomastoid muscle

Back 1

Muscle that arises from sternum & medial part of clavicle & extends diagonally across neck to mastoid process behind ear; head rotation & head flexion; innervated by CN XI (spinal accessory)

Front 2

Trapezius muscle

Back 2

Muscle that arises from occipital bone & the vertebrae & extends fanning out to scapula & clavicle; the pr form a trapezoid shape on upper back; move the shoulders & extend & turn the head

Front 3

Preauricular

Back 3

Lymph nodes in front of ear

Front 4

Posterior auricular

Back 4

Lymph nodes superficial to the mastoid process

Front 5

Occipital

Back 5

Lymph nodes at the base of the skull

Front 6

Submental

Back 6

Lymph nodes behind the tip of the mandible

Front 7

Submandibular

Back 7

Lymph nodes halfway b/n the angle & tip of the mandible

Front 8

Jugulodigastric

Back 8

Lymph nodes under the angle of the mandible

Front 9

Superficial cervical

Back 9

Lymph nodes overlying the sternomastoid muscle

Front 10

Deep cervical

Back 10

Lymph nodes deep under the sternomastoid muscle

Front 11

Posterior cervical

Back 11

Lymph nodes in the posterior triangle along the edge of the trapezius muscle

Front 12

Supraclavicular

Back 12

Lymph nodes just above & behind the clavicle, at the sternomastoid muscle

Front 13

Anterior triangle

Back 13

Lies in front, b/n sternomastoid & midline of body, w/its base along lower border of mandible & apex down at suprasternal notch

Front 14

Posterior triangle

Back 14

Behind sternomastoid, w/trapezius muscle on other side & w/its base along the clavicle below; contains posterior belly of omohyoid muscle

Front 15

Lymphadenopathy

Back 15

Enlargement of the lymph nodes (>1 cm) from infection, allergy, or neoplasm

Front 16

Acute infection

Back 16

In this abnormal finding, nodes are bilateral, enlarged, warm, tender, & firm but freely moveable

Front 17

Cancer

Back 17

In this abnormal finding, nodes are hard, unilateral, nontender, fixed

Front 18

Tympanic membrane

Back 18

eardrum; separates external & middle ear & is tilted obliquely to the ear canal, facing downward & somewhat forward; shiny, translucent membrane w/pearly gray color & prominent cone of light in anteroinferior quadrant (R-5:00, L-7:00); oval, slightly concave

Front 19

Malleus

Back 19

"Hammer"; first of the 3 middle ear ossicles; made up of umbo, manubrium, & short process

Front 20

Pars flaccida

Back 20

Small, slack, superior section of tympanic membrane

Front 21

Pars tensa

Back 21

Thick, taut, central/inferior section of tympanic membrane

Front 22

Annulus

Back 22

Outer fibrous rim of the drum

Front 23

Conductive hearing loss

Back 23

Involves mechanical dysfunction of external/middle ear; partial loss b/c person able to hear if sound amplitude is increased enough to reach normal nerve elements in inner ear; causes: impacted cerumen, foreign bodies, perforated tympanic membrane, pus/serum in middle ear, otosclerosis (decrease in mobility of ossicles)

Front 24

Otosclerosis

Back 24

Gradual hardening that causes foot plate of stapes to become fixed in oval window --> decrease in mobility of ossicles

Front 25

Sensorineural hearing loss

Back 25

Pathology of inner ear, CN VIII, or auditory areas of cerebral cortex; increase in amplitude may not enable person to understand words; causes: presbycusis, ototoxic drugs (affect hair cells in cochlea)

Front 26

Presbycusis

Back 26

Gradual nerve degeneration in inner ear/auditory nerve that occurs w/aging

Front 27

Otitis media

Back 27

Middle ear infection that occurs b/c of obstruction of eustachian tube or passage of nasopharyngeal secretions into middle ear; one of most common illnesses in children

Front 28

Cerumen

Back 28

Yellow waxy material that lubricates & protects ear canal; genetically determined, comes in two major types

Front 29

Dry cerumen

Back 29

Gray, flaky, frequently forms a thin mass in ear canal; Asians & American Indians have 84% frequency

Front 30

Wet cerumen

Back 30

Honey brown to dark brown & moist; Blacks have 99% frequency, whites have 97% frequency

