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PCM II Final Exam > 2. URE > Flashcards

2. URE Flashcards

1
Q

Upon inspection of the ear, what are we mainly looking at?

A

external ear

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2
Q

how we do examine the ear can

A

straighten

adults=> pull up, out and posterior

kids=> pull down, out and posterior

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3
Q

Normal tympanic membrane is

A

translucent and pearly

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4
Q

Ear examination allow you to see: •

Cone of Light
•	Umbo- \_\_\_\_\_\_\_\_
•	Malleus
•	Manubrium- \_\_\_\_\_\_\_
•	Pars tensa- \_\_\_\_\_\_\_\_
•	Pars Flaccida- \_\_\_\_\_\_
•	Chorda tympani nerve- Runs in the \_\_\_\_\_\_\_\_
A

umbo is where the eardrum meets the tip of the malleus. From here, the light fans downward and anterior

manubrium is the handle of the malleus

pars tensa is below the pars flaccida

pars flaccida is located above the malleus

chorda tympani runs the superior part, near the pars flaccida

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5
Q

Perform the Whisper test.

what is normal and abnormal

A

Doctor stands behind the patient. Have patient occlude one ear. The doctor exhales fully and then whispers a combination of numbers and letters (ex: 2-K-4). The patient repeats the sequence. Repeat with a different sequence if responds incorrectly.

Normal: patient correctly repeats the sequence or after 2 sequences, can identify 3 of the 6.

Abnormal: patient incorrectly identifies 4 of the 6

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6
Q

Webers test tests for __________.

Rinne test tests for _____________.

A

Webers- lateralization

Rhinne- tests air vs bone conduction

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7
Q

If AC > BC; then what?

A

Weber is abnormal
Rinne is normal

Patient has sensorineural deficits in the opposite ear

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8
Q

If BC >AC; then what?

A

Patient has conductive hearing loss in the SAME ear.

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9
Q

Perform the Rinne and Weber test and understand the clinical significance.

A
  1. Weber test for lateralization:
    vibrate tune fork and place it on head
    Normal: patient can hear sound equally at at both ears. Abnormal: hears stronger in one ear then the other. If abnormal: do rhinne.
  2. Rinne test will tell us if it is conduction loss in same ear or sensorineural loss in opp. ear.
    To do so, set the tuning fork and place it behind ear on the mastoid process. When the patient stops hearing the sound, place bring it in front of the ear.
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10
Q

conductive loss is d/t what?

A 
cerum impaction
fluid in middle ear
ossicles dont move
trauma 
obstruction
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11
Q

Sensorineural loss can be d/t what?

A

usually d/t inner ear, cochlear nerve or central brain connection problems

genes
meneirze dz
MS
drugs

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12
Q

• Aphthous ulcers

A

canker sores

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13
Q

• Cheilitis

A

red cracks on corner of mouth d/t Vb12 or iron def

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14
Q

• Gingivitis

A

swelling or ulceration of guns

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15
Q

torus palatinus

A

benign lump on hard palate

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16
Q

what external structures do we look at when looking at mouth and throat

A

Lips

Vermillion border

17
Q

what external landmarks do we look at when examining nose

A

[insert pic]

18
Q

what internal landmarks do we look at when examining nose

A
  1. septum
  2. vestibule (the most anterior part of the nasal cavity
  3. turbinates: covered by mucosa and clean, humdify, and control temp of air
19
Q

Perform examination of the nose, sinuses and name structures.

A
  1. look at external landmarks; apply pressure to tip of nose to and check tenderness
  2. look at internal landmarks by using otoscope and look at mucosa and check 4:
    A. viral rhinitis (red and edema)
    B. allergic (pale, bluish or red)
    C. Septal perforation d/t cocaine, meth, trauma or surgery
3. Look at sinuses:
A. frontal
B. maxillary
C. ethmoid 
D. sphenoid sinuses
  1. Palpate maxillary sinuses and frontal (under the brow bone)
20
Q

Sinuses are air filled cavities in the skull of the bone.

which sinuses dont open until after 7 YO

A

frontal sinuses

21
Q

Perform examination of the lymph nodes of the head and neck.

A

To check LN: use pads of middle 3 fingers and look for: texture, size and tenderness.
LN include:

  1. Pre-auricular
  2. post-auricular
  3. submental
  4. submandibular
  5. tonsilar
  6. anterior cervical
  7. posterior cervical
  8. supraclavicular
22
Q

is pharyngitis always strep?

A

NOO

23
Q

what is pharyngitis?

A

viral or bacterial inflammation of the pharynx, causing a sore throat

24
Q

What are common sx for viral pharyngitis?

A
  1. coryza (inflammed mucus membrane).
  2. conjunctivitis
  3. malaise or fatigue
  4. hoarseness
  5. low-grade fever
25
Q

Steptococcal pharyngitis is d/t

A

GABHS (streptococcus pyogenes: bacterial).

26
Q

Sx of stretococcal pharyngitis

A
  1. sore thorat
  2. HA
  3. fatgiue
  4. body aches
  5. naseau**** occurs bc the pharynx is located near intra-abdominal organs on homunuculus
27
Q

who and when is it more likely to get strep pharyngitis (GABHS)

A 
1. children 5-15
2, winter and early spring
3, no cough
4, anterior cervical  lymphadenopathy is tender, 
5. tonsillar exudate, 
6. fever.
28
Q

what labs do we perform if someone comes in with what we think is phargygitis?

A

FIRST CONSIDER DIFFERENTIALS

  1. rapid steptococcal test antigen testing to test for group A Bhs

2 throat swab

  1. monospot test
29
Q

Acute otitis media (AOM

A

inflammation of middle ear d/t bacteria or viruses.

TM is bulging, red, reduced mobility

30
Q

Acute suppurative OM

A

[acute OM] + [purulent material] in the middle ear.

31
Q

Otitis media with effusion (serous OM)

A

inflammation + fluid buildup in behind the eardrum (middle ear) WITHOUT bacterial or viral infection.

  1. Can be d/t fluid that stays after AOM or blockage of eustachian tubes that can last 3 months.
  2. If chronic (>6 wks), makes kids susceptible to new ear infections
32
Q

Otitis media with effusion (serous OM) that is chronic (>6 wks) does what

A

makes kids susceptible to near ear infections

33
Q

Chronic suppurative OM

A

persistent EI that causes tearing of eardrum

34
Q

Otitis externa

A

bacteria enters small break in skin in the canal, causing drainage or pain when touching the external ear

35
Q

inner ear infection is called

A

Labyrinthitis

36
Q

Otitis Media with Effusion

(aka Serous Otitis Media) can last _________, called ________. This can affect what?

A

3 months

chronic otitis media with
effusion

hearing

PCM II Final Exam (7 decks)

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