Term
| number of bones in the skull |
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Definition
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Term
| neck Anterior triangle borders |
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Definition
| lower border of mandible (superiorly), the midline of the neck (anteriorly), and the SCM muscle (laterally) |
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Term
| neck posterior triangle borders |
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Definition
| SCM (anteriorly), the middle third of the clavicle (inferiorly), and the trapezius muscle (posteriorly) |
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Term
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Definition
• Zone I, including the thoracic inlet, up to the level of the cricothyroid membrane
• Zone II, the middle anatomic zone, is between the horizontal plane passing through the cricoid cartilage and the horizontal plane passing through the angle of the mandible
• Zone III, above the angle of the mandible to the skull base, is treated as a head injury lies between the horizontal |
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Term
| Midline Structures of the Neck |
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Definition
• The hyoid just below the mandible. The thyroid cartilage (NOT the thyroid gland) is suspended from the hyoid bone.
• The thyroid cartilage is easy to identify, especially on men, because the thyroid notch is the Adam’s apple.
• The thyroid cartilage houses the vocal cords.
• Inferior to the thyroid cartilage is the cricoid cartilage, which is located at the top of the trachea |
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Term
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Definition
• The isthmus of the thyroid gland lies
inferiorly to the cricoid cartilage.
• The lateral lobes of the thyroid gland curve posteriorly around the sides of the trachea and the esophagus. They are covered by thin strap like muscles, SCM.
• The thyroid gland is more easily palpable in women. |
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Term
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Definition
| • Deviates towards the Opposite side with PneumOthorax, sAme side with Atelectasis |
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Term
| Stensen’s duct (parotid duct) opens into |
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Definition
| buccal mucosa near upper 2nd molar |
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Term
| most highly calcified tissue in the body |
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Definition
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Term
|
Definition
– Anterior 2/3 • Sweet
• CN VII (facial)
– Posterior 1/3
• Sour and bitter
• CN IX (glossopharyngeal)
– Lateral • Salty |
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Term
| Opening of submandibular gland |
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Definition
| Wharton’s duct, floor of mouth |
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Term
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Definition
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Term
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Definition
| Clusters of lymphatic tissue just under the mucous membranes that line the nose, mouth, and throat (pharynx), enlarge from infection or tumor |
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Term
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Definition
| Lies above the short process of the malleus |
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Term
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Definition
| Remainder of the ear drum, below umbo, incus and pars flaccida |
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Term
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Definition
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Term
| Connects the tympanic cavity to the nasopharynx where it opens posterior to the inferior nasal meatus |
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Definition
| The Eustachian Tube. function is to equalize pressures |
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Term
| Bony labyrinth of inner ear contains |
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Definition
– Cochlea-hearing
– Vestibular apparatus- balance
• The utricle, saccule and semicircular canals |
|
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Term
|
Definition
– Suspended within bony labyrinth
– Series of communicating sacs and ducts
– Contains endolymph
– Two divisions
• Vestibular-utricle and saccule and semicircular ducts
• Cochlea-cochlear duct |
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Term
| converts sound waves to electrical impulses |
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Definition
| The cochlea after it senses and codes vibrations transmitted to inner ear. nerve impulses go to brain via cochlea nerve |
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Term
| 1st part of pathway-external ear thru middle ear |
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Definition
| conductive phase of hearing |
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Term
| 2nd part of pathway via cochlea and cochlea nerve |
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Definition
| sensineural phase of hearing |
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Term
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Definition
• Covered by highly vascular mucous membrane
• Below each turbinate is a groove (meatus)
• Nasolacrimal duct drains into the inferior meatus
• Most of the paranasal sinuses drain into the middle meatus |
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Term
|
Definition
• Cleansing
• Humidification
• Temperature control of inspired air |
|
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Term
|
Definition
• Air filled cavities within the bones of the face
• Main function is to produce a mucus that moisturizes the inside of the nose. This mucus layer protects the nose from pollutants, micro- organisms, dust and dirt
• Maxillary
• Ethmoid
– Approximately 6-12 small sinuses per side located in between the eyes
• Frontal
• Sphenoid
– Behind the ethmoid sinuses, near the middle of the skull |
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Term
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Definition
|
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Term
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Definition
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Term
| immobile stare, Face and upper neck flexed forward |
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Definition
|
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Term
|
Definition
| Cushing’s syndrome, over secretion of cortisol from adrenal gland |
|
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Term
| Hypersecretion of growth hormone |
|
Definition
– In childhood leads to gigantism
– In adulthood leads to acromegaly
• Coarsening of facial features, bony prominences of the forehead, nose and lower jaw |
|
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Term
|
Definition
• Characteristic of hypothyroidism
• Dull, puffy face
• Edema pronounced around the eyes and does not pit
• The hair and eyebrows are thin and coarse |
|
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Term
• Bulging tongue.
• Eyes that slant upward. • Atypically shaped ears. |
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Definition
|
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Term
|
Definition
| Consisting of a broad forehead, medial eyebrow flare, strabismus, flat nasal bridge, malar flattening, a short nose with a long philtrum, full lips, and a wide mouth |
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Term
|
Definition
| Prolongedmouthbreathing due to adenoid hypertrophy may affect facial and dental growth and development, resulting in the characteristic "adenoid facies" (open mouth, flattening and elongation of the midface, retraction of the upper lip, and narrowing of the hard palate resulting in crowding of the maxillary teeth) |
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Term
|
Definition
• A an abnormal accumulation of cerebrospinal fluid (CSF) within cavities in the brain called ventricles.
