Block 1 - HENT Exam Flashcards
Describe purpose, procedure, and findings of Weber test regarding auditory acuity
Purpose: Assess unilateral hearing loss
Procedure: Place 512Hz tuning fork on middle of head, ask pt if sound heard bilaterally or better in one ear, (if one is) cover one ear and occulded ear should sound better.
Findings: Should be bilateral; if lateralization occurs - conductive hearing loss if sound heard better in bad ear, sensorineural hearing loss if sound heard better in good ear.
Describe purpose, procedure, and findings of Rinne test regarding auditory acuity
Purpose: Distinguish if pt hears better by air or bone conduction
Procedure: Place 512Hz tuning fork against pt’s mastoid bone, ask if sound is heard, when no longer heard move by ear, when no longer heard record time.
Findings: Positive - AC>BC in 2:1 ratio; conductive hearing loss - BC>AC on affecte side; sensorineural hearing loss - AC>BC but less than 2:1 ratio
Describe procedure and findings of gross hearing test regarding auditory acuity
Proceure: Occlue pt’s untested ear, stand out of vision, whisper word with 2 syllables, have pt repeat word, repeat on other side.
Findings: Failure could indicate hearing loss.
Describe purpose and procedure of audiogram regarding auditory acuity
Purpose: Used to show the amount of hearing loss individual has for each ear. Graphical display - frequency (Hz) vs intensity of sound (dB).
Procedure: Continuous and interrupted tons presented at various frequencies. Hearing threshold - softest tone which person can hear recorded by audiogram.
Describe the difference between sensorineural hearing loss and conductive hearing loss
Sensorineural hearing loss: Any type of damage from cochlear hair cells beyond (eg CN VIII) - eg noise-induced hearing loss, old age, genetics, head injuries. Marked by loss of high-frequency sounds. Permanent.
Conductive hearing loss: Any obstruction or defect or interference with mechanism of sound transmission (ear infections, fluid in middle ear, abnormal bone growth, cerumen impaction, TM perforation). Not permanent - usually fixed with surgical or medical intervention.
Discuss the otoscope
Used for illumination of external auditory canal and tympanic membrane. Select largest size that will fit in pt’s ear.
Discuss the insuffilator
Provides information about tympanic membrane mobility and middle ear space.
Discuss the transilluminator
Used to examine sinuses. Helps differentiate presence of media in cavity (air, fluid, tissue).
Describe normal dentition in the adult
Most adults have 32 permanent teeth. 2I, 1C, 2PM, 3M, bilaterally and superiorly and inferiorly.
Define and describe septal deviation
Nasal septum is displaced to one side making one nasal passage smaller. This can reduce airflow causing breathing difficulty.
Define and describe nasal polyp
Boggy, dependent mucosa that is round and elongated which projects into nasal cavity - tissue blockage of nasal passageway.
Define and describe rhinitis/rhinorrhea
Inflammation or irritation of nasal passages, “runny nose,” nasal congestion, and/or postnasal drainage. Can be seasonal or accompany sickness.
Define and describe otorrhea
Often purulent discharge from the ear
Define and describe effusion
Loss of fluid from the blood vessels or lymphatics into the tissue or a body cavity. Edema, pain, and tension in area of build up.
Define and describe retraction of tympanic membrane
Concave, accentuated bony landmarks, distored light reflex.
Define and describe bulging of tympanic membrane
Very conical, exaggerated loss of bony landmarks, distored ligh reflex.
Define and describe otosclerosis
Chronic progressive deafness caused by formation of spongy bone and ankylosis of stapes. Diminished sound transmission through bone noted with Rinne test.
Define and describe torticollis
Stiff neck associated with muscle spasms. Causes lateral flexion, contracture of cervical spine musculature.
Define and describe glossitis
Inflammation of tongue. Tongue is painful, red, swollen.
Define and describe pharyngitis/tonsilitis
Inflammation of pharynx or tonsils, “sore throat,” enlarged, reddened, tender glands, may be covered with exudate.
Define and describe gingivitis/gingival hyperplasia
Inflammation of gums, redness, swelling, bleeding, overgrowth of gums.
Define and describe dental caries
Tooth decay caused by bacteria, cavity, blackened/dark areas of teeth.
Define and describe frontal bossing
Prominent, protruding forehead or eyebrow ridge. Common sign of acromegaly.
Define and describe goiter
Enlargement of thyroid gland.
Define and describe geographic tongue
Area of tongue lack papillae. Appear as smooth red islands with raised border - motile, harmless.
Define and describe strawberry tongue
Initially tongue appears white with prominent papillae. White gradually decreases leaving tongue bright red - looks like a strawberry. Characteristic of scarlet fever.
Define and describe torus palatinus
Benign exotosis (bony growth) on midline of hard palate.
Define and describe atrophic tongue
Papillae shrink and disappear leaving tongue red, think, shiny, with patches of redness and inflammation. Painful and sensitive to spicy foods; bad breath.
Define and describe hairy tongue
Overgrowth of papillae on tongue caused by bacteria or yeast. Projections capture food, drinks, bacteria altering color of tongue. Black, brown, yellow, green.
Define and describe Darwin’s tubercle
Thickening along upper ridge of helix - an expected variation.
Define and describe cauliflower ear
Result of blunt trauma and necrosis of underlying cartilage. Deformity of auricle.
