EARS, NOSE & THROAT ASSESSMENT

Question 1

GENERAL APPROACH:

Answer 1

1. Patient Position: Patient seated on exam table

2. Examiner Position: Stand to patient’s right side

Question 2

EAR EXAMINATION:

3. EXTERNAL EAR/AURICLE INSPECTION:

Answer 2

A.   Size
B.    Shape
C.    Symmetry
D.    Landmarks
E.    Color
F.    Position
G.   Deformities Or Lesions

Question 3

4. EXTERNAL EAR/AURICLE/MASTOID AREA PALPATION:

Answer 3

A. Tenderness
B. Swelling
C. Nodules

Question 4

5. OTOSCOPIC EXAMINATION:

Answer 4

A. Auditory Canal Inspection:
Cerumen, color, lesions, discharge, foreign bodies
B. Tympanic Membrane Inspection:
Landmarks, color, contour, perforations, mobility

Question 5

6. HEARING ASSESSMENT:

Answer 5

A. Responses To Questions During History/Exam
B. Responses To Whispered Voice/Whisper Test
C. Weber Test: Tuning fork midline of skull
D. Rinne Test: Tuning fork over mastoid process & then placed in front of ear

Question 6

NOSE/SINUS EXAMINATION:

7. EXTERNAL NOSE INSPECTION:

Answer 6

A.  Nose shape, 
B.  size, 
C.  color, 
D.  nasal discharge, 
E.  flaring, 
F.  narrowing

Question 7

8. EXTERNAL NOSE PALPATION: Bridge & soft tissues

Answer 7

A. Tenderness
B. Displacement Of Cartilage & Bone
C. Masses

Question 8

9. PATENCY OF NARES TESTING:

Answer 8

Have patient occlude one side of nose and breathe out while you feel for the air on expiration and repeat with other side.

Question 9

10. NASAL MUCOSA & SEPTUM INSPECTION: **Use otoscope with cover or penlight for light source-Avoid touching septum or sides of nares

Answer 9

A.   Color
B.    Alignment
C.    Discharge
D.   Swelling Of Turbinates
E.    Perforation

Question 10

11. FRONTAL & MAXILLARY SINUS EXAMINATION:

Answer 10

A. Inspection: Swelling
B. Palpation: Tenderness & Swelling
C. ADVANCED SKILL: TRANSILLUMINATION OF SINUSES

Question 11

MOUTH EXAMINATION: **Use otoscope or penlight for light source
12. LIP INSPECTION & PALPATION:

Answer 11

A. Color
B. Symmetry
C. Edema

Question 12

13. TEETH INSPECTION:

Answer 12

A. Occlusions-Occlusion is defined as the way the teeth meet when the lower jaw (mandible) and upper jaw (maxilla) come together. It is how the teeth contact in any type of functional relationship.
B. Caries
C. Loose/Missing Teeth
D. Surface Abnormalities

Question 13

14. GINGIVA & BUCCAL MUCOSA INSPECTION & PALPATION:

Answer 13

A. Color
B. Lesions
C. Tenderness

Question 14

15. TONGUE INSPECTION & PALPATION:

Answer 14

A. Color
B. Symmetry
C. Swelling
D. Ulcerations

Question 15

16. ASSESS FUNCTION OF CRANIAL NERVE XII (HYPOGLOSSAL):

Answer 15

A. Inspect Tongue In Mouth While Protruded For Symmetry, Tremors, Atrophy
B. Inspect Tongue Movement Toward Nose & Chin
C. Test Tongue Strength With Index Finger When Tongue Is Pressed Against Check
D. Evaluate Quality Of Lingual Speech Sounds (l,t,d,n)

Question 16

17. PALATE & UVULA INSPECTION:

Answer 16

A. Color & Landmarks
B. Movement: Using tongue blade to depress tongue, ask patient to say “ah” while observing soft palate rise (should be symmetrical & midline)

Question 17

18. TONSILS/POSTERIOR WALL OF PHARYNX INSPECTION (use tongue blade to depress tongue):

Answer 17

A. Color
B. Tonsil Size/Grade: 1+ visible; 2+ halfway between tonsillar pillars & uvula; 3+ nearly touching uvula; 4+ touching each other
C. Exudate

Question 18

19. ELICIT GAG REFLEX

Answer 18

Prepare patient & touch posterior wall of pharynx (tests cranial nerve IX-glossopharyngeal & X-vagus)