Front 31

Inspecting w/otoscope

Back 31

Pull pinna up & back on adult, pull pinna down & back on infant & child < 3 yrs; hold otoscope upside down, have dorsa of hand along pt's cheek; insert speculum along axis of canal, put eye up to otoscope; may need to rotate otoscope slightly to visualize all the eardrum

Front 32

Whispered voice test

Back 32

Rapidly push tragus in & out of auditory meatus, shield lips; 1-2 ft from pt's ear, exhale & whisper slowly 2-syllable words (e.g. Tuesday, baseball); normal = pt repeats ea. word correctly

Front 33

Tuning fork tests

Back 33

Measure hearing by air conduction (AC) or bone conduction (BC); AC - through ear canal & middle ear, usu. more sensitive; BC - sound vibrates through cranial bones to inner ear; to activate tuning fork, hold it by stem & strike tines softly on back of hand

Front 34

Weber test

Back 34

Valuable when pt reports hearing better w/one ear than the other; place vibrating tuning fork in midline of person's skull, ask whether tone sounds the same in both ears or better in one; normal = tone should sound equally loud in both ears

Front 35

Rinne test

Back 35

Compares air conduction & bone conduction sound; place stem of vibrating tuning fork on person's mastoid process, ask pt to signal when sound goes away; quickly invert fork so vibrating end near ear canal, person should still hear sound; normal = positive Rinne test (AC > BC, sound heard twice as long by air conduction)

Front 36

Frostbite

Back 36

Reddish blue discoloration & swelling of auricle after exposure to extreme cold; vesicles/bullae may develop, person feels pain & tenderness, & ear necrosis may ensue

Front 37

Otitis externa

Back 37

"Swimmer's ear"; infection of outer ear, w/severe painful movement of pinna & tragus, redness & swelling of pinna & canal, scanty purulent discharge, scaling, itching, fever, enlarged tender regional lymph nodes; hearing normal/slightly diminished; more common in hot humid weather; after swimming, skinfolds set up for infection

Front 38

Darwin's tubercle

Back 38

Small painless nodule at helix; congenital variation, not significant

Front 39

Tophi

Back 39

Small, whitish-yellow, hard, nontender nodules in/near helix/antihelix; contain greasy, chalky material of uric acid crystals; sign of gout

Front 40

Keloid

Back 40

Overgrowth of scar tissue, invades original site of trauma; more common in dark-skinned ppl, in ear it is most common at lobule at site of pierced ear

Front 41

Carcinoma

Back 41

Ulcerated crusted nodule w/indurated base that fails to heal; bleeds intermittently; must refer for biopsy; usu. occurs on superior rim of pinna (most sun exposure); may occur in ear canal & show chronic serosanguineous/bloody discharge

Front 42

Furuncle

Back 42

Exquisitely painful, reddened, infected hair follicle; may occur on tragus, cartilaginous part of ear canal; regional lymphadenopathy often accompanies it

Front 43

Perforation (TM)

Back 43

Usu. appears as round/oval darkened area on drum; central - occur in pars tensa, marginal - occur at annulus, attic perforation - when they occur in pars flaccida (superior part of drum); causes: untreated acute otitis media, trauma

Front 44

Cochlea

Back 44

Inner ear structure containing the central hearing apparatus

Front 45

Eustachian tube

Back 45

Connects middle ear w/nasopharynx & allows passage of air

Front 46

Helix

Back 46

Superior, posterior free rim of pinna

Front 47

Incus

Back 47

"Anvil"; middle of the 3 middle ear ossicles

Front 48

Mastoid

Back 48

Bony prominence of skull located just behind ear

Front 49

Organ of Corti

Back 49

Sensory organ of hearing

Front 50

Pinna

Back 50

Auricle or outer ear

Front 51

Stapes

Back 51

"Stirrup"; inner of the 3 middle ear ossicles

Front 52

Tinnitus

Back 52

Ringing in the ears

Front 53

Umbo

Back 53

Knob of malleus that shows through the tympanic membrane

Front 54

Vertigo

Back 54

Spinning, twirling sensation

Front 55

Cholesteatoma

Back 55

Overgrowth of epidermal tissue in middle ear/temporal bone, may result over the years after marginal TM perforation; pearly white, cheesy appearance; can erode bone & produce hearing loss; early signs: otorrhea, unilateral conductive hearing loss, tinnitus

