(5) HENT Flashcards by Tina Tu

What condition best describes a “form of cutaneous and dermal edema”?

Determine the cause:

Myxedema

Caused by: hypothyroidism (increased in deposition of connective tissue)

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What condition best describes “prominent orbital ridges, enlarged frontal sinus, long face, enlarged maxillary sinus, large nose, prominent mandible, thickened lips”?

Determine the cause:

Acromegaly

Caused by: overproduction of GH from a pituitary tumor

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What condition best describes “decreased facial expression, decreased blinking, staring”?

Determine the cause:

Parkinsonism

Caused by: Motor impairment

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What condition best describes a “moon face, red cheeks, excessive hair growth”?

Determine the cause:

Cushing Syndrome

Caused by: Increased adrenal cortisol production

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What condition best describes “facial and periorbital edema, pale skin”?

Determine the cause:

Nephrotic Syndrome

Caused by: loss of protein via the kidneys (proteinuria) that leads to low protein levels in the blood (hypoalbuminemia)

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What condition best describes “unilateral swelling anterior to earlobe, unilateral swelling above the angle of the jaw”?

Parotitis (parotid gland swelling)

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What are the (4) anatomical structures of the Auricle/Pinna (external ear)?

Helix
Anti-helix
Lobule
Tragus

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Define air-filled cavity (tympanic cavity).

area of the middle ear that transmits sound by the ossicles

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What are auditory ossicles?

3 bones in the middle ear: malleus, incus, stapes

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What does the tympanic cavity connect to?

eustachian tube (which then connects to the nasopharynx)

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Describe the tympanic membrane.

a thin opaque membrane held by malleus (barrier between outer and middle ear)

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What is the function of the tensor tympani muscle? What nerve innervates the tensor tympani muscle?

Adjusts tension on the TM to adjust for loud noises

CN V (trigeminal nerve)

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What are the (6) landmarks of the tympanic membrane?

Short process of malleus
Manubrium of malleus
Cone of light
Pars tensa (below the short process)
Umbo (center)
Pars flaccida (above short process)

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What is the function of the cochlea?

What is the function of the semicircular canals?

Cochlea: sense of hearing/sound

Semicircular canals: maintain equilibrium/balance

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What is the function of the auditory nerve (CN VIII)?

responsible for sound in the cochlear division and balance in the vestibular division

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Large, visible bumps made of uric acid crystals; can be seen on helix of ear

Gout Tophi

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What is “mastoiditis”? Cause?

inflammation of the mastoid bone; bacterial infection of the middle ear (otitis media) can travel into the air cells of the mastoid bone

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What condition is best described?

inflammation of the external ear or ear canal; referred to “swimmer’s ear” because repeated exposure to water can make the ear canal more vulnerable to inflammation

movement of the pinna elicits pain

otitis externa (or cellulitis)

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What condition is best described as “erythema, bulging to the middle ear” on an otoscope exam?

Otitis Media “Middle Ear Infection” (not effusion)

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What condition best describes a “buildup of non-infectious fluid to the tympanic membrane” an otoscope exam?

Serous (Suppurative) Otitis Media

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Define Conductive Hearing Loss (CHL).

Impairment of sound conduction in the middle or external ear

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Define Sensorineural Hearing Loss (SNHL).

Cochlear nerve function impaired

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What (2) tests examines for CHL and SNHL?

Weber and Rinne Test

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What indicates a normal Weber test?

Sound heard bilaterally (no lateralization of sound)

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Weber: lateralization to the right ear Rinne: positive bilaterally

Lateralization to the right ear = Right CHL or Left SNHL Positive BL (sounds is louder in AC > BC) = Left SNHL

Weber: lateralization to the right ear Rinne: negative to right

Lateralization to the right ear = Right CHL or Left SNHL Negative to Right (sounds is louder in BC > AC) = Right CHL

Weber: no lateralization Rinne: positive bilaterally

No lateralization = normal Positive BL (sounds is louder in AC > BC) = BL SNHL or normal

A patient reports hearing loss on the right side. which of the following physical exam findings would be consistent with a sensorineural origin? A. Weber test lateralizes to the left side B. Rinne test reveals that patient has longer bone conduction than air conduction C. Bone conduction and air conduction are equivalent on Rinne test D. Weber test lateralizes to the right side

A. Weber test lateralizes to the left side

What is located to the medial wall of the nose?

Nasal Septum

What is located to the lateral wall of the nose?

Turbinates

What are the (4) Paranasal Sinuses?

1. Frontal 2. Ethmoid 3. Sphenoid 4. Maxillary

What are the only (2) paranasal sinuses that can be examined during a physical exam?

