head and neck disorders

diffuse thyroid enlargement

Includes isthmus and lateral lobes. There are no discretely palpable nodules.

diffuse thyroid enlargement causes

graves disease, hashimoto thyroiditis, and endemic goiter

single thyroid nodule

May be a cyst, a benign tumor, or one nodule within a multinodular gland. It raises the question of malignancy

single nodule risk factors

prior irradiation, hardness, rapid growth, fixation to surrounding tissues, enlarged cervical nodes, and occurrence in men.

multinodular goiter

enlarged thyroid gland with two or more nodules suggests a metabolic rather than neoplastic process

multinodular goiter risk factors for malignancy

family history

continuing nodular enlargement

facies

expression or appearance of face and features of the head and neck that, when considered together, is characteristic of a clinical condition or syndrome

cushing syndrome

round or "moon face"

red cheeks

excessive hair growth

(located on upper lip especially)

hyperthyroidism

fine hair, moist skin

fine hair

prominent eyes & lid retraction

staring/startled expression

myxedema

dull, puffy skin

non-pitting periorbital edema

dry, course, thin eyebrows

loss of lateral third of eyebrow

bell palsy

asymmetry of one side of face

eyelid does NOT close completely

dropping lower eyelid and corner of mouth

loss of nasolabial fold

(can be associated with viruses)

acromegaly

Elongated head

Bony prominence of forehead, nose,

and lower jaw

Enlargement of soft tissues

Coarse facial features

nephrotic syndrome

Periorbital Edema Puffy pale face• Swollen lips

Slit-like eyes

Usually occurs in morning

parotid enlargement

• Swelling anterior ear

• +/- Pain

• +/- Infection/tumor

cushing syndrome (book)

nephrotic syndrome (book)

myxedema (book)

parotid gland enlargement (book)

acromegaly (book)

parkinson disease

neurodegenerative disease

linked to the loss of dopamine

DECREASED facial mobility

masklike facies

decreased blinking

characteristic stare

neck and upper trunk tend to flex forward

pt seems to peer upward toward observer

facial skin: oily

drooling may occur