Front 56

Otorrhea

Back 56

Discharge from the ear

Front 57

Otalgia

Back 57

Pain in the ear

Front 58

Weber test - conductive loss

Back 58

Sound lateralizes to affected/poorer ear b/c it's not distracted by background noise & has better chance to hear bone-conducted sound

Front 59

Weber test - sensorineural loss

Back 59

Sound lateralizes to unaffected/better ear b/c affected/poor ear is unable to perceive sound

Front 60

Rinne test - conductive loss

Back 60

Sound is heard as long (AC=BC) or longer (AC<BC) by bone conduction; negative Rinne test

Front 61

Rinne test - sensorineural loss

Back 61

Normal ratio of AC>BC is intact but reduced overall; person hears poorly both ways

Front 62

Hyperthyroidism

Back 62

Goiter; exophthalmos; symptoms: nervousness, fatigue, weight loss, muscle cramps, heat intolerance; signs: tachycardia, shortness of breath, excessive sweating, fine muscle tremor, thin, silky hair & skin, infrequent blinking, staring appearance

Front 63

Hypothyroidism

Back 63

Deficiency of thyroid hormone, when severe, causes a non-pitting edema or myxedema; puffy edematous face, esp. around eyes (periorbital edema), coarse facial features, dry skin, dry coarse hair & eyebrows

Front 64

Turbinates

Back 64

3 parallel bony projections that increase surface area so that more blood vessels & mucous membranes are available to warm, humidify, & filter inhaled air

Front 65

Frontal sinus

Back 65

Sinus located in frontal bone above & medial to orbits

Front 66

Maxillary sinus

Back 66

Sinus in maxilla (cheekbone) alone side walls of nasal cavity

Front 67

Ethmoid sinus

Back 67

Sinus b/n the orbits

Front 68

Sphenoid sinus

Back 68

Sinus deep w/in skull in sphenoid bone

Front 69

Hard palate

Back 69

Part of the arching roof of the mouth that is made up of bone & whitish in color

Front 70

Soft palate

Back 70

Arch of muscle that is pinker, mobile

Front 71

Parotid, submandibular, sublingual

Back 71

3 pairs of salivary glands (name them)

Front 72

Function of salivary glands

Back 72

Secrete saliva, which moistens & lubricates the food bolus, starts digestion, & cleans & protects the mucosa

Front 73

Parotid gland

Back 73

Largest of the salivary glands; lies w/in the cheeks in front of the ear extending from the zygomatic arch down to angle of the jaw; Stensen's (its duct)

Front 74

Stensen's duct

Back 74

Duct of the parotid gland that runs forward to open on the buccal mucosa opposite the second molar

Front 75

Submandibular gland

Back 75

Walnut-sized; lies beneath mandible at angle of the jaw; Wharton's (duct)

Front 76

Wharton's duct

Back 76

Duct of the submandibular gland that runs up & forward to the floor of the mouth & opens at either side of frenulum

Front 77

Frenulum

Back 77

Midline fold of tissue that connects tongue to floor of the mouth

Front 78

Sublingual gland

Back 78

Smallest of the salivary glands, almond-shaped; lies w/in floor of the mouth under the tongue; has many small openings along sublingual fold under the tongue

Front 79

Bifid uvula

Back 79

Uvula is split either completely or partially; may indicate a submucous cleft palate, which may affect speech development b/c it prevents necessary air trapping; occurs in some Native American groups (18%) & Asians (10%), uncommon in whites, rare in blacks

Front 80

Cleft lip

Back 80

Maxillofacial clefts are the most common congenital deformities of head & neck; incidence highest in American Indians & Japanese & lowest in blacks; early treatment preserves functions of speech & language formation & deglutition (swallowing)

Front 81

Cleft palate

Back 81

Failure of fusion of maxillary processes; congenital defect; wide variation occurs in extent of cleft formation, from upper lip only, palate only, uvula only, to cleft of the nostril & the hard & soft palates; most common in American Indians & Asians & least common in blacks

Front 82

Rhinitis

Back 82

Nasal mucosa swollen, bright red w/an upper respiratory infection

Front 83

Chornic allergy

Back 83

Mucosa looks swollen, boggy, pale, gray

Front 84

Inspecting the nasal cavity

Back 84

Gently lift up tip of nose w/your finger, & insert into nasal vestibule the short wide-tipped speculum attached to the otoscope head; view each nasal cavity w/person's head erect & then w/head tilted back; normal = red color & smooth moist surface; note swelling, discharge, bleeding, foreign body

Front 85

Superior turbinate

Back 85

Which turbinate cannot be inspected w/the otoscope?