• It occurs when there is an imbalance between the amount of CSF that is produced and the rate at which it is absorbed |
|
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Term
| Paget’s Disease of the Bone |
|
Definition
• May affect one or many bones
• Favors axial skeleton
• Bone turnover becomes faster and out of control
• Osteoclasts not functioning right, osteoblasts increase to make new bone material, bones wrongly woven
• Usually asymptomatic, pain, deformity, fractures, nerve compression, arthritis, systemic complications |
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Term
|
Definition
sign of trauma behind ears
• An indication of fracture of middle cranial fossa of the skull, and may suggest underlying brain trauma |
|
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Term
|
Definition
• Use the pads of the index and middle fingers
• Note the
– Size (may be enlarged in infection or malignancy)
– Shape (most nodes are round or ovoid; irregularly shaped or nodular nodes may be malignancy)
– Consistency (firm vs. fluctuant)
– Delimitation (discrete vs matted)
– Mobility (mobile vs. fixed-neoplastic)
– Tenderness |
|
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Term
| If the thyroid gland is enlarged |
|
Definition
| listen over the lateral lobes with the bell of your stethoscope to detect a bruit |
|
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Term
|
Definition
| (angular stomatitis, aka cheilosis-softening of skin at the angles of the mouth, followed by cracking and fissures) |
|
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Term
|
Definition
| (aphthous ulcers aka canker sores; Koplick spots-measles) |
|
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Term
| Petechiae on hard/soft pallet could incidate |
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Definition
| endocarditis, leukemia, mono |
|
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Term
|
Definition
| a white patch adherent to a mucous membrane-may be premalignant |
|
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Term
| 10th (Vagus) nerve paralysis |
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Definition
| Uvula deviates to opposite side. Also can appear deviated in tonsillar abscesses |
|
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Term
| Ask the patient to say “AHH” |
|
Definition
– Watch rise and fall of soft palate CN IX, CN X
(glossopharyngeal and vagus)
– Listen for hoarseness CN X
– Insert tongue blade and observe gag reflex CN IX and
X |
|
|
Term
| grayish membrane on pharymx |
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Definition
|
|
Term
| whitish adherent plaques on pharynx |
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Definition
|
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Term
|
Definition
| Color normally pearly gray to transparent when healthy; red TM-infection; blue otosclerosis |
|
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Term
|
Definition
| Masses-middle ear carcinomas, cholesteatoma |
|
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Term
|
Definition
| Lesions-vesicles Herpes Zoster and bullous myringitis |
|
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Term
|
Definition
| usuallyindicates fluid or pus behind the TM. |
|
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Term
|
Definition
| usually indicates OM or conditions that occlude the drainage of the Eustachian tube into the nasopharynx |
|
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Term
|
Definition
| complete audiometric exam in a noise proof sound booth |
|
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Term
|
Definition
• Performedtoevaluatemobilityof the TM
• Positivepressurethatforcesairinto the EAC thereby pushing down the TM, is done first.
• Thepressureisthenreleased,with the subsequent negative pressure pulling the TM outwards.
• A non-mobile TM may occur because of fluid in the middle ear cavity, a mass in the middle ear cavity, or a stiff or sclerotic TM.
• A hypermobile TM may indicate ossicular chain disruption
• The TM may only move with negative pressure; this can be caused by retraction of the TM or middle ear with a blocked Eustachian tube, resulting in negative middle ear pressure. |
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Term
|
Definition
| may be associated with underlying carcinomas, infection, septal degeneration |
|
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Term
| The middle and inferior turbinates |
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Definition
| shelf-like projections along the lateral wall. Look for any polypoid growths, which may be associated with allergies and obstructive symptoms or any ulcerations |
|
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Term
|
Definition
• Always unilateral, usually begins around the eye or temple
• Pain begins quickly, reaches a crescendo within minutes
• Pain is deep, continuous, excruciating and explosive in quality
• Duration 15 minutes to 3 hours
• Patient remains inactive
• AssociatedSymptoms:Ipsilaterallacrimationand redness of the eye; ptosis; stuffy nose; rhinorrhea, pallor, sweating, Horner syndrome; restlessness or agitation; focal neurologic symptoms are rare; sensitivity to alcohol
• Maybeconfusedwithlife-threateningheadachessince the pain can reach full intensity within minutes
• Treatment:oxygen,triptans,lidocaine,ergots, octreotide
• Preventative:verapamil,glucocorticoids,lithium, topiramate, greater occipital nerve blocks |
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Term
|
Definition
typically torn dural vessels, such as middle meningeal artery; associated skull fracture usually; lenticular-shaped and tend not to be associated with underlying brain damage
-primary brain injury |
|
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Term
|
Definition
damage to bridging veins, which drain the cerebral cortical surfaces to dural venous sinuses, or from the blossoming of a superficial cortical contusion; crescent shaped and often with underlying cerebral injury
-primary brain injury |
|
|
Term
| Subarachnoid hemorrhage (SAH) |
|
Definition
can occur with disruption of small pial vessels and commonly occurs in the sylvian fissures and interpeduncular cisterns
-primary brain injury |
|
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Term
| Intraventricular hemorrhage |
|
Definition
| is believed to result from tearing of subependymal veins, or by extension from adjacent intraparenchymal or subarachnoid hemorrhage |
|
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Term
| anterior cervical lymph node enlargement |
|
Definition
| often enlarged because of one of a variety of infections of the head and neck or due to some systemic infections such as Epstein-Barr virus (EBV), cytomegalovirus infection, or toxoplasmosis |
|
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Term
| posterior cervical lymphadenopathy |
|
Definition
| may occur with EBV infection, tuberculosis, lymphoma, or head and neck malignancy (either lymphomas or metastatic squamous cell carcinoma) |
|
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Term
|
Definition
• Infection with Mycobacterium tuberculosis or atypical mycobacteria is suggested when multiple enlarged cervical nodes develop over weeks to months and become fluctuant or matted without significant inflammation or tenderness, and it is occasionally associated with fever.
• Tuberculous adenitis is usually regional (except in cases of miliary tuberculosis) and mainly affects nodes of the head and neck.
• Infection with Bartonella henselae, the agent of cat scratch disease, can also present as multiple enlarged cervical lymph nodes.
• Hard cervical lymph nodes, particularly in older patients and smokers, suggest metastatic head and neck cancer (oropharynx, nasopharynx, larynx, thyroid, or esophagus). |
|
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Term
|
Definition
drain the conjunctiva, ear canal, and the anterior and temporal scalp
• Commonly enlarged in conjunctivitis caused by viral or bacterial pathogens.
