Physical Examination and Diagnosis of the Head and Neck
Learning Unit IIIDepartment of Surgery
College of MedicineUniversity of the Philippines Manila
Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg
Been conducting this 3-hour preceptorial session (2-5 pm) since 2006 October 3, 2014 – created this teaching-learning moduleROJ official retirement date from UPM: January 31, 2014
Physical Examination and Diagnosis of the Head and Neck
General Learning Objectives:1.Systematically and proficiently perform a physical examination of the head and neck on adults.2.Correlate physical examination findings with anatomic and physiologic characteristics of the head and neck.
*Given General Learning Objectives by Curriculum Makers
Physical Examination and Diagnosis of the Head and Neck
Specific Learning Objectives:1.Describe the common methods of physical examination of the head and neck.
Inspection Palpation Auscultation
*Given Specific Learning Objectives by Curriculum Makers
Physical Examination and Diagnosis of the Head and Neck
Specific Learning Objectives:2.Identify the areas that should be included in the physical examination of the head and neck.
• Scalp• Face• External ears, nose, eyes• Lips, oral cavity, throat• Neck (thyroid and lymph nodes)• Nape
*Given Specific Learning Objectives by Curriculum Makers
Physical Examination and Diagnosis of the Head and Neck
Specific Learning Objectives:3.Gather essential data from examination of the head and neck.
Inspection With eyes, look for anything unusual in structure and
function Palpation
With fingers, feel for anything unusual in structure and function
Auscultation With a stethoscope, listen for anything unusual in structure
and function
*Given Specific Learning Objectives by Curriculum Makers
Physical Examination and Diagnosis of the Head and Neck
Specific Learning Objectives:4.State the basic parameters for a quality inspection, palpation and auscultation of the head and neck
*Given Specific Learning Objectives by Curriculum Makers
Inspection Palpation Auscultation
Relevantly Complete ✔ ✔ ✔
Accurate ✔ ✔ ✔
Gentle ✔ ✔
Physical Examination and Diagnosis of the Head and Neck
Specific Learning Objectives:5.Make a written record of findings of a physical examination of the head and neck.
Line drawing of head and neck, whole or involved areas
Illustrative findings with description and explanation
*Given Specific Learning Objectives by Curriculum Makers
Physical Examination and Diagnosis of the Head and Neck
Specific Learning Objectives:5.Make a written record of findings of a physical examination of the head and neck.
Line drawing of head and neck, whole or involved areas
*Given Specific Learning Objectives by Curriculum Makers
Physical Examination and Diagnosis of the Head and Neck
Specific Learning Objectives:5.Make a written record of findings of a physical examination of the head and neck.
Illustrative findings with description and explanation
*Given Specific Learning Objectives by Curriculum Makers
Physical Examination and Diagnosis of the Head and Neck
Specific Learning Objectives:6.Process data derived from physical examination of the head and neck to come out with a physical diagnosis.
Data from physical examination: Usual vs Unusual:
Nothing unusual – Normal Unusual but asymptomatic – Normal variant Unusual and symptomatic – Abnormal
Diagnostic label: name of disorder, involved area, organ or tissue
Descriptive label of unusual findings: if name of disorder is not known, state involved area, organ or tissue.
*Given Specific Learning Objectives by Curriculum Makers
Physical Examination and Diagnosis of the Head and Neck
Teaching-learning Activities (3 hours) Facilitator’s inputs Demonstration and return demonstration on physical
examination of the head and neck (subjects: actual patients if available; students and facilitator) Taking note of quality parameters of complete, accurate, gentle.
Gathering of essential data and information Making of medical records with line drawings and illustration of
findings Processing of data and information to come out with a physical
diagnosis Reinforcement of learning on physical diagnosis using cases
with pictures Recap
Physical Examination and Diagnosis of the Head and Neck
Pictures of Teaching-learning Activities Done in the Past:
Physical Examination and Diagnosis of the Head and Neck
Pictures of Teaching-learning Activities Done in the Past:
Physical Examination and Diagnosis of the Head and Neck
Pictures of Teaching-learning Activities Done in the Past:
Physical Examination and Diagnosis of the Head and Neck
Pictures of Teaching-learning Activities Done in October 3, 2014:
Physical Examination and Diagnosis of the Head and Neck
Pictures of Teaching-learning Activities Done in October 3, 2014:
Medical recordingswith line drawings
Physical Examination and Diagnosis of the Head and Neck
Pictures of Teaching-learning Activities Done in October 3, 2014:
Physical Examination and Diagnosis of the Head and Neck
Pictures of Teaching-learning Activities Done in the Past:
Physical Examination and Diagnosis of the Head and Neck
Physical Examination and Diagnosis of the Head and Neck
Physical Examination and Diagnosis of the Head and Neck
Diagnosis Physical DiagnosisClinical Diagnosis
Physical Examination of the Head and Neck
Findings Anatomical (Structure)Physiological (Function)
Physical Examination and Diagnosis of the Head and Neck
Physical Examination of the Head and NeckMethods:
Inspection – Look - EyesPalpation – Feel – Fingers (gloved / non-gloved)Auscultation – Listen - Stethoscope
Physical Examination and Diagnosis of the Head and Neck
Physical Examination of the Head and NeckMethods:
Inspection – Usual / Unusual: Comparison of Sides : ASYMMETRY; Abnormal Findings such as JAUNDICE / PALE CONJUNCTIVAE / etc.
