Internal Medicine: Head and Neck Examination
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Questions and Answers

What are the components examined during a head examination?

Eye brows, lids, sclera, cornea, pupils, nose, mouth

What are the components examined during a neck examination?

Thyroid gland, lymph nodes, pulsations

___ pulsations are examined during neck examination.

Neck

ما هي الأدوات المستخدمة في قياس درجة حرارة الجسم؟

<p>الترمومتر الزئبقي، الترمومتر الإلكتروني الرقمي، الترمومتر الإشعاعي الرقمي.</p> Signup and view all the answers

ما هي ميزة الترمومتر الزئبقي؟

<p>يشكل المعيار الذهبي</p> Signup and view all the answers

درجة حرارة المستقيم هي أفضل تقريب لدرجة حرارة النواة؟

<p>True</p> Signup and view all the answers

ما هي الأسباب الرئيسية للارتفاع الفجائي في درجة حرارة الجسم؟

<p>إصابة، اضطراب مناعي، أورام، أدوية، إصابة بالدماغ، اضطرابات هرمونية.</p> Signup and view all the answers

Study Notes

Head Examination

  • Examination of eyebrows and lids is crucial
  • Sclera, cornea, and pupils are key areas to inspect

Neck Examination

  • Three main areas to focus on:
  • Thyroid gland
  • Lymph nodes (L.N)
  • Pulsations

Measuring Body Temperature

  • The lecturer, Dr. Mohamed Farouk, is a Lecturer of Tropical Medicine and Gastroenterology at New Valley University.

Importance of Measuring Body Temperature

  • Identify the instruments used in measuring body temperature.
  • Identify the normal range of body temperature.
  • Describe the different abnormalities of body temperature.

Technique of Measuring Body Temperature

  • The right approach: stand at the patient's right-hand side.
  • Preparing for the examination and precautions:
    • Greet the patient, introduce yourself, take permission, and explain the procedure.
    • Ask the patient to sit comfortably.
    • Maintain confidentiality and respect for the patient.
    • The patient must not have hot or cold drinks or exercise 15 minutes before measuring temperature.

Instruments Used in Measuring Body Temperature

  • Medical Thermometers:
    • Mercury Thermometer (Advantages: Gold standard, Accurate, Cheap; Disadvantage: Mercury toxicity if broken in the mouth).
    • Digital Electronic Thermometer (Advantages: Easy to use, Rapid, Cheap; Disadvantage: Less Accurate compared to Mercury type).
    • Digital Infrared Thermometer (Advantages: Very Rapid; Disadvantage: Expensive, Less Accurate compared to Mercury type).
    • Non-contact Infrared Thermometer (Thermometer Gun) (Advantages: Very Rapid, Non-Contact, useful in outbreak of emerging diseases; Disadvantage: Expensive, not 100% accurate compared to Mercury type).

Sites of Measuring Body Temperature

  • Mouth (Standard Method)
  • Axilla
  • Rectum
  • Ear (external auditory meatus)
  • Forehead

Oral Temperature (from the mouth)

  • Place the clinical thermometer after sterilization and shaking under the tongue for at least 3 minutes.
  • The patient must breathe through the nose and keep the lips firmly closed during the observation.
  • False low reading: mouth breathing, incomplete closure of mouth, leave the thermometer for too short time, ingest cold substances just before recording the temperature.
  • False high reading: incomplete shaking of the thermometer, ingest hot drinks just before recording the temperature.
  • Contraindications: infants, mouth breathing, convulsions, and coma.

Axillary Temperature

  • The underarm must be dry prior to measurement.
  • Sterilized clinical thermometer bulb or tip is inserted in the axilla with adducted arm for 3 minutes.
  • The recorded temperature is 0.5°C lower than oral temperature.

Rectal Temperature

  • Rectal temperature is the best approximation to core temperature.
  • The lubricated sterilized thermometer tip or bulb is inserted into the rectum for 2 minutes.
  • Indications: infant, comatose patient, unconscious, extremely ill patient, mouth breather.
  • Do not use the same thermometer for both oral and rectal readings.

Normal Range of Body Temperature

  • Normal range of body temperature (mouth): (36.5-37.2) °C.
  • Rectal and ear temperature are 0.5 °C higher than in the mouth (oral temperature).
  • In the axilla is 0.5 °C lower than in the mouth (oral temperature).
  • Diurnal variation in temperature: lowest values are recorded in the early morning between 2 and 4 AM, with a maximum between 4 and 6 pm.

Abnormalities of Body Temperature

  • Fever (Pyrexia): body temperature above normal (>37.2 °C).
  • Causes of fever: infection, immunological disturbance, malignancy, drugs, brain injury, endocrine disturbances.
  • Physiological causes of fever: after vigorous exercise, after hot water bath, after meals, ovulation, pregnancy, hot weather, infants.
  • Hyperpyrexia: temperature > 41.5 °C.
  • Causes of Hyperpyrexia: heat stroke, encephalitis, others.
  • Hypothermia: core (rectal) temperature below 35 °C.
  • Causes of Hypothermia: shock state, starvation, water immersion or near-drowning, alcohol intoxication, others.

Temperature Ranges in Centigrade and Grades of Fever

  • Normal body temperature: (36.5-37.2) °C.
  • Febrile: > 37.2 °C.
  • Mild/low grade fever: 37.3-38 °C.
  • Moderate grade fever: 38.1-39 °C.
  • High-grade fever: 39.1-41.5 °C.
  • Hypothermia: < 35 °C.
  • Hyperpyrexia/hyperthermia: > 41.5 °C.

Types and Pattern (Course) of Fever

  • Fevers can be classified into 3 types based on duration: acute, subacute, chronic fever.
  • The course of fever has several patterns.

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Description

This quiz covers the essential points to consider when conducting a head and neck examination, including inspection of the eyes, nose, mouth, thyroid gland, lymph nodes, and pulsations. Learn about the key features to inspect and palpate during a thorough physical examination.

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