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SWC W2 Heep Headneck

Head and Neck, Survey of western clinical sciences, Heep, Bastyr

What are the Bones of the head?: Skull, Orbit, Nose, Maxilla and Mandible
What are the facial nerves? Face: nerves – CN V and CN VII
Describe CN V: (trigeminal): Motor and Sensory branches
Describe CN VII: (facial): Facial expression and movement
What is the major joint in the head: Temporomandibular joint (TMJ)
Brief anatomy of the eye: Anterior and posterior chambers, canal of Schlemm.
What CN are involved in eye: II (Optic): visual acuity and visual field II and III (Oculomotor): pupillary reaction III, IV (Trochlear) and VI (Abducens): extra-ocular movements III: innervates eyelids
Right eye: OD (Oculus Dexter)
Left eye: OS (Oculus Sinister)
Miosis: contraction of the pupil
Mydriasis: dilation of the pupil
Myopia: near-sightedness, ability to see near.
Hyperopia: far-sightedness. Ability to see far.
Presbyopia: aging vision (see far better)
Diplopia: double vision
Describe Visual Acuity: Means clearness and acuteness of vision. Expressed as a fraction (20/20) The top number distance you from the chart. The bottom number distance a person with normal eyesight could read the same line.
Define Ptosis : drooping of the upper eye lid. Congenital, senile, Myasthenia gravis, damage of CN III and sympathetic nervous system.
Describe Horner’s syndrome: Sympathetic dysfunction, can cause Ptosis, Miosis and ipsilateral anhydrosis.
define Anhydrosis: , no tearing
Define miosis: the constriction of the pupil of the eye to two millimeters or less.
Describe Entropion and Ectropion: Inward/outward turning of the lid. Mostly in elderly
Describe eye lid conditions: Lid retraction and exophthalmos caused by Hyperthyroidism, Graves disease, tumor in the back of the eye.
Describe graves disease: Hyperactivity of thyroid.
Describe Infections around the eye: Hordeolum: Chalazion: Inflammation of the lachrymal sac
Describe Hordeolum: acute purulent inflammation of the eyelid. (big pimple) Stye is a hordeolum of a hair follicle or tear gland
Describe Chalazion: chronic inflammation of a meibomian gland, or granulation of a hordeolum. Also called a meibomian cyst.
Why would eyes become red? redness due to hyperemia (increased blood flow) in the conjunctiva.
What causes red eye? Hypertension, Conjunctivitis (pink eye): viral, allergy, bacterial. Hemorrhage: trauma, HTN Corneal injury or infection, Glaucoma
Define Erythema: Redness due to increased capillary flow.
What are systemic Systemic diseases with eyes: HTN: red eye, retinal neovascularization, retinal detachment, papilledema Diabetes: retinopathy, neovascularization Hyperthyroidism: exophthalmus, lid lag. MS: non-responsive pupil, optic nerve atrophy. Syphilis (pupils – small irregular non-reactive)
Define neovascularization: new capillary growth.
Describe cataracts: Leading cause of blindness in the world. Is a clouding of the lens in the eye that affects vision. A cataract can occur in either or both eyes. It cannot spread from one eye to the other.
Who is most susceptible of cataracts: Most cataracts are related to aging and very common in older people. By age 80, more than half of all Americans either have a cataract or have had cataract surgery.
What is the pathogenesis of cataracts? Acquired cataract: age, sunlight exposure, diabetes, steroid use. Traumatic cataract. Congenital cataract: often in both eyes, may be small and do not affect vision. Radiation cataract. After exposure to radiation
Describe Glaucoma: Optic neuropathy, usually associated with increased IOP, leading to decreased peripheral vision & blindness.
Risk factors of Glaucoma: FHx, DM, African-American, Asians (acute closed angle), BP fluctuations.
What are the Two major types of Glaucoma: Chronic or open-angle glaucoma Acute closed-angle/narrow-angle glaucoma. Other variations include congenital glaucoma, pigmentary glaucoma and secondary glaucoma.
Describe Open-angle glaucoma: is often called "the silent thief of sight“. No warning signs! Usually Asx (Asymptomatic) Late stage: peripheral field loss (tunnel vision) Visual acuity is preserved Can develop into acute closed-angle glaucoma
Describe Closed-Angle Glaucoma: Most common form of glaucoma worldwide. Decreased or no drainage of fluid from anterior chamber
Describe Acute closed angle glaucoma: Acute closed-angle glaucoma occurs when the angle is completely blocked.
Sx of Acute Closes angle Glaucoma: Acute onset, severe eye pain, headaches, haloes around lights, vision loss, nausea and vomiting. Each attack takes with it part of field of vision.
Three parts of ear: Anatomy: external, middle and inner ear
Nerves involved in Ears: CN VIII (Acoustic or vestibularcochlear nerve) Cochlear – hearing Vestibular – equilibrium
What are the two types of hearing loss: Conductive: Air and Bone Sensorineural Meds: Aspirin, NSAIDS, Aminoglycosides, furosemide (anti-HTN).