– The “Parinaud oculoglandular syndrome” refers to an uncommon unilateral granulomatous conjunctivitis affecting the bulbar or palpebral conjunctivae.
• Cat scratch disease accounts for most cases, though other bacterial and fungal causes are less commonly identified |
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Term
| Postauricular(alongwithsub- occipital nodes) |
|
Definition
commonly enlarge and become tender in rubella infection. The adenopathy can precede the rash
– Most commonly, however, enlargement of this node group is noted in bacterial or fungal infections of the parieto-temporal scalp.
• Suboccipital-receivedrainagefrom the posterior scalp and are commonly involved in bacterial or fungal infections |
|
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Term
| Supraclavicular lymphadenopathy |
|
Definition
is associated with a high risk of malignancy.
• Right supraclavicular adenopathy is associated with cancer in the mediastinum, lungs, or esophagus
• Left supraclavicular adenopathy ("Virchow's node") suggests
abdominal malignancy (stomach, gallbladder, pancreas, kidneys, testicles, ovaries, lymphoma, or prostate) |
|
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Term
|
Definition
receive drainage from the arm, thoracic wall, and breast. Infections, including cat scratch disease, are common causes of axillary lymphadenopathy.
• In the absence of upper- extremity lesions, cancer is often the cause |
|
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Term
|
Definition
| Palpable epitrochlear nodes are always pathologic. The differential diagnosis includes infections of the forearm or hand, lymphoma, sarcoidosis, tularemia, and secondary syphilis |
|
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Term
|
Definition
| often palpable in the inguinal region in healthy people, perhaps because chronic trauma and infection is so common in the lower extremities. Inguinal lymphadenopathy is usually caused by lower-extremity infection, sexually transmitted diseases (such as chancroid, lymphogranuloma venereum, genital herpes, syphilis), or cancer. |
|
|
Term
| Generalized lymphadenopathy may be from systemic diseases: |
|
Definition
– HIV
– Mycobacterial infections – Infectious Mononucleosis – SLE
– Medications
– Sarcoidosis
– Lymphoma |
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Term
|
Definition
inflammation or an infection of the lymphatic channels that occurs as a result of infection at a site distal to the channel
– Signs and symptoms include a deep reddening of the skin,
warmth, lymphadenitis (inflammation of a lymphatic gland), and a raised border around the affected area
– the terms "lymphadenitis" and "lymphadenopathy" often are used interchangeably |
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Term
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Definition
malformationsofthelymphatic system characterized by lesions that are thin-walled cysts; these cysts can be macroscopic, as in a cystic hygroma, or microscopic.
• Thelymphaticsystemisthenetworkofvessels responsible for returning to the venous system excess fluid from tissues as well as the lymph nodes that filter this fluid for signs of pathogens.
• Thesemalformationscanoccuratanyageandmay involve any part of the body, but 90% occur in children less than 2 years of age and involve the head and neck.
• Thesemalformationsareeithercongenitaloracquired. |
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Term
|
Definition
• A congenital malformation resulting from lymph accumulation in the jugular lymphatic sacs due to obstruction of the lymphatic system in the fetal neck.
• Cystic hygromas may be septated or simple (nonseptated or biseptate)
• Cystic hygromas are associated with an increased risk for fetal aneuploidy (particularly trisomy 21) and structural malformations (particularly congenital heart defects), both of which increase the risk for miscarriage, hydrops, fetal demise, and neonatal death
• Fetal genetic analysis and Ultrasound examination |
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Term
|
Definition
consistsofadiverse group of malignant neoplasms variously derived from B cell progenitors, T cell progenitors, mature B cells, mature T cells, or (rarely) natural killer cells.
• SomeNHLsbehaveindolentlywithlymphadenopathy waxing and waning over years. Others are highly aggressive, resulting in death within weeks if left untreated.
• Symptoms:Upto40percentofpatientswithNHL present with systemic complaints of fever, weight loss, or night sweats (B symptoms), painless lymphadenopathy that may wax and wane |
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Term
| Hodgkin lymphoma (HL), formerly called Hodgkin's disease |
|
Definition
arises from germinal center or post-germinal center B cells.
• HL has a unique cellular composition, containing a minority of neoplastic cells (Reed-Sternberg cells and their variants)
• HL starts at a single site within the lymphatic system, usually a lymph node, and then progresses to adjacent lymph nodes via lymphatic channels before disseminating to distant nonadjacent sites and organs.
• Painless, localized peripheral lymphadenopathy, typically involving the cervical region
• Most often as an asymptomatic enlarged lymph node or a mass on chest radiograph.
• B symptoms (fever, night sweats, weight loss) are present over weeks to months, though other symptoms such as fatigue or lymphadenopathy may be present over many months, pruritus,
• History and physical, tissue biopsy, labs, PET/CT scan |
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Term
|
Definition
• Triad of fever, tonsillar pharyngitis, lymphadenopathy
• EBV; herpes family
• Transmission: person-to-person, breastfeeding, sexual transmission
• The incubation period prior to the development of symptoms averages four to eight weeks
• Other symptoms: hepato/splenomegaly, rash, neurologic symptoms like Guillain- Barre
• Labs: lymphocytosis, elevated aminotransferases, heterophile test, Monospot, EBV testing
• Treatment: supportive, fluids, NSAID’s, avoid sports if spleen enlarged, Acyclovir and antivirals-controversial |
|
|
Term
|
Definition
• Infectiousdisease
• Self-limitedregionaltenderlymphadenopathy
• Transmission:scratch,bitefromaninfectedcat,and exposure to fleas, via cat saliva to broken skin
• Organisms:B.henselae,Bartonellaclarridgeiae,A. felis, B. clarridgeiae
• ClinicalManifestations:lesion,proximaltothesiteof inoculation lymphadenopathy
• Mayincludevisceralorgans,neurologic,andocular involvement
• Clinicaldiagnosis,serology,PCR,bloodcultures
• Treatment:maybeselflimiting,Cipro,Azithromycin, more drug regimens if systemic involvement |
|
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Term
|
Definition
• Iodine deficiency is the most common cause of goiter worldwide
• In patients with iodine deficiency or chronic autoimmune (Hashimoto's) thyroiditis, an increase in thyroid-stimulating hormone (TSH) secretion is the predominant cause of goiter.
