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Summer Final PDNA > ENT > Flashcards

ENT Flashcards

1
Q

Common or concerning symptoms of head

A

Headache

History of head injuries

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2
Q

Common or concerning symptoms of eyes

A 
Pain
Redness
Excessive tearing
Flashing lights
Visual loss
Double vision
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3
Q

Nose and sinuses common or concerning symptoms

A

Nose: sneezing, runny nose, congestion, nose bleed (epistaxis)

Sinuses: pain or tenderness

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4
Q

Oropharynx common or concerning symptoms

A

Gums bleeding, sore throat, trouble swelling, hoarseness

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5
Q

Neck common or concerning symptoms

A

Swollen salivary glands

Goiter

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6
Q

Inspection of head: hair

A

Quality, texture, distribution pattern

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7
Q

Scalp inspection

A

Bumps, textures, redness, any spots if discoloration

Bogginess or edem

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8
Q

Skull inspection

A

Size and contours

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9
Q

Face inspection

A

Asymmetry: structural or in facial expression
Skin: temp, texture, edema, masses

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10
Q

Hyperthyroidism and hair

A

Extra hair growth

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11
Q

Tension type headache distribution

A

Diffuse-type, musculature

Band across the forehead

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12
Q

Migraine distribution

A

Focal, vascular

One sided

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13
Q

Closure type headache distribution

A

Multifocal, vascular

In one focal spot, like the orbit

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14
Q

Brian tumor temporal pattern

A

Show chronic/insidious onset, steady progression

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15
Q

Migraine gtemproal pattern

A

Episodic, not at regular frequency

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16
Q

Tension headache temporal pattern

A

Chronic pattern, fairly regular

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17
Q

Cluster headache temporal pattern

A

Similar to migraine

Periods where its intense, and periods of remission

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18
Q

Acute onset headache

A
  • urgent/emergency likely
  • intracranial hemorrhages
  • other cerebrovacualr events
  • meningitis or encephalitis
  • ophthalmic events
  • other less common causes
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19
Q

Subacute onset HA

A

Non emergent

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20
Q

Auricle exam

A

Redness, tenderness, masses/lesions

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21
Q

Ear canal exam

A

Redness, swelling, pain, FB, discharge

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22
Q

Tympanic membrane exam

A

Color, contour, mobility (sign of altered pressure)

23
Q

Auditory acuity exam

A

Finger rub tests, “whispered voice test”

24
Q

Hearing impairment eval

A

Questions for the patients

Air condition vs bone condition (Rinne and Weber tests)

25
Q

External ear exam

A

Inspection of the external acoustic meatus and the tympanic membrane (at the interior end of the meatus) typically requires “straightening” the somewhat curved contours. Examiner can tug on helix in a lateral, superior, and posterior direction. Beware when inserting otoscope: the length of the meatus is much shorter in infants than in adults

26
Q

Otitis externa

A

Pain at outer ear level
Exostosis can be present
Skin of the canal wis often thickened, red, and itchy

Look for color and perfusion differences

27
Q

View of the tympanic membrane

A
  • parts of the ossicles in the middle ear bulging against the membrane
  • abnormal accumulation of fluid/material in the middle ear produces visible changes in the appearance of hte typmpanic membrane, e.g. red with inflammation, normally concave parts become convex due to increased pressure
28
Q

Retracted membrane in tympanic membrane

A

Appears bowed inward toward, ossicles more prominent than normal. Assocaited with blockage of Eustachian tube

29
Q

If the tympanic membrane is bulging externally

A

Indicates increased pressure/material in middle ear such as excess serious fluid, infection, pus

30
Q

Color changes to tympanic membrane

A
  • amber or yellow suggests serous fluid build IOP
  • white suggests infection
  • red suggests blood in middle ear
  • all can be assocaited with otitis media (infection)
31
Q

Perforation of the tympanic memebtane

A

Often followed by closure and scarring, again association with otitis media

32
Q

Auditory acuity )hearing sensitivity)

A
  • neurologists test: finger rub

- general physician test: whispered voice test

33
Q

Frequency specific hearing loss

A

Age related loss of high frequency sensitivity, suggested selective loss of hair cells in cochlea

34
Q

Generalized hearing loss

A

Originate from pathology at various levels: external ear, middle ear, non specific damage to hair cells across cochlea

35
Q

Unilateral hearing loss

A

Localization from external ear to ipsilateral medulla (auditory nucleus). Lesions further along auditory pathway in the brain do not result in unilateral deafness

36
Q

Frequency specific loss

A

Cochlea

37
Q

Sensorineural vs conductive hearing loss

A

Sensorineural
-cochlea or neurological pathology

Conductive
-tympanic membrane and occlusive (middle ear).

Distinguish with the rinne or Weber’s reset

38
Q

Nose surface

A

Asymmetry, deformity (deviated septum)

39
Q

Nasal cavity

A
  • mucosa: color, swelling, bleeding, ulcers or polyps
  • turbinates: conchae
  • septum: perforation, inflammation
40
Q

Olfactory neurons

A

Deep to the superior conchae is where they are located

41
Q

Paranasal air sinuses

A
  • connection etween nasal cavity and maxillary/sphenoid sinuses
  • lined by mucosa, like nasal cavity
  • inflamamtion,infection presents as painful
  • palpate and test for tenderness
  • transillumination is a test for obstruction, inflammation, infection
42
Q

Normal transillumination of sinuses

A

Significant “glow” or typical degree transillumination

43
Q

dull transillumination of sinuses

A

Reduced transillumination

44
Q

Opaque transillumination of sinuses

A

No transillumination

45
Q

Things to look at for oral cavity and pharynx

A
  • lips
  • oral mucosa
  • gums and teeth
  • hard palate
  • tongue and floor
  • pharynx
46
Q

Erosion of teeth

A

Chemical action
Results from recurrent regurgitation of stomach contents, such as in bulimia

Can see a white rim on the outer edges of the tooth

47
Q

Tongue

A

Benign atypical, local infection, systemic vital infection

48
Q

Smooth tongue

A

B12 deficiency

49
Q

Tonsil size

A
  • can be large without pathology
  • could block airway
  • also note if posterior pharyngeal surface protrudes into paharynx
  • must depress the tongue to see epiglottis
50
Q

Neck exam

A
  • inspect for asymmetry, enlarged salivary glands and lymph nodes, masses
  • inspect trachea-position
  • inspect and palpate thyroid gland
  • palpate lymph nodes in key locations
51
Q

Questions for patient, related to thyroid function

A
  • have you noticed any swollen glands or lumps in your neck?
  • do you dress more warmly or less warmly than others
  • do you perspire a lot more or less than others?
52
Q

Tracheal position

A

Masses in the neck may cause tracheal deviation to one side, raising suspicion of conditions in the thorax such as mediastinal mass, atelectasia, or a large pneumothorax

53
Q

Palpating the thyroid

A
  • usually need to extend the neck
  • isthmus may not be detectable
  • thyroid lobes can be positioned inferiority and posterior to sternum

Summer Final PDNA (6 decks)

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