Three parts of ear: Anatomy: external, middle and inner ear
Nerves involved in Ears: CN VIII (Acoustic or vestibularcochlear nerve) Cochlear – hearing Vestibular – equilibrium
What are the two types of hearing loss: Conductive: Air and Bone Sensorineural Meds: Aspirin, NSAIDS, Aminoglycosides, furosemide (anti-HTN).
Nerve involved in smelling: CN I, Olfactory
Types of nose problems: Rhinorrhea, Epistaxis
Symptoms of Rhinorrhea Clear vs purulent Viral, allergic, foreign body, tumor Pressure and pain in face: sinusitis
Symptoms of Epistaxis Trauma, dryness, tumor, foreign body, HTN
What is a commonMouth and throat pathology: Angular stomatitis/cheilitis
Describe Angular stomatitis/cheilitis: cracks or sores in the corner of the mouth. yeast infections vitamin deficiencies (vitamin B2) iron-deficiency anemia (low red blood cells due to too little iron) allergic reaction poorly fitting dentures
What are pathologies of the throat: Pharyngitis/Sore throat Thrush/ candidiasis
Describe Pharyngitis/Sore throat: Exudative vs. non-exudative Exudative Ex: Strep A (strep throat) – Epstein Barr Virus (infectious mononucleosis)
Describe Thrush/ candidiasis: Yeast infection, white plaques adherent Anywhere in mouth Due to steroids, antibiotics, AIDS, cancer and chemotherapy.
Common Mouth and throat conditions: Leukoplakia and Gingival conditions
Describe Leukoplakia: White patch, anywhere in the mouth. The cause of leukoplakia is unknown, but it's considered to result from chronic irritation especially using tobacco. Does not scrape off. Pre-cancerous
Describe Gingival conditions: Marginal gingivitis Gingival hyperplasia Puberty, pregnancy, leukemia, MEDs (dilantin)
What are Sores in the mouth? Aphthous ulcer aka canker sore Cancer
Describe Aphthous ulcer aka canker sore: Painful, round, white yellow gray/ seems CLEAN Self limited
What can cause Apthous ulcer? Stress or tissue injury may cause the eruption of canker sores. Other causes may include: Faulty immune system function Nutritional problems, such as a deficiency of vitamin B-12, zinc, folic acid or iron… Food allergies Menstrual periods
Describe Cancer in the mouth: Mostly on the base of mouth Not painful Ulcerated/ doesn’t seem CLEAN
Describe Parotid glands: Saliva-producing glands buried within each cheek. What is an inflammation of the parotid gland?
Describe parotitis: Acute bacterial parotitis Chronic recurrent parotitis Viral parotitis (mumps) Tuberculosis
Describe Viral parotitis (mumps): Bilateral inflammation of the Parotid Glands.
Describe Sub-mandibular and sublingual glands: responsible for saliva and digestive enzyme production.
What pathologies can come from Sub-mandibular glands? Infection: pain and swelling Tooth, sore throat (exp strep throat). Stones in the gland Trauma Autoimmune
Describe Sjogren’s syndrome: Autoimmune condition in which there is a decrease in activity of the exocrine glands (saliva, tears). The diagnosis is made with blood tests or by examination of a biopsy of salivary gland
Sx of Sjogren’s syndrome: Dry mouth and intermittent salivary gland enlargement, dry eyes, vaginal dryness, and joint pains.
Describe TMJ – temporomandibular joint: Most active joint in the body Made between temporal bone and mandible Between ear canal and zygomatic arch Is a synovial joint: ball and socket, disc. Group of muscles Opening: external Pterygoids Closing: internal Pterygoids, temporalis and massete
Describe TMJ syndrome: Pain and swelling in the TMJ Mostly unilateral Symptoms: Pain in TMJ joint, ear, HA, neck and shoulder Pain mostly in moving the joint Clicking and popping of the joint
Causes of TMJ syndrome: Trauma, overuse (clenching, grinding, and inappropriate chewing), OA and RA.
Describr Bell’s palsey: Weakness or paralysis of the muscles that control expression on one side of the face.
Etiology of Bells Palsy: Damage to facial nerve (CN VII) that runs beneath the ear to the muscles in the face. Mostly seen as post viral URI, associated with Herpes simplex virus (cold sores). Other conditions: pregnancy in women, diabetics,compromised immune systems.
Sx of Bell’s palsy: Sudden onset of paralysis, weakness one side of face, facial droop: difficult to smile or close th eye + difficulty w facial expressions. Facial stiffness or face is being pulled to one side. Ear Pain on affected side Headache. Changes in tears + sa
Describe severity of Bell’s Palsey: The severity of Bell's palsy can range from mild weakness to total paralysis on one side of the face. The faster the signs and symptoms progress, the more serious the weakness or paralysis.
Describe onset of Bell’s Pasey: fairly abrupt, generally becoming apparent within several hours to a day or two. Pain in the vicinity of the ear can precede the palsy by a day or two. Weakness or paralysis usually peaks within 48 hours after onset of signs and symptoms.
Created by: bastyr41