• In contrast, most patients with sporadic nontoxic multinodular goiters have normal serum TSH concentrations. In these individuals, the thyroid enlargement is probably caused by several growth factors (including TSH) that act over time on thyroid follicular cells that have different synthetic and growth potentials. |
|
|
Term
|
Definition
• Symptoms: weight loss, heat intolerance, tremor, palpitations, anxiety, increased frequency of bowel movements, shortness of breath, increased appetite, and goiter
• Other symptoms that may be present include hyperdefecation (not diarrhea), urinary frequency, oligomenorrhea or amenorrhea in women, and gynecomastia and erectile dysfunction in men
• PE: hyperactivity, lid lag, rapid speech, thin and fine hair, tachycardia, systolic HTN, tremor, proximal muscle weakness, hyperreflexia
• Labs: low TSH. The serum TSH concentration alone cannot determine the degree of biochemical hyperthyroidism; serum free T4 and T3 are required to provide this information
• Many patients with overt hyperthyroidism have high free T4 and T3 concentrations. In some patients, however, only the serum T3 or serum T4 is elevated.
• In patients with subclinical hyperthyroidism, TSH is below normal (but usually >0.05 mU/L) and serum free T4, T3, and free T3 are normal.
• Subclinical hyperthyroidism, defined as normal serum levels of free thyroxine (T4) and triiodothyronine (T3) with a suppressed TSH level |
|
|
Term
|
Definition
• Graves' disease is an autoimmune disease that may consist of hyperthyroidism, goiter, eye disease (orbitopathy), and occasionally a dermopathy referred to as pretibial or localized myxedema.
• In this disorder, the body makes an antibody (a protein produced by the body to protect against a virus or bacteria) called thyroid- stimulating immunoglobulin (TSI) that causes the thyroid gland to make too much thyroid hormone.
• Symptoms: exophthalmos, periorbital and conjunctival edema, limitation of eye movement, and infiltrative dermopathy (pretibial myxedema)
• Labs: If TSH is low and only serum T3 is high (normal free T4 concentration), the patient most likely has Graves' disease, radioiodine uptake test, a serum T3/T4 ratio >20 ng/mcg and a serum free T3/free T4 ratio >0.3
• A quantitative thyroid blood flow by ultrasonography may be helpful to differentiate Graves' hyperthyroidism from painless thyroiditis |
|
|
Term
|
Definition
encompassesadiversegroupof disorders characterized by some form of thyroid inflammation
• Theclassicpatternofchangesinthyroidfunctionin patients with subacute and painless thyroiditis is hyperthyroidism, followed by hypothyroidism and then recovery.
• Hyperthyroidism,whenitoccurs,isduetodamageto thyroid follicular cells and breakdown of stored thyroglobulin, leading to unregulated release of thyroxine (T4) and triiodothyronine (T3).
• HyperthyroidismlastsonlyuntilthestoresofT4andT3 are depleted, usually two to six weeks. Hypothyroidism is also usually transient but can rarely be permanent.
-presents with thyroid pain and tenderness is typically caused by subacute thyroiditis and, less frequently, by infectious or traumatic etiologies. It may also occur after radioiodine therapy.
• Painless thyroiditis is often autoimmune mediated and can also occur after exposure to certain drugs, such as interferon alfa, interleukin-2, lithium, tyrosine kinase inhibitors, and checkpoint inhibitor immunotherapy |
|
|
Term
|
Definition
• Symptoms: fatigue, cold intolerance, weight gain, constipation, dry skin, myalgia, and menstrual irregularities, bradycardia, diastolic hypertension, and a delayed relaxation phase of the deep tendon reflexes
• Primary hypothyroidism is characterized by a high serum thyroid-stimulating hormone (TSH) concentration and a low serum free thyroxine (T4) concentration
• Subclinical hypothyroidism is defined biochemically as a normal free T4 concentration in the presence of an elevated TSH concentration
• Secondary (central) hypothyroidism is characterized by a low serum T4 concentration and a serum TSH concentration that is not appropriately elevated
• The treatment of choice for correction of hypothyroidism is synthetic thyroxine (T4, levothyroxine) |
|
|
Term
|
Definition
• Hashimoto'sthyroiditis(chronicautoimmunethyroiditis) is the most common cause of hypothyroidism in iodine- sufficient areas of the world
• TheusualcourseofHashimoto'sthyroiditisisgradual loss of thyroid function.
• Infection,stress,sexsteroids,pregnancy,iodineintake, and radiation exposure are the known possible precipitating factors
• ThetwomajorformsofHashimoto'sthyroiditisare goiterous autoimmune thyroiditis and atrophic autoimmune thyroiditis (often called primary myxedema), with the common pathologic feature being lymphocytic infiltration and follicular destruction |
|
|
Term
|
Definition
• Thyroidfollicularepithelial-derivedcancersinclude papillary, follicular, and anaplastic cancer.
• Papillaryandfollicularcancersareconsidered differentiated cancers, and patients with these tumors are often treated similarly despite biologic differences.
• Papillaryisthemostcommon
• Follicularpeaksages40-60;papillaryages30-50 Presents as a thyroid nodule. Either noted by the patient or during routine physical examination; or when incidentally noted during a radiologic procedure, such as carotid US, neck CT, MRI, PET scanning
• RiskFactors:radiation,familyhistory
• Nonpalpable nodules (incidentalomas) have the same risk of malignancy as palpable nodules of the same size.