Palpation – Usual / Unusual: Comparison of sides: MASS / TENDERNESS / THRILL / etc.
Auscultation – Usual / Unusual: Comparison of sides: BRUIT
Physical Examination and Diagnosis of the Head and Neck
Physical Examination of the Head and NeckPurposes:
Screening-driven assessmentPatientsSelf
Symptom-driven assessment
Physical Examination and Diagnosis of the Head and Neck
Clinical Diagnostic Processes:
Pattern Recognition •realization that the patient’s presentation conforms to a previously learned picture or pattern of disease
Prevalence•choice of a diagnosis is based on the frequency of occurrence of the disease in a certain locality, in a certain age and sex group, and in the affected organ and system
Physical Examination and Diagnosis of the Head and Neck
Physical Examination of the Head and NeckDiagnostic Algorithm for Masses
1. Location of mass2. Possible / probable organ or tissue of origin3. Pathology: General / Specific
General:Inflammatory / infectious massMalignant massNon-malignant mass
Physical Examination and Diagnosis of the Head and Neck
Physical Examination of the Head and NeckDiagnostic Algorithm for Pathology of Masses
1. Look for signs of inflammation / infection:Pus; erythema; tenderness; warmth
2. Look for signs of malignancy:Distant mass suspicious for metastasis;
regional mass (lymph node) suspicious for spread; signs of invasion (fixation); ill-defined border; hard
consistency3. Look for sign of benignity:
Cystic nature of mass with no signs of malignancy and no signs of
inflammation / infection
Physical Examination and Diagnosis of the Head and Neck
Physical Examination of the Head and NeckDiagnostic Algorithm for Pathology of Head and Neck Lymph Nodes
Differentials:•Reactive hyperplasia of lymph nodes•Tuberculous lymphadenopathy•Primary malignancy – Lymphoma•Secondary malignancy – Spread from a primary cancer
Physical Examination and Diagnosis of the Head and Neck
Physical Examination of the Head and NeckDiagnostic Algorithm for Pathology of Head and Neck Lymph Nodes
1. Look for clues for secondary malignancy – another mass nearby suspicious for malignancy
2. Look for clues for reactive hyperplasia – inflammation /infection nearby
3. Look for clues for primary malignancy – multiple regional lymph node enlargement
4. Look for clues for tuberculosis lymphadenopathy (cold abscess and TB elsewhere)
Physical Examination and Diagnosis of the Head and Neck
Go to:Pictorial Inquiry and Interaction on Physical
Findings on Head and Neck
Physical Examination and Diagnosis of the Head
and Neck
Pictorial Inquiry and Interaction
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Sudden onset
Asymptomatic
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Bony hard
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
PR = 120 / min
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
By prevalence
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Perihyoid area
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Cystic
Present at birth
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
With pus
Long-standing
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
With intermittent bleeding from the back of the nose
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
With masses in the axillary and inguinal areas
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Moves with deglutition
Physical Examination and Diagnosis of the Head
and Neck
What is your physical diagnosis based on the data & picture?
Unusual Findings / Abnormality?
Location Disorder Disease
Physical Examination and Diagnosis of the Head and Neck
Go to:Online Learning cum Evaluation Test Exercises (OLETE)
Instructions on how to take the OLETE:
Physical Examination and Diagnosis of the Head and Neck
Go to:Online Learning cum Evaluation Test Exercises (OLETE)
Instructions on how to take the OLETE:
Get into the Internet. URL: http://quizstar.4teachers.org/
Under Student Login Page, click “Students, get started” Click “Sign-up”
Place your first name; last name - middle name; username; passwords.
Then, click “register.”
Physical Examination and Diagnosis of the Head and Neck
Go to:Online Learning cum Evaluation Test Exercises (OLETE)
Instructions on how to take the OLETE:
Then login your username and password. Then click “Search”
In the box, under quiz title, enter the following: Physical Examination and Diagnosis of the Head and Neck – UPCMLU3 – 2014
Click “exact match” then “register.”Then, “go to test” then “take.”
Then, take your test.
Physical Examination and Diagnosis of the Head and Neck
Go to:Online Learning cum Evaluation Test Exercises (OLETE)
Instructions on how to take the OLETE:
Note: You can see the results of your test (the score and your mistakes if any) immediately. If you did not get a perfect score on the first try (pretest), don’t feel bad as you are given 5 attempts to get a perfect score (posttest). You can retake the online test right after your first try, second try, third and fourth try, that is, if you still cannot get a
perfect score even up to the fourth try.
Physical Examination and Diagnosis of the Head and Neck
Learning Unit IIIDepartment of Surgery
College of MedicineUniversity of the Philippines Manila
Reynaldo O. Joson, MD, MHA, MHPEd, MSc Surg
THE ENDFeedback to: [email protected]
Top Related