Front 86

U-shaped area under the tongue behind the teeth

Back 86

Where do oral malignancies most likely develop on the tongue?

Front 87

Tonsils

Back 87

Oval, surface rough & peppered w/indentations; located behind anterior tonsillar pillar; pink like oral mucosa

Front 88

Tonsil grade

Back 88

1+ visible, 2+ halfway b/n tonsillar pillars & uvula, 3+ touching the uvula, 4+ touching each other

Front 89

Tonsil - acute infection

Back 89

Tonsils enlarged to 2+, 3+, 4+

Front 90

Testing CN X (vagus)

Back 90

Ask the person to say "ahhh" & note soft palate & uvula rise in the midline

Front 91

Testing CN IX (glossopharyngeal) & X (vagus)

Back 91

Touch the posterior wall of oral cavity w/tongue blade to elicit gag reflex

Front 92

Testing CN XII (hypoglossal)

Back 92

Ask the person to stick out the tongue; normal = it protrudes in the midline; note any tremor, loss of movement, or deviation to the side

Front 93

Epistaxis

Back 93

May be spontaneous from local cuase or a sign of underlying illness; causes: nose picking, forceful coughing/sneezing, fracture, foreign body, rhinitis, heavy exertion, coagulation disorder; bleeding from anteror septum is easily controlled, rarely severe; posterior hemorrhage is less common (<10%) but more profuse, harder to manage, more serious

Front 94

Kiesselbach's plexus in anterior septum

Back 94

Most common site of nosebleed

Front 95

Acute rhinitis

Back 95

1st sign is a clear, watery discharge, rhinorrhea, which later becomes purulent; accompanied by sneezing & swollen mucosa, which causes nasal obstruction; turbinates are dark red, swollen

Front 96

Allergic rhinitis

Back 96

Rhinorrhea, itching of nose & eyes, lacrimation, nasal congestion, sneezing; note serous edema & swelling of turbinates to fill the air space; turbinates usu. pale (may appear violet) & their surface looks smooth, glistening; may be seasonal/perennial, depending on allergen; strong family history of seasonal allergies

Front 97

Herpes Simplex 1

Back 97

Cold sores; clear vesicles w/surrounding indurated erythematous base that evolve into pustules, which rupture, weep, & crust, & heal in 4-10 days; most likely site is lip-skin junction & infection often recurs in same site; caused by herpes simplex virus (HSV-1); highly contagious & spread by direct contact; recurrent herpes infections may be precipitated by sunlight, fever, colds, allergy; very common lesion (50% of adults)

Front 98

Gingivitis

Back 98

Gum margins are red, swollen, & bleed easily; gingival tissue has desquamated (peeled off), exposing roots/teeth; inflammation usu. due to poor dental hygiene or vitamin C deficiency; may occur in pregnancy/puberty b/c of changing hormonal balance

Front 99

Koplik's spots

Back 99

Small blue-white spots w/irregular red halo scattered over mucsoa opposite the molars; early sign & pathognomonic of measles

Front 100

Candidiasis (monilial infection)

Back 100

White, cheesy, curdlike patch on buccal mucosa & tongue; scrapes off, leaving raw, red surface that bleeds easily; termed "thrush" in newborn; opportunistic infection that occurs after use of antibiotics, corticosteroids, & in immunosuppressed persons

Front 101

Oral Kaposi's sarcoma

Back 101

Bruiselike, dark red/violet, confluent macule; usu. on hard palate, may be on soft plalte or gingival margin; oral lesions may be among earliest lesions to develop w/AIDS

Front 102

Perforated nasal septum

Back 102

Hole in septum, usu. in cartilaginous part; may be caused by snorting cocaine, chronic infection, trauma from continual picking of crusts, nasal surgery; seen directly or as spot of light when penlight directed into other naris

Front 103

CAUTION

Back 103

Changes in bathroom habits; A sore that doesn't heal; Unusual discharge/bleeding; Thickness/lumps in breast or other areas; Indigestion & difficulty in swallowing; Obvious changes in moles/warts; Nagging cough & hoarseness