• 80 percent have lymph node metastases (half of which are microscopic)
• The primary therapy for differentiated (papillary and follicular) thyroid cancer is surgery and preoperative ultrasound evaluation of the central and lateral neck lymph nodes
• T4 replacement may be needed, monitor TSH levels, radioiodine, recombinant human TSH |
|
|
Term
|
Definition
• Abnormallylarge
• Cantouchtheuvulaand obscure the posterior pharynx
• Symptoms:halitosis,mouth- breathing, snoring, sleep apnea, decreased appetite, chronic ear infections, recurring sinus infections
• RiskFactors:Familyhistory
• Management:antibiotics, tonsillectomy |
|
|
Term
|
Definition
• Peritonsillarabscess(PTA,quinsy)isthemostcommon deep neck infection
• Peritonsillarcellulitisisaninflammatoryreactionofthe tissue between the capsule of the palatine tonsil and the pharyngeal muscles that is caused by infection, but not associated with a discrete collection of pus. An alternate term for cellulitis is phlegmon.
• Peritonsillarabscessisacollectionofpuslocated between the capsule of the palatine tonsil and the pharyngeal muscles
• Diagnosingthetypeofperitonsillarinfectionpresent requires needle aspiration or incision and drainage to determine if pus is present.
• Intraoral or submandibular ultrasonography (US) can help distinguish PTA from cellulitis and guide the need for needle aspiration
• CT with IV contrast is the preferred imaging modality for identifying deep space neck infections such as retro- or parapharyngeal abscess
• Management: Drainage, antimicrobial therapy, and supportive care; include coverage for Group A streptococcus, Staphylococcus aureus and respiratory anaerobes. Ampicillin-sulbactam or clinda; vanco or linezolid; oral antibiotics for 14 days-Augmentin, Clinda; may need tonsillectomy |
|
|
Term
|
Definition
• Canceroftheoralcavityisassociated with ulcers or masses that do not heal and with dental changes or poorly fitting dentures
• Maybeinsidemouth,lip,hardpalate, or tongue
• Riskfactors:smoking,alcohol
• Types:SCC;Asubsetof oropharyngeal squamous cell carcinoma is associated with human papillomavirus (HPV) infection, particularly with high-risk type 16
• Symptoms:non-healing,pain
• Management:biopsy |
|
|
Term
|
Definition
• 2nd most common cancer to lip
• Usually squamous cell
• Induration increases chance of malignancy
• Most often on the side of the tongue followed by base |
|
|
Term
|
Definition
• A thick, white patch located anywhere in mouth, although frequently on buccal mucosa
• Caused by chronic irritation as from tobacco or smokeless tobacco
• May lead to cancer
• Management: biopsy, retinoid compounds |
|
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Term
|
Definition
• EBV mediated, associated with HIV
• Mucocutaneous manifestation
• Most common lateral portions of tongue
• White corrugated painless plaques that, unlike candida, cannot be scraped from the surface to which they adhere
• Not associated with fever
• OHL is not considered a premalignant lesion, being unlikely to progress to squamous cell carcinoma
• Therapy not always indicated but can symptomatically treat with antivirals. Treat underlying condition |
|
|
Term
Oral Proliferative Verrucous Leukoplakia
(OPVL) |
|
Definition
• A rare, aggressive form of oral leukoplakia characterized by multifocality and a strong tendency to develop exophytic and wart-like lesions and to undergo malignant transformation
• Symptoms: multifocal lesions; presence of verrucous areas; lesions recurring after treatment; female sex; and lack of exposure to tobacco
• Treatment: None proven
• Management: lifelong close clinical and histopathologic monitoring for the development of SCC.
• The mortality rate after an average follow-up time of 10 years is approximately 30 percent |
|
|
Term
|
Definition
• Oralpigmentedlesions;ABCD’s
• Melanomaoftheoralcavityis frequently diagnosed at more advanced stages as providers fail to recognize it
• DDX:melanosis-extremelycommon in individuals with dark skin and generally are symmetric; oral melanotic macules-darkly pigmented, benign macules that occur on lips and oral mucosa, symmetric with sharp borders, stable
• Management:biopsy,surgery |
|
|
Term
|
Definition
• Blue-black macules seen in the adjacent gingival margin or proximal buccal mucosa near amalgam dental fillings
• They are caused by inadvertent placement of dental silver amalgam restorative material into the oral soft tissues
• May mimic oral melanomas |
|
|
Term
|
Definition
• Benign neoplasms of sebaceous gland etiology.
• They present as isolated to scattered, white to yellow, 1 to 2 mm discrete papules, particularly prominent on
the vermilion/buccal mucosal border |
|
|
Term
|
Definition
• Fluid filled cavities with mucous glands lining the epithelium. They typically are seen after mild oral trauma as a result of disruption of the salivary gland duct, most frequently of the lower lip (as a result of biting of the lip)
• May have a gelatinous fluid within that presents clinically
as pinkish/blue soft papules or nodules
• Management: cryotherapy or excision of the entire cyst if symptomatic; CO2 laser vaporization, aspiration |
|
|
Term
|
Definition
• Exostosis located on the midline of the hard palate
• A bony hard, nodular, lobular, or spindle-shaped mass covered with normal mucosa
• May be asymptomatic
• Management: Biopsy; Surgical removal may be an option if patients develop symptoms or the lesion precludes proper fitting of dentures or prosthetic devices |
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Term
| Recurrent Apthous Ulcers (RAS) |
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Definition
• Cankersore;usuallypainful, yellowish with surrounding red “halo” and may have grayish base
• Mostcommoncauseofmouth ulcers
• Maybeviral,seeninceliac disease, IBD, HIV
• Etiologynotwelldefined
• Morecommoninchildren
• Healin10-14days
• Treatment:Orabase,topicalgels, – Thalidomide, glucocorticoids |
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Term
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Definition
• A neutrophilic inflammatory disorder that presents with recurrent oral and genital ulcerations.
• Recurrent oral ulcers (three times per year) are required for the diagnosis of Behçet syndrome, in addition to two other clinical findings (recurrent genital ulcers, eye lesions, skin lesions, or a positive pathergy test [24 to 48 hours after oblique insertion of a 20 to 25 gauge needle])
• Treatment: oral colchicine, topical anesthetics, topical or intralesional corticosteroids, or systemic glucocorticoids,Thalidomide and dapson e |
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Term
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Definition
• Bullouspemphigoidisan autoimmune blistering disorder.
