6. Chapter 10, 11, 12, 14 - HEENT

Question 1

How is accommodation tested

Answer 1

Looks at a distant object (over shoulder0 then near (finger) – pupils should constrict BOTH

Question 2

When assessing a non-asian infant, you notice prominent epicanthal folds. This can be indicative of

Answer 2

Down Syndrome

Question 3

Initial s/s of Epstein-Barr virus mono most often include

Answer 3

High fever, ant/post nodes and submandiular lymph node swelling and EXUDATE on tonsils

fatigue.
fever.
inflamed throat.
swollen lymph nodes in the neck.
enlarged spleen.
swollen liver.
rash.

Question 4

The harder and more discrete a node, the more likely an

Answer 4

Hard=malignancy
Tender=inflammatory process
Nodes do not pulsate; arteries do
Palpable supraclavicular node on left (Virchow node)=thoracic/abdominal malignancy
Rapid enlargement=malignancy
Slow enlargement=benign process

The harder the node and especially if non-tender, consider malignancy.

Question 5

When assessing fontanels of infant/child, anterior fontanel should ..

Answer 5

posterior closes at age approx. by 2 months , anterior closes at ages 12-15 months

Question 6

Which two of the four sinuses cannot be palpated

Answer 6

Ethmoid and Sphenoid

Question 7

Which nodes are also called virchow nodes

Answer 7

supraclavicular

Question 8

When assessing thyroid, what findings may indicate hyperthyroidism

Answer 8

goiter

Question 9

When performing the rinne test, sensorineural hearing loss is noted you would expect..

conductive hearing loss?

Answer 9

Sensiorneural: > 2:1 Ear
Weber: lateralization to unaffected ear

Conductive: Bone > Ear
Weber: lateralization to affected ear

Question 10

Lymph order of HEENT

Answer 10

Occipital 
Prearricular 
Postarricular 
Tonsilar 
Submandibular 
Submental 
Posterior cervical chain
Anterior cervical chain 
Supraclavicular (virchow) 
Infraclavicular