Ears/Nose/Mouth/Throat Flashcards
function of the EARS
the SENSORY ORGANS that are responsible for our HEARING & maintaining EQUILIBRIUM
what are the THREE PARTS of the ear?
- EXTERNAL EAR **only part we typically assess
- MIDDLE EAR
- INNER EAR
important assessment for MASTOID PROCESS location
can be an indication of BRAIN INFECTION - MENINGITIS (if swollen/abnormality)
tympanic cavity / what should it look like?
the SMALL AIR-FILLED CHAMBER within the TEMPORAL BONE
- should be ROUND, PEARLY, and GRAY in appearance
what is the MAIN DIFFERENCE between CONDUCTIVE HEARING LOSS & SENSOINEURAL HEARING LOSS?
CONDUCTIVE;
often will affect the OUTER EAR/issue regarding bones
SENSORINEURAL;
often will affect a little bit of the MIDDLE/INNER EAR/issue regarding the nerves
definition of HEARING LOSS
anything that is OBSTRUCTING the transmission of sound that begins to IMPAIR HEARING
what are some RISK FACTORS for hearing loss?
- OTOTOXIC MEDS; these are strong antibiotics –with a high dosage; can cause hearing loss
- ILLNESS/FEVER
- amount of NOISE EXPOSURE
- OLDER ADULTS
- PREMATURE BIRTHS
labyrinth
inner ear structure that CONSTANTLY FEEDS INFO to the brain about specific BODY POSITION within space
how does the LABYRINTH WORK?
works similar to a PLUMB LINE–helps to determine verticality or depth
- also considers position in relation to GRAVITY
what happens if our LABYRINTH is INFLAMED?
- can send WRONG INFO to the brain
- causes STAGGERING GAIT
- can cause VERTIGO
- increases FALL RISK
what is typically found in OLDER ADULT’s ears?
- dried CERUMEN often with IMPACTION
presbycusis
AGE-RELATED + GRADUAL progressive SENSORINEURAL HEARING LOSS
important to look for during the PHYSICAL EXAM of the ear
- proper symmetry
- any signs of trauma, lesions, drainage, or swelling
- note any changes in color, size, shape
what CN are we testing? what tests can we use?
testing the AUDITORY/VESTIBULOCOCHLEAR CN VIII
- can use the WHISPER VOICE TEST
- WEBER/RINNE TEST
what are the TWO PARTS OF the VESTIBULOCOCHLEAR NERVE?
- AUDITORY PART
damaged; DEAFNESS/TINNITUS - VESTIBULAR PART
damaged; VERTIGO/IMBALANCE
conductive hearing loss
soundwaves cannot PASS THROUGH the MIDDLE EAR to the INNER EAR
what can CAUSE CONDUCTIVE HEARING LOSS?
- INFECTIONS
- EARWAX BUILDUP
- PUNCTURED EARDRUM
- FLUID within the MIDDLE EAR
- DAMAGE to bones within MIDDLE EAR
sensorineural hearing loss
where there is DAMAGE to any part of the SPECIALIZED NERVOUS SYSTEM of the ear
(the CN VIII, HAIR CELLS)
what can CAUSE SENSORINEURAL HEARING LOSS?
- long exposure to LOUD NOISES
- AGING
Rinne test
- compares AIR CONDITION to BONE CONDUCTION
- AIR; air vibration by the ear (ear canal/ear drum)
- BONE; vibration through the bone – picked up by the nervous system
explain the Weber test
- tuning fork is PLACED ON MIDDLE OF THE HEAD
- asking patient where sound is best heard; L/R ear or EQUALLY
results;
**should be EQUAL ON BOTH EARS
**if CONDUCTIVE; heard best in ABNORMAL EAR
**if SENSOINEURAL; heard best in NORMAL EAR
rinne test results
should have a LONGER AIR CONDUCTION time vs. BONE CONDUCTION **around 2x
**if CONDUCTIVE =
BONE CONDUCTION > AIR CONDUCTION
**if SENSOINEURAL =
AIR CONDUCTION > BONE CONDUCTION
otitis externa
an INFLAMMATION of the AUDITORY CANAL & the EXTERNAL SURFACE of the TYMPANIC MEMBRANE
acute OTITIS MEDIA
inflammation in the MIDDLE EAR; often due to MIDDLE EAR EFFUSION/infection of bacteria
what are our SINUS CAVITIES
- FRONTAL
- ETHMOID
- SPHENOID
- MAXILLARY
epistaxis
also known as a NOSEBLEED
what glands to assess?
- PAROTID GLAND
- SUBLINGUAL GLAND
what to assess - NOSE?
- any signs of NASAL DISCHARGE
- any tenderness around the SINUSES?
- does the patient SNORE when they sleep?
- epistaxis; duration/obstructions/specific site?
what could be causing SINUS PAIN?
- NASAL CONGESTION/NASAL DISCHARGE
- FEVER/COUGHING
- TOOTHACHES
- can use DECONGESTANTS to clear up
what to assess in the MOUTH?
- any issues regarding DENTAL PROBLEMS/APPLICANCES?
- any signs of MOUTH LESIONS/SORES/HERPES?
- any variations or changes in buccal mucosa/tongue?
what does a NORMAL NASAL CAVITY/EXTERNAL NOSE LOOK LIKE?
- should be clear, symmetric, and have CLEAR NOSE PATENCY
- nares inside; should be again SYMMETRIC; should have PINK, MOIST MUCOSA/no masses or lesions
what CN are we testing when we are assessing the nose?
CN I - olfactory ; can use familiar smells to test smell sensations
what sinuses do we typically inspect & palpate?
mainly just the FRONTAL & MAXILLARY SINUSES
- looking for swelling/tenderness/sign of infection
why is it important to also assess the TEETH & GUMS?
a really important indicator of the patient’s GENERAL HEALTH & SELF-CARE
what CN’s are assessed when observing the mouth and tongue? what does the ABNORMAL FINDINGS LOOK LIKE?
CN IX & X - GLOSSOPHARYNGEAL & VAGUS
**Observing GAG REFLEX tests
CN IX; (sensory)
- issues with swallowing
- absent gag reflex
- parotid gland dysfunction
- impaired sensation of 1/3 of tongue
CN X; (sensory/motor)
- issues with HR/GI secretion/ANS issues
- palate/throat paralysis
how do we TEST CN XII
testing the HYPOGLOSSAL NERVE;
want patient to stick out tongue; look for any deviations to the side
**if damaged, will point to the damaged side
- also can assess tongue strength
what is the GRADING SCALE OF THE TONSILS?
+1 - VISIBLE
+2 - MIDWAY between the SOFT PALATE & UVULA
+3 - TOUCHING the UVULA
+4 - TONSILS are TOUCHING EACH OTHER
what can be indicated if a patient’s tonsils are +4?
can be a SERIOUS INFECTION–could be a potential sign of STREP THROAT
- must be treated asap; can lead to the heart
what are some age-related changes to the MOUTH?
- decreased SALIVA
- drier ORAL MUCOSA
- more receding/worn down mouth structures
- decreased SMELL + TASTE
sinusitis
an BACTERIAL INFECTION of ONE or MORE of the PARANASAL SINUSES
oral cancer
cancer that affects the ORAL CAVITY and other structures
acute bacterial pharyngitis
infection of the TONSILS or POSTERIOR PHARYNX
periodontal disease
a CHRONIC INFECTION of the GUMS, BONES, nd other tissues that help to support and surround the teeth