• Lesionscommonlyoccurinthe flexural areas, groin, and axillae.
• Oralinvolvementconsistingof intact bullae or erosions occurs in about one-third of cases but is rarely the presenting feature.
• Management:direct immunofluorescence testing of lesion and perilesional skin, oral glucocorticoids |
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Term
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Definition
• Pemphigusvulgarisis characterized by flaccid bullae that typically begin in the oropharynx and then may spread to involve the skin, with a predilection for the scalp, face, chest, axillae, and groin
• Causes:occurswhenthe immune system mistakenly makes antibodies against proteins in healthy skin and mucous membranes.
• Management:steroids |
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Term
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Definition
• Isolated event or in conjunction with genital disease
• Lace-like white patches (Wickham striae) on the buccal mucosa to erosions on the gingival margin
• Chronic
• Increases risk for oral cancer
• Management: corticosteroids, antimalarials |
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Term
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Definition
• Uncommon
• Predominantly post- menopausal women
• Persistent burning with no medical or dental cause
• Exclude other diseases such as xerostomia and allergic contact stomatitis first |
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Term
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Definition
• An inflammatory disorder of the tongue that leads to the atrophy of the filiform papillae. The tongue appears smooth, glossy, and erythematous
• Causes: Nutritional deficiencies, dry mouth, Sjogren syndrome, oral candida, protein-calorie malnutrition, celiac disease
• Complain of a burning sensation and increased sensitivity when eating acidic or salty foods.
• Treatment is directed at the underlying condition |
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Term
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Definition
• Fissured tongue is a benign condition of unknown etiology usually seen in adults.
• Deep grooves are located on the midline or evenly distributed on the tongue surface
• Seen in patients with Down syndrome or Melkersson-Rosenthal syndrome (a rare syndrome characterized by the triad of fissured tongue, facial palsy, and granulomatous cheilitis)
• Asymptomatic and Permanent
• Management: does not require treatment unless the patient gets irritation from entrapped debris in the fissures-brushing the affected area or using an oral irrigator may help |
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Term
| Hairy Tongue (lingua villosa nigra) |
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Definition
• Elongated papillae on the dorsum of the tongue, usually towards the back, which are yellow/brown/black.
• Associated with antibiotic use, poor hygiene, candida infection
• Benign
• Management: soft-bristle toothbrush 3x day |
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Term
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Definition
• Known as benign migratory glossitis is a disorder of unknown etiology that affects the epithelium of the tongue
• Local loss of filiform papillae leads to ulcer-like lesions that appear as erythematous patches on the dorsal tongue with circumferential white polycyclic borders
• Lesions can change location, pattern, and size within minutes to hours, and patients may have numerous exacerbations and remissions over time. Exacerbations are usually asymptomatic, although some patients complain of oral discomfort, burning, or foreign body sensations.
• Diagnosis: Clinical, biopsy reassuring but not necessary
• No therapy |
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Term
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Definition
• Hyperpigmentationofthe tongue and oral mucosa is commonly seen in dark-skinned individuals.
• Otherlesscommoncausesof tongue hyperpigmentation include drugs
(tetracyclines, linezolid, bismuth subsalicylate, antidepressants, proton pump inhibitors, interferon), Addison disease, Laugier-Hunziker disease, or pellagra |
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Term
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Definition
• Softening then fissuring of the skin at the edges of the mouth
• Causes: nutritional deficiency or overclosure of the mouth, candida
• Fix underlying cause |
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Term
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Definition
• Excessive exposure to sun
• Usually lower lip
• Pallor, scaly, thickened and slightly everted lip
• Treat: cryo, electrocautery, laser ablation |
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Term
| Contact and Irritant Stomatitis |
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Definition
• A less common cause of oral lesions, but may present with a wide variety of manifestations, including erosions, ulcerations, lichenoid-like reactions, leukoplakic lesions, or only erythema
• Allergic reactions are primarily due to metallic mercury, cinnamon aldehyde, and gold salts, among others
• Lip and perioral involvement is seen when the offending agent is chewed or applied topically.
• Repetitive friction, particularly in relationship to dental appliances, may result in traumatic ulcers.
• Leukoplakic-like lesions can occur due to repeated friction from poorly fitting prostheses, cheek sucking, or with the use of oral tobacco.
• Lichenoid, lace-like, localized, buccal mucosal patches may occur secondary to amalgam. Symptoms usually outweigh clinical disease.
• Contact urticaria is seen most commonly due to allergies to dental materials or natural rubber latex, and anaphylaxis can occur. Food related inflammation may present with prominent lip swelling.
