Chapter 1: The Head and Neck History and Examination Flashcards
Position
- The examiner may stand or sit but should be comfortable
- The patient is seated with the head slightly higher than the examiner’s head
- The patient should lean forward slightly, keeping his back straight with feet on the floor and legs uncrossed
Light source
- Simple unfrosted 100-watt or stronger light bulb, situated on a gooseneck stand without a reflector
- Positioned slightly behind and just to the right of the patient’s head
Head mirror
- 3 1/2 inch with 1/2 inch hole in the center and focal length of about 14 inches
- Positioned over the physician’s left eye
Examination of ear
Adult: retract it backward and upward
Infant: retract it backward and downward
- Used in conjunction with a head mirror and light source
- Thin-walled and funnel-shaped, should have a non reflective surface
- Best when manipulation, such as wax removal need to be done
Hand-held aural speculum
Give a magnified view of the TM and are provided with a sealed head and pneumatic bulb attachment
Battery-powered otoscope
Readily detect the presence of a perforation of the TM or fluid in the middle ear
Pneumatic otoscopy
Pneumatic otoscopy: TM will have no movement
Perforation is present
Pneumatic otoscopy: movement will be abnormal
Presence of fluid
Pneumatic otoscopy: shifting meniscus
Air-filled level in the middle ear
Best single fork
Riverbank 512 cycle fork
Higher frequency tuning fork may not…
Sustain a tone long enough to allow adequate testing
Lower frequency tuning forks…
Stimulate vibratory sensation in bone
Nasolacrimal duct exits into…
Inferior meatus
Anterior ethmoid sinuses, maxillary sinus and frontal sinus drain into…
Middle meatus
