Block 1 - HENT Exam

Question 1

Describe purpose, procedure, and findings of Weber test regarding auditory acuity

Answer 1

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.

Question 2

Describe purpose, procedure, and findings of Rinne test regarding auditory acuity

Answer 2

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

Question 3

Describe procedure and findings of gross hearing test regarding auditory acuity

Answer 3

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.

Question 4

Describe purpose and procedure of audiogram regarding auditory acuity

Answer 4

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.

Question 5

Describe the difference between sensorineural hearing loss and conductive hearing loss

Answer 5

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.

Question 6

Discuss the otoscope

Answer 6

Used for illumination of external auditory canal and tympanic membrane. Select largest size that will fit in pt’s ear.

Question 7

Discuss the insuffilator

Answer 7

Provides information about tympanic membrane mobility and middle ear space.

Question 8

Discuss the transilluminator

Answer 8

Used to examine sinuses. Helps differentiate presence of media in cavity (air, fluid, tissue).

Question 9

Describe normal dentition in the adult

Answer 9

Most adults have 32 permanent teeth. 2I, 1C, 2PM, 3M, bilaterally and superiorly and inferiorly.

Question 10

Define and describe septal deviation

Answer 10

Nasal septum is displaced to one side making one nasal passage smaller. This can reduce airflow causing breathing difficulty.

Question 11

Define and describe nasal polyp

Answer 11

Boggy, dependent mucosa that is round and elongated which projects into nasal cavity - tissue blockage of nasal passageway.

Question 12

Define and describe rhinitis/rhinorrhea

Answer 12

Inflammation or irritation of nasal passages, “runny nose,” nasal congestion, and/or postnasal drainage. Can be seasonal or accompany sickness.

Question 13

Define and describe otorrhea

Answer 13

Often purulent discharge from the ear

Question 14

Define and describe effusion

Answer 14

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.

Question 15

Define and describe retraction of tympanic membrane

Answer 15

Concave, accentuated bony landmarks, distored light reflex.

Question 16

Define and describe bulging of tympanic membrane

Answer 16

Very conical, exaggerated loss of bony landmarks, distored ligh reflex.

Question 17

Define and describe otosclerosis

Answer 17

Chronic progressive deafness caused by formation of spongy bone and ankylosis of stapes. Diminished sound transmission through bone noted with Rinne test.

Question 18

Define and describe torticollis

Answer 18

Stiff neck associated with muscle spasms. Causes lateral flexion, contracture of cervical spine musculature.

Question 19

Define and describe glossitis

Answer 19

Inflammation of tongue. Tongue is painful, red, swollen.

Question 20

Define and describe pharyngitis/tonsilitis

Answer 20

Inflammation of pharynx or tonsils, “sore throat,” enlarged, reddened, tender glands, may be covered with exudate.

Question 21

Define and describe gingivitis/gingival hyperplasia

Answer 21

Inflammation of gums, redness, swelling, bleeding, overgrowth of gums.

Question 22

Define and describe dental caries

Answer 22

Tooth decay caused by bacteria, cavity, blackened/dark areas of teeth.

Question 23

Define and describe frontal bossing

Answer 23

Prominent, protruding forehead or eyebrow ridge. Common sign of acromegaly.

Question 24

Define and describe goiter

Answer 24

Enlargement of thyroid gland.

Question 25

Define and describe geographic tongue

Answer 25

Area of tongue lack papillae. Appear as smooth red islands with raised border - motile, harmless.

Question 26

Define and describe strawberry tongue

Answer 26

Initially tongue appears white with prominent papillae. White gradually decreases leaving tongue bright red - looks like a strawberry. Characteristic of scarlet fever.

Question 27

Define and describe torus palatinus

Answer 27

Benign exotosis (bony growth) on midline of hard palate.

Question 28

Define and describe atrophic tongue

Answer 28

Papillae shrink and disappear leaving tongue red, think, shiny, with patches of redness and inflammation. Painful and sensitive to spicy foods; bad breath.

Question 29

Define and describe hairy tongue

Answer 29

Overgrowth of papillae on tongue caused by bacteria or yeast. Projections capture food, drinks, bacteria altering color of tongue. Black, brown, yellow, green.

Question 30

Define and describe Darwin’s tubercle

Answer 30

Thickening along upper ridge of helix - an expected variation.

Question 31

Define and describe cauliflower ear

Answer 31

Result of blunt trauma and necrosis of underlying cartilage. Deformity of auricle.