BASIC ENT EXAMINATION (AB) Flashcards
Why is a general history and physical examination important in a basic ENT exam?
Systemic diseases often demonstrate signs and symptoms in the head and neck.
What is the prerequisite for a basic ENT examination?
A thorough physical examination and history taking.
What is the proper position for the examiner during an ENT exam?
The examiner may stand or sit but must not stoop down and should be comfortable for proper ergonomics.
What is the ideal position for a patient during an ENT exam?
Seated with head slightly higher than the examiner’s, slightly leaning forward, back straight, and legs uncrossed and flat.
What type of light source is recommended for an ENT exam?
A 100-watt or stronger unfrosted light bulb mounted on a gooseneck stand without a reflector.
Where should the light source be positioned in an ENT exam?
Slightly to the right or left of the patient’s head, on the same side as the head mirror.
Why is a strong light source important in an ENT exam?
ENT examination includes areas where natural sunlight does not reach.
What is the size of a standard head mirror used in ENT exams?
3 ½ inches in diameter with a ½ inch central hole.
What is the focal length of a standard ENT head mirror?
14 inches.
Why should the head mirror be placed as close as possible to the face?
To provide a wider angle of view and allow binocular vision for depth perception.
What is the main challenge of using a head mirror?
Maintaining the correct angle and focal length, requiring patient head movement instead of examiner repositioning.
What is an alternative to the head mirror in ENT exams?
A focusable light mounted on a headband.
What are the four basic maneuvers of physical examination?
Inspection, Palpation, Percussion, and Auscultation.
What is the order of examination in an ear exam?
Start from least invasive to most invasive.
Why is percussion used in an ear exam?
To check for dullness and tenderness in the sinuses.
What does the presence of bruits in the neck indicate?
Possible inferior vena cava thrombosis or arteriovenous malformations.
Why should hemangiomas not be punctured or aspirated?
Hemangiomas do not clot and may cause significant bleeding.
What is the first step in examining the ear?
Inspect and palpate the pinna and surrounding areas.
Why should the external auditory canal be examined without a speculum first?
To inspect the concha and estimate the size of the external auditory meatus for proper speculum selection.
What is the advantage of using the largest comfortable speculum?
It maximizes the angle of view while avoiding pain.
What is the disadvantage of using a small speculum?
A small speculum provides a narrow angle of view and limits examination.
What is the anatomical significance of the mastoid process?
It contains air cells connected to the middle ear, making it a site for potential mastoiditis.
What structures are closely related to the external auditory canal?
Temporomandibular joint, greater temporal arteries, nerves, veins, and parotid gland.
Why should ear pulling techniques be adjusted for different age groups?
Adults: Pull ear backward and upward to straighten the S-shaped canal; Infants: Pull ear backward and downward due to C-shaped canal.
What is the purpose of a hand-held speculum in ear exams?
To better visualize the tympanic membrane.
What is the advantage of a hand-held speculum?
Easy to use.
What is the disadvantage of a hand-held speculum?
No magnification.
What is the most commonly used instrument for ear examination?
Battery-powered otoscope.
What is the function of a pneumatic otoscope?
To assess tympanic membrane mobility and detect perforations or middle ear effusion.
What indicates a perforated tympanic membrane on pneumatic otoscopy?
No movement of the tympanic membrane.
What does shifting of the meniscus on pneumatic otoscopy indicate?
Presence of fluid in the middle ear.
What is the color of a serous effusion in the middle ear?
Amber, sometimes with air-fluid levels or bubbles.
What is the appearance of a mucoid effusion in the middle ear?
Dull gray to white with loss of middle ear landmarks.
What are the three parts of a pneumatic otoscope?
Handle (battery pack), Head (houses bulb), and Speculum.
Why is the largest possible speculum preferred in otoscopy?
A larger speculum provides a better angle of view without causing discomfort.
What is the function of tympanoscopy (pneumatic otoscopy)?
To change the pressure in the external auditory canal and assess tympanic membrane compliance.
What is an operating head otoscope used for?
Removing foreign bodies, impacted cerumen, and performing tympanostomy.
What should be inspected in the external examination of the nose?
Deformities, asymmetry, skin quality, lesions, or discoloration.
What is the proper technique for anterior rhinoscopy?
Hold the nasal speculum with the right hand for the left nostril and vice versa.
Why should the nasal speculum be inserted closed?
To avoid injuring the patient and ensure gentle opening of the nasal cavity.
Why should the nasal speculum not be completely closed when removing it?
To prevent pulling out nasal hairs, which may cause discomfort.
What does anterior rhinoscopy assess?
Nasal septum, inferior turbinates, and internal nasal valve.