• Management: stop offending agent |
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Term
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Definition
• Small red spots on lips
• Osler-Weber-Rendu Syndrome
• When slight pressure is applied, telangiectasia’s blanch, then quickly refill when the pressure is released. This distinguishes telangiectasia from a petechia
• Treatment: laser |
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Term
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Definition
• Characterized by development of noncancerous growths called hamartomatous polyps in the GI tract
• Pigmented spots on lips and buccal mucosa, also eyes, nostrils, anus, hands and feet
• High risk of developing cancer-regular follow-up needed |
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Term
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Definition
• Corynebacterium diptheriae
• Erythema, grey exudate forms pseudomembrane on uvula, pharynx and tongue
• Treatment: Vaccine (DPTa), anti-toxin, PCN, Erythromycin |
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Term
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Definition
• Early sign of measles (rubeola)
• White specs like grains of salt on red background
• Buccal mucosa near 1st and 2nd molar
• Treatment: treat measles |
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Term
| Necrotizing Ulcerative Gingivitis |
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Definition
• Accompanied by fever, malaise, enlarged lymph nodes
• Ulcers in interdental papillae
• Grey pseudomembranes form along gum margins
• Gums bleed, foul breath
• Treatment: chlorhexidine, antibiotics, antifungals |
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Term
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Definition
• Swelling and inflammation
• Causes: Dilantin, puberty, pregnancy, leukemia
• Treatment: gingivectomy, stop causative agents, routine scaling |
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Term
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Definition
Also known as pregnancy tumor, cause unknown
Tumor like mass, Staph Aureus frequently found in it
Originates in interdental papilla
Red, soft, bleeds easy
Treatment: shave removal, electrocautery |
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Term
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Definition
• Condition of teeth
• Chewing surfaces worn down
• Cause: clenching, bruxing
• Yellow-brown dentin exposed |
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Term
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Definition
• Smaller, more widely spaced teeth, notched on biting surfaces
• Causes: sign of congenital syphilis
• Treatment: irreversible |
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Term
| Tooth Abrasion with Notching |
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Definition
• Recurrent trauma
– Holding things between teeth, grinding, excessive harsh chewing, GERD, acidic or carbonated beverages
• Contour, size and spacing of teeth not affected
• Treatment: root canal dentistry, night-guards |
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Term
|
Definition
• Rounded bony growths
• Inner surfaces of mandible
• Usually bilateral
• Asymptomatic
• Treatment: surgery |
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Term
| Varicose Veins/Caviar Tongue |
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Definition
• Small, purplish or blue- black
• Round swellings • Under tongue
• Seen with age
• Benign
• Causes: may be portal HTN, superior vena cava syndrome |
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Term
| 10th CN Pathology (Vagus) |
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Definition
• Motor paralysis due to dysfunction of the tenth cranial nerve has the following clinical features:
• Loss of reflex contraction of the palate seen in the gag reflex
• Hoarseness of voice - this may occur in a unilateral recurrent laryngeal nerve lesion
• A bovine cough may occur with a bilateral recurrent nerve lesion (non- explosive cough of someone unable to close their glottis)
• The intactness of cranial nerves IX and X are usually tested with an overlapping set of tests, thus:
– palatal movement - the gag reflex
– quality of speech:
• nasal
• guttural
– the ability to cough |
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Term
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Definition
•
CN 10 Palsy (Vagus)
The patient complains of hoarse voice, difficulty in swallowing (dysphagia), and choking when drinking fluid.
There is also loss of gag reflex.
Uvula deviates away from the side of lesion, and there is
Failure of palate to elevate |
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Term
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Definition
| • On protrusion, the tongue will deviate to the affected side due to unopposed muscle action |
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Term
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Definition
• Chronicpresenceofoneormoreofthefollowing:nasal congestion (stuffiness), rhinorrhea, and postnasal drainage.
• Diagnosisofexclusion,mustruleout:allergic, infectious, pharmacologic, structural, hormonal, vasculitic, metabolic, and atrophic causes
• Distinguishedfromallergicby:
– Onset at a later age
– Absence of nasal and ocular itching and prominent sneezing
– Nasal congestion and postnasal drainage are prominent symptoms
– Symptoms are perennial
Management:Topicalintranasalglucocorticoids,topical antihistamines, ipratropium nasal spray, nasal saline irrigation, oral decongestants, surgery-last resort |
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Term
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Definition
whichischaracterizedby intermittent symptoms of congestion
(stuffiness) and/or watery nasal discharge, and an exaggerated reaction to nonspecific irritants, such as air pollution or temperature changes, especially exposure to cold, dry air |
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Term
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Definition
| whichisanepisodicconditionwith prominent watery rhinorrhea triggered most often by hot or spicy foods and is caused by a vagally-mediated reflex |
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Term
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Definition
• Regular use over-the-counter decongestant nasal sprays leads to rebound nasal congestion as the medication wears off, prompting patients to administer the medicine more frequently to obtain relief.
• This begins a vicious cycle of nasal congestion both caused and temporarily relieved by the medication, with escalating use and eventual dependency
• Rhinoscope reveals swollen, red nasal mucous membranes |
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Term
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Definition
• Acute rhinosinusitis – Symptoms for less than four weeks
• Subacute rhinosinusitis – Symptoms for 4 to 12 weeks
• Chronic rhinosinusitis – Symptoms persist greater than 12 weeks
• Recurrent acute rhinosinusitis – Four or more episodes of ARS per year, with interim symptom resolution
• Sinusitis and rhinosinusitis refer to inflammation in the nasal cavity and paranasal sinuses
• Most common viral infection associated with the common cold |
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Term
| Acute Viral Rhinosinusitis |
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Definition
• Begins with viral inoculation via direct contact with the conjunctiva or nasal mucosa.
• Viral replication in a nonimmune individual leads to detectable viral levels in nasal secretions within 8 to 10 hours
• Most commonly: rhinovirus, influenza virus, and parainfluenza virus
• Symptoms: nasal congestion and obstruction, purulent nasal discharge, maxillary tooth discomfort, and facial pain or pressure that is worse or localized to the sinuses when bending forward, fever may be present in first day-48hours, purulent nasal discharge during the course of their illness; discolored nasal discharge is a sign of inflammation. Most often, the discharge starts clear, becomes purulent, and then becomes clear again.
• A combination of mucosal edema, copious thickened secretions, and ciliary dyskinesia results in sinus obstruction and perpetuates the disease process
• Partial or complete resolution of symptoms within 7 to 10 days |
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Term
| Acute Bacterial Rhinosinusitis |
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Definition
• A biphasic pattern illness ("double worsening"), characterized by worsening symptoms after an initial period of improvement, also suggests a bacterial cause
• Onset of severe symptoms or signs of high fever (>39°C or 102°F) and purulent nasal discharge or facial pain for at least 3-4 consecutive days at the beginning of illness |
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Term
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Definition
• Growths inside the nose or the sinuses that usually occur bilaterally.
• Potential causes: sinusitis
• Symptoms: stuffiness, blocked feeling in nose, pressure, fullness, trouble smelling
• Treatment: steroid pills or spray, surgery, nasal spray with saline |
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Term
| Chronic Otitis Media Clarifications |
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Definition
• Chronicotitismedia(COM)isdiagnosedinanear with a TM perforation in the setting of chronic ear infections, such as an ear with chronic purulent drainage despite appropriate antibiotic treatment
– COM may be benign and is often characterized by a dry tympanic membrane perforation.
