Introduction and Head and Neck examination.pptx

‫الله‬ ‫بسم‬
‫الرحيم‬ ‫الرحمن‬

Introduction
What is the Internal Medicine ?

Introduction
Internal Medicine includes:
CNS
 CVS
Pulmonary (Respiratory System)
GIT+ Hepatology
Endocrinology
Hematology
Musculoskeletal S.
Renal S.
Head and Neck tumors

Introduction
Introduction:
What is meaning of internal Medicine in Arabic?

Introduction
Introduction:
The importance of internal diseases for the
Dentist

Introduction
The importance of internal diseases for the Dentist
For example:
• RHD
• Hypertension
• DM
• Infection
• Liver disease

Introduction
Medical History: Anamneses
• Personal history:
• Date of the patient visit or admission.
• Chief complaint
• History of present illness
• Review of other systems
• Past History
• Family History
• Socioeconomic history

Introduction
• Clinical examination(General and Local)
• Differential diagnosis
• Investigations
• Diagnosis
• Treatment

Introduction
Personal history:
Age
Gender(Male , Female)
Where is she or he from & where is he live
Married or single & Offspring
Habits(qat, shamma, Smoking).
Education & Job
RT or left handed

Introduction
• Date of visit or admission

Introduction
Chief compliant
History of present illness
Review of other systems

Introduction
Medical History: Anamneses
Past History
Family History
Drug History & Allergic History

Introduction
Medical History:
Socioeconomic History
General examination
Local examination

Introduction
Head and neck examination:
It is a fundamental part of the standard physical
examination.
It is typically one of the first parts of the physical
examination and is performed with the patient
in a seated position.

Introduction
In adult patients, the parts of the examination
dealing with the ears and nose are generally not
required unless there is a pertinent complaint

Introduction
Examination of the head:
• Inspect the skull and face.
• Inspect the skin and scalp.

Introduction
• Palpate skull (especially if patient complains of
tenderness or recent trauma).

Introduction
• Assess facial sensation and motor function:
Trigeminal nerve function: Lightly touch the
forehead of the patient on both sides and the
upper and lower areas of the cheek with the
index finger.
Ask the patient whether this feels the same on
both sides of the face.

Introduction
• Assess facial sensation and motor function:
Trigeminal nerve function(V):
It is classified into three different branches that
have distinct territories of innervation.
 These branches are namely the ophthalmic, the
maxillary, and the mandibular nerves.

Introduction
Examination of the head: Trigeminal Nerve

Introduction
Cutaneous innervation to the head and neck.

Introduction
• Facial nerve function(VII):
Ask the patient to furrow their forehead, close
their eyes, show their teeth, and inflate their
cheeks.

Introduction
Examination of the neck:
• Inspection and palpation.

Introduction
Examination of the neck:

Introduction
• Inspect for any obvious deformities, asymmetry,
masses, tracheal deviation.
• Palpation of the lymph nodes of the head and
neck
• Palpation of the parotid gland

Introduction
• Assessment of range of motion of the cervical
spine
• Ask the patient to tilt his chin so that it is resting
against his chest or to flex his neck.

Introduction
• Assessment of spinal accessory nerve function
• Ask the patient to move his head to the left and
right, and to lift his shoulders against resistance.
• Evaluate for jugular venous distention.
• Examination of the thyroid

Introduction
•

Introduction
Examination of the neck: Goiter
•

Introduction
• Examination of the throat

Introduction
Head and neck examination: Signs:
Face: Loss of cranial nerve function:
Eyes: Ptosis, Incomplete lid closure:
Cranial nerve palsies: Ischemic stroke,

Introduction
Face: Loss of cranial nerve function:Ptosis


Introduction
Xanthelasma: Hyperlipidemia
Exophthalmos: Graves disease

Introduction
Xanthelasma

Introduction
Exophthalmos

Introduction
Yellow sclera: Jaundice
Conjunctival congestion: Conjunctivitis
Conjunctival pallor: Anemia

Introduction

Introduction
Head and neck examination:Signs:
Angular cheilitis: Iron deficiency
Tonsillar erythema: Acute tonsillitis
Strawberry tongue (also called raspberry
tongue): Scarlet fever

Introduction
Angular cheilitis

Introduction

Staphylococcal Skin Infection
Impetigo

Staphylococcal Skin Infection
Staph
Infection
Impetigo

Introduction
Vesicles, blisters: Herpes virus infection
Tongue coating:Leukoplakia or Oral candidiasis
Hearing impairment ,Hearing loss.
 Pain, exudate: Ear infection

Introduction
Lymph nodes: Enlarged lymph nodes
Jugular venous distention: Volume overload
Heart failure.
Thyroid gland enlargement: Goiter, Thyroid
cancer

Introduction
Lymph nodes: Enlarged lymph nodes

Introduction
Presenting problems:
Medical students and junior doctors must not
only assimilate a great many facts about various
disorders but also develop an analytical
approach to formulating a differential diagnosis
and a plan of investigation for patients who
present with particular symptoms or signs.

Introduction
: ‫المشكلة‬ ‫عرض‬
‫أال‬ ‫المبتدئين‬ ‫واألطباء‬ ‫الطب‬ ‫طالب‬ ‫على‬ ‫يجب‬
‫حول‬ ‫الحقائق‬ ‫من‬ ‫العديد‬ ‫فقط‬ ‫يستوعبوا‬
‫نهج‬ ‫تطوير‬ ‫ا‬ً‫ض‬‫أي‬ ‫ولكن‬ ‫المختلفة‬ ‫االضطرابات‬
‫وخطة‬ ‫تفريقي‬ ‫تشخيص‬ ‫لصياغة‬ ‫تحليلي‬
‫الذين‬ ‫للمرضى‬ ‫والشعاعية‬ ‫المخبري‬ ‫الفحوصات‬
‫معينة‬ ‫عالمات‬ ‫أو‬ ‫أعراض‬ ‫يظهرون‬.

Introduction
General Information :
These include causes of the disease, clinical
features, investigations, treatment and other
useful information.

Introduction
Practice Point: There are many practical skills
that students and doctors must master.
 These vary from:
 inserting a nasogastric tube
reading an ECG or X-ray, or
interpreting investigations such as arterial blood
gases or thyroid function tests.

Introduction
Practice Point: You are going to deal with:
Emergency.
Old age.
Pregnancy.
Adolescence.

Introduction
 Introduction:
• A great deal of knowledge and skill is required to
practice as a doctor.

Introduction
Clinical examination overviews:
 Introduction:
Dentist in the 21st century need to have:
a comprehensive knowledge of basic and
clinical
sciences.
 have good communication skills.
 be able to perform procedures.
 work effectively in a team and demonstrate
professional and ethical behavior.

Introduction
Clinical skills and decision-making:
Even with major advances in medical technology,
the history remains the most important part of
the clinical decision-making process.

Introduction
 Clinical skills and decision-making:
Studies show that physicians make a diagnosis in
70–90% of cases from the history alone.

Introduction
 Clinical skills and decision-making:
It is important to remember that a good history
is gathered not only from the patient but also, if
necessary (and with consent if required), from
all available sources: for example, paramedic
and emergency department notes, eye
witnesses, relatives and/or carers.

Introduction and Head and Neck examination.pptx

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