What is the narrowest part of the nasal airway?
Internal nasal valve.
What should be examined in the oral cavity?
Lips, buccal mucosa, teeth, gingiva, tongue, and floor of the mouth.
What tool is used to inspect the oral cavity?
Wooden or metal tongue depressor with a headlamp.
What conditions may be suspected if white plaques are present in the oral cavity?
Oral thrush (scrapable) or leukoplakia (non-scrapable).
What are Fordyce spots?
Normal sebaceous glands appearing as small yellow spots in the buccal mucosa.
What is the best technique for examining the tongue?
Gently grasp the tongue with gauze and inspect all surfaces.
How should the patient be instructed when examining the tongue?
Ask the patient to lift the tongue toward the hard palate instead of sticking it out.
What is the purpose of including a general history and physical examination in every head and neck evaluation?
“Many systemic diseases manifest in the head and neck
What is the recommended position for an examiner during a basic ENT examination?
“The examiner may stand or sit but must be comfortable and avoid stooping down for work ergonomics.”
How should a patient be positioned during an ENT examination?
“The patient should be seated with their head slightly higher than the examiner’s
What is the recommended light source for an ENT examination?
“A 100-watt or stronger unfrosted light bulb mounted on a gooseneck stand without a reflector.”
Why is the light source positioned slightly to the right or left of the patient’s head?
“To align with the side where the head mirror is placed and provide proper illumination for the examination.”
What is the purpose of using a head mirror in an ENT examination?
“To reflect light from the lamp into the area being examined
What is the focal length of a standard head mirror?
“14 inches.”
What is the main challenge in using a head mirror?
“Maintaining the angle and focal length
What is an alternative to using a head mirror?
“A focusable light mounted on a headband.”
What are the four basic maneuvers in the physical examination of the ear?
“Inspection
Why is percussion performed on the sinuses during an ear examination?
“To check for dullness and tenderness.”
What does the presence of bruits in the neck indicate?
“Possible inferior vena cava thrombosis or arteriovenous malformations.”
Why should hemangiomas not be punctured or aspirated?
“They do not clot and could lead to significant bleeding.”
What is the first step in an ear examination?
“Inspection and palpation of the pinna and surrounding areas.”
Why is the external auditory canal initially examined without a speculum?
“To inspect the concha and estimate the size of the external auditory meatus before inserting an otoscope.”
Why should the largest speculum that fits comfortably be chosen for otoscopy?
“To maximize the angle of view while avoiding patient discomfort.”
How should the ear be straightened in adults for otoscopy?
“By pulling the auricle backward and upward.”
How should the ear be straightened in infants for otoscopy?
“By pulling the auricle backward and downward.”
What is the advantage of a hand-held speculum?
“It is easy to use.”
What is the disadvantage of a hand-held speculum?
“It does not provide magnification.”
What is the most commonly used instrument for ear examination?
“A battery-powered otoscope.”
What is the purpose of pneumatic otoscopy?
“To detect tympanic membrane perforation or middle ear effusion by altering external auditory canal pressure and observing membrane movement.”
What does no movement of the tympanic membrane indicate during pneumatic otoscopy?
“A perforation of the tympanic membrane.”
What does a shifting meniscus in pneumatic otoscopy indicate?
“Partial fluid accumulation in the middle ear.”
What color does serous effusion appear as in pneumatic otoscopy?
“Amber
What color does mucoid effusion appear as in pneumatic otoscopy?
“Dull gray to white
What are the three main parts of a pneumatic otoscope?
“Handle (battery pack)
What is the purpose of a tympanoscopy?
“To assess tympanic membrane mobility by changing pressure in the external auditory canal.”
Where does nasopharyngeal carcinoma most commonly present?
“In the fossa of Rosenmüller.”
What instrument is used to visualize the nasopharynx?
“A nasopharyngeal mirror (size 0) warmed with a humidifier
What should the patient do to relax the soft palate during nasopharynx examination?
“Breathe through the nose.”
How is the laryngeal mirror used during hypopharynx and larynx examination?
“It is warmed
What should be done if a patient gags during a laryngeal examination?
“Ask the patient to pant or apply a topical anesthesia spray.”
Why should patients avoid eating or drinking after topical anesthesia in the throat?
“To prevent aspiration pneumonia
What structures should be examined in the hypopharynx?
“Vallecula
What is the function of the true vocal cords?
“They open during inhalation and close during vocalization.”
What are the arytenoids, and what is their function?
“Cartilages that pivot on the cricoid cartilage to open and close the vocal cords.”
What is the significance of the pyriform sinus?
“It is the opening of the esophagus
What is the common term for the upper esophageal sphincter?
“‘Bab el-Mandeb