• Continuousserousdrainage(typicallystraw-colored) is termed chronic serous otitis media or COM with effusion
• Chronicpurulentdrainagethroughaperforated tympanic membrane is termed chronic suppurative otitis media (CSOM). |
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Term
| Otitis Media with Effusion (OME) |
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Definition
• Alsocalledserousotitismedia
• Definedasmiddle-eareffusionwithoutacutesignsof infection
• Theterm"glueear"issometimesusedasasynonymfor OME but should be reserved for cases in which the
effusion is long-standing and the fluid in the middle ear has become thick and glue-like
• OMEoftenoccursafteracuteotitismedia(AOM),butit also may occur with Eustachian tube dysfunction in the absence of AOM
• Middleeareffusionmaypersistforweekstomonths after the acute symptoms of AOM have resolved
• Predisposing Factors: Family history of otitis media, bottle feeding (as opposed to breastfeeding), daycare center attendance, adenoidal hypertrophy, exposure to tobacco smoke, low socioeconomic status, cleft palate
• May be asymptomatic; hearing loss, detected by school audiometry, pain, sleep disturbance, a feeling of fullness in the ear, tinnitus, or balance problems, clumsiness
• Otoscopicfindings:impaired mobility of TM when positive pressure is applied with the bulb during pneumatic otoscopy
– This doesn’t differentiate OME from AOM
• Anair-fluidlevelmaybepresent behind the tympanic membrane
• Amber-coloredmiddleearfluidis common
• Tympanicmembraneinaneutral or retracted position; bulging or fullness of the tympanic membrane
• Resolves spontaneously or may need tympanostomy tubes
• Complications and sequelae of OME that persists for ≥3 months (chronic OME) include conductive hearing loss, tympanosclerosis, and, rarely, a tympanic membrane retraction pocket in which a cholesteatoma may eventually form |
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Term
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Definition
• Blood in the tympanic cavity of the middle ear
• Main causes, therapeutic nasal packing epistaxis, clotting disorders, blunt head trauma and anticoagulation
• Management: CT, MRI; Antibiotics may be prescribed for infection prophylaxis. A myringotomy tube may be needed for patients with persistent effusion to prevent long-term complications |
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Term
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Definition
• Akeratinized,desquamatedepithelialcollectioninthe middle ear or mastoid and may occur secondary to tympanic membrane perforation but also may occur as a primary lesion.
• Benigntumorofthemiddleear
• Primaryacquired:Eustachiantubedysfunction
• Secondaryacquired:oftenformwithhealingof perforated TM
• Candestroyossiclesastheygrowandcausedeafness
• Hearingloss,recurrentottorhea
• Management:Surgery |
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Term
| Tympanosclerosis (Myringosclerosis) |
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Definition
• Chalkywhitepatchwithirregular borders, deposition hyaline
• Mayfollowsevereinfection
• Tympanostomytubesare associated with structural changes of the TM
– Develop asymptomatic whitish plaques of calcium and phosphate crystals (tympanosclerosis) after tube extrusion
• Conductivehearingloss
• Usuallynotreatment,hearingaids |
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Term
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Definition
• Bullous myringitis is a presentation of AOM in which blisters (bullae) are seen on the tympanic membrane.
• Despite earlier belief that this condition was associated with mycoplasmal infection, more recent evidence indicates that the prevalence of viral, bacterial, or mycoplasmal infection is the same in bullous myringitis as in nonbullous otitis media
• Painful hemorrhagic vesicles, bullae, earache, blood tinged otorrhea, hearing loss
• Treatment: Antibiotics, NSAIDS, ENT |
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Term
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Definition
• Infectionofthegeniculateganglionbyhumanherpes3 (varicella-zoster virus)
• Acuteperipheralfacialneuropathy
• Associatedwitherythematousvesicularrashofthe skin of the ear canal and auricle
– Tinnitus, deafness, vertigo, nystagmus, ataxia
• Akaherpeszosteroticusand/ormucousmembraneof the oropharynx
• Treatment:antivirals |
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Term
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Definition
-external ear lesion
• Deposit uric acid crystals as seen in gout
• Lesions may discharge chalky white crystals through the skin
• Also seen in joint, hands and feet |
|
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Term
|
Definition
-external ear lesion
• Firm, nodular, hypertrophic mass of scar tissue
• May develop on any scarred area- after ear piercing |
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Term
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Definition
• Also known as perichondrial hematoma, is a swelling of the ear caused by a blood clot
• Repeated trauma
• The trauma leads to a series of small blood clots that block blood flow, leading to tissue damage; Shears away cartilage and connection between skin and cartilage is disrupted
• Liquid fills new space between and eventually hardens if not drained
• Boxers, wrestlers, martial arts, also may occur with piercings of the upper ear
• Symptoms: pain, swelling, deformity; occasional hearing loss, tinnitus, headache, facial swelling, blurred vision
• Treatment: ice, drainage, protective gear, otoplasty |
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Term
|
Definition
• Pearly, raised lesion with telangiectatic vessels
• Slow growing, rarely metastasizes
• More common in fair-skinned people with sun exposure |
|
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Term
|
Definition
• 20 percent all primary melanomas are located on the head and neck
• Asymptomatic |
|
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Term
|
Definition
– Vestibular neuritis accompanied by hearing symptoms
– Infectious, autoimmune, vascular |
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Term
|
Definition
• Discoloration under the eyes seen with allergic conjunctivitis and allergic rhinitis
• Treat underlying condition
• Patients with allergic shiners frequently push the tip of their nose up with the back of their hand- get allergic salute
• Leads to formation of transverse nasal crease
• Treat rhinitis |
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Term
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Definition
• Prominent hypertrophy of the sebaceous glands with overgrowth of the soft tissue
• May occur as part of phymatous rosacea
• Forms gradually over several years
• More common in men
• Treat Rosacea; surgery, laser, cryo, dapsone, tacrolimus |
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