H&P

Card Set Information

Author:
ed70
ID:
38204
Filename:
H&P
Updated:
2010-09-28 22:51:37
Tags:
head neck nose throat
Folders:

Description:
head, neck, nose, and throat
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  1. seven fused skull bones
    • frontal
    • parietal
    • temporal
    • occipital
  2. 3 Facial Cavities
    • eyes
    • nose
    • mouth
  3. 8 face bones
    frontal, zygomatic, nasal, ethmoid, lacrimal, sphenoid, maxillary, mandible
  4. major landmarks (2)
    • palpebral fissures
    • nasolabial folds
  5. cranial nerves 5 and 7
    innervate face
  6. 3 paired salivary glands
    • parotid gland
    • submandibular gland
    • sublingual gland
  7. neck structure formed by: (4)
    • cervical vertebrae
    • ligaments
    • sternocleidomastoid muscles
    • trapezius muscles
  8. Lymph nodes (8)
    • preauricular
    • posterior auricular
    • occipital
    • tonsilar
    • submandibular
    • submental
    • superficial, posterior, deep cervical
    • supraclavicular
  9. Inspection (head and face)
    • head position and shape
    • skull size and shape
    • scalp
    • hair pattern
    • facial features
    • facial asymmetry
    • tics
    • spasms
  10. Palpation (head and face)
    • skull symmetry/smoothness
    • scalp movement
    • hair texture
    • temporal arteries
    • facial bones
    • TMJ
    • salivary glands
  11. percussion and auscultation (head and face)
    • (not routine)
    • sinuses can be percussed: frontal, maxillary, and ethmoid sinuses
    • can listen for temporal artery bruits
  12. Inspection (neck)
    • muscle symmetry
    • alignment of the trachea
    • triangles landmarks
    • fullness at base of neck
    • masses
    • webbing
    • excess skin folds
    • unusual shortness - Turners syndrome
    • asymmetry
    • carotid artery prominence
    • jugular vein distension
    • ROM (flexion, extension, lateral)
  13. Palpation and Auscultation (neck)
    • tracheal alignment
    • smoothness/tenderness
    • tracheal tugging
    • lymph nodes

    auscultate carotids
  14. Neck-throid gland (inspect, palpate, and auscultate)
    • Inspect: symmetry and swallowing symmetry
    • Palpation: size, shape, configuration, consistency, tenderness, nodules
    • Auscultate: enlarged gland (vascular sounds (bruit)
  15. Nose and nasopharynx: how formed
    • nose warms and moisturizes air
    • detects odors (CN 1)
    • cartilage forms external nose and nares
    • frontal/maxillary bones form nasal bridge
    • the floor formed by hard and soft palate
    • turbinates form the lateral wall
    • nasolacrimal duct and paranasal sinuses drain into inferior and medial meatus respectively
  16. examination of the nose
    • Inspect: color, size, position, shape
    • nares for discharge
    • occlude each nare for patency
    • speculum exam of turbinates: boggy, injected, purulent
    • palpate for tenderness (nasal bridge)
    • olfactory CN1 (use 2 distinct senses)
  17. mouth and oropharynx
    • vocalization, digestion, food passage, tast
    • tounge: dorsal surface supports filiform papillae
    • salivary glands
    • 32 adult teeth anchored in alveolar ridge
    • tonsillar pillars separate mouth from oropharynx
  18. Inspection (mouth)
    • lips
    • buccal mucosa, teeth, gums
    • oral cavity, tongue, mouth, and floor
    • hard and soft palate, uvula
    • oropharynx, tonsils
    • gag reflex
  19. Palpate (mouth)
    • with glove!
    • gums, tongue, floor
    • submandibular (wharton's ducts)
    • parotid (stenson's ducts)
    • sublingual glands
  20. Related History
    • Onset
    • Location
    • Duration
    • Character
    • Associated symptoms
    • Related factors
    • Treatment factors
    • --medications
  21. common symptoms
    • headache
    • change in vision/double vision
    • hearing loss, earache, tinnitus
    • vertigo
    • nosebleed
    • sore throat
    • swollen glands
    • goiter
  22. related history: PMH
    • head trauma
    • recent lumbar puncture
    • randon/radium tx of the neck or head
    • seizures
    • headaches
    • thryoid dysfunction/surgery
  23. Related family history
    • headaches
    • thyroid dysfunction
    • sore throats
    • sinus problems
  24. Social History
    • employment risks
    • stress
    • injury risks
    • recent weight gain/loss
    • food intolerances
    • use of ETOH/drugs/tobacco
    • sexual practices
  25. Review of Systems:
    Head, Neck, Nose, Mouth/Throat
    • Head: cephalgia, head injury, migraines
    • Neck: history of injury, masses, pain or stiffness
    • Nose: chronic sinusitis, decreased smell, excessive rhinorrhea, unexplained epistaxis, nasal fractures
    • Mouth/Throat: tenderness or lesions in oral cavity, frequent sore throats, dysphagia or persistent hoarseness

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