1. frontal 2. maxillary

What condition best describes "pale, blue-ish or red, boggy nasal mucosa"?

Allergic Rhinitis

What condition best describes "localized sinus tenderness with pain, fever, nasal discharge"?

Sinusitis

What can Upper Respiratory Infection (URI) cause to the nasal area?

nasal mucosa will be reddened and swollen

What condition is best described? typically produces white or yellow exudates on the tonsils or posterior pharynx, a beefy-red uvula, and palatal petechiae a bacterial infection that may cause a sore, scratchy throat

Strep pharyngitis

What condition is best described? Reddened throat without exudate. Redness and vascularity of the pillars and uvula are mild to moderate. Pain or irritation in the throat that can occur with or without swallowing; can be a symptom of strep throat

Pharyngitis

What condition is best described? a sore that develops in the soft tissue lining of your gums, tongue, inner cheeks, lips or palate

mouth ulcer

What condition is best described? A condition in which one or more white patches or spots forms inside the mouth; can't be scraped off

Leukoplakia

What condition is best described? a form of leukoplakia; a white patch on the side of the tongue with a corrugated or hairy appearance; CANNOT BE SCRAPED OFF Determine the cause:

Hairy Leukoplakia Caused by Epstein-Barr virus (EBV) Seen in HIV/AIDS infection

What condition is best described? a condition in which the fungus Candida Albicans accumulates on the lining of your mouth; CAN SCRAPE OFF to see irritation underneath

Oral Candidiasis

What is Oral Candidiasis also referred as?

Oral Thrush

What condition is best described? sores around the mouth and lips (sometimes called fever blisters or cold sores)

HSV 1

What is indicated if something appears as a crusty spot on the lips that will not heal?

Basal Cell Carcinoma

A patient is seen by you and you palpate a mass on the postero-lateral portion of the left side of their tongue. What are risk factors for cancer of the tongue?

1. Chewing tobacco 2. Smoking 3. Alcohol use 4. Hx of HPV 16 & 18 5. Male over age of 50

List the (4) ROS for the head:

1. Headache -New onset? -Different from past headaches? 2. Head trauma 3. Lightheadedness 4. Dizziness

List the (6) ROS for the ears:

1. Hearing changes 2. Skin changes on the ear 3. Earaches 4. Ear discharge 5. Tinnitus (ringing noise) 6. Vertigo (spinning sensation (feels like surroundings are moving)

Describe the function of the Eustachian Tube:

Equalize the intra-tympanic air pressure with the pressure in the external auditory canal

What is the easiest method of testing for a gross hearing loss?

Gross Auditory Acuity Testing

What auditory test compares air conduction to bone conduction?

Rinne Test

List the (8) ROS for the nose and sinuses:

1. Rhinorrhea 2. Nasal congestion 3. Sinus pressure 4. Epistaxis 5. Sneezing 6. Throat discomfort 7. Facial pain 8. Injury or trauma to the face

List the (9) ROS for the throat/larynx and oral mucosa:

1. Condition of teeth 2. Bleeding gums 3. Dentures 4. Sore tongue 5. Dry mouth 6. Hoarseness 7. Sore throat 8. Lesions on oral mucosa 9. Dysphagia

List the causative organism for oral candidiasis:

Candida Albicans

What are the paranasal sinuses lined with that secretes fluid?

Mucous membranes

What is the labial frenulum and lingual frenulum

Labial frenulum: connect lips with gingiva Lingual frenulum: connect tongue to floor of mouth

Identify the number and type of teeth in adult dentition:

Most adults have permanent dentition of 32 teeth: - 8 incisors - 4 canines, also called cuspids - 8 premolars, also called bicuspids - 12 molars, including 4 wisdom teeth

Identify the populations most commonly affected with leukoplakia:

Occurs in those with HIV/AIDS; history of tobacco use

Identify common abnormalities of the teeth and gingiva:

Abnormalities of gingiva: gingivitis, recession, gingival hyperplasia Abnormalities of teeth: missing, misshaped, discolored, abnormally positioned teeth

Describe expected age-related physical changes for the oral cavity:

1. Cells renew at a slower rate 2. Tissues become thinner and less elastic 3. Bones become less dense and strong 4. The immune system can become weaker, so infection can occur more quickly and healing takes longer

Describe expected age-related physical changes for the ears:

Presbycusis, or age-related hearing loss, comes on gradually as a person gets older; makes it hard for a person to tolerate loud sounds or to hear what others are saying

Identify the location of the following: a. Torus mandibularis b. Torus palatinus

Torus mandibularis: rounded bony growths on the inner surfaces of the mandible are typically bilateral, asymptomatic, and harmless. Torus palantinus: benign midline lump of the hard palate