ENT Lab Flashcards
Order of ENT exam
inspect external ears examine internal ears w/ otoscope test for hearing (whisper test) inspect external nose inspect inside of nose palpate/percuss sinuses palpate lymph nodes (w/ pads of figner) inspect external mouth inspect internal mouth (using light) palpate gums & tongue (w/ gloves)
Structures of external ear to visualize
auricle helix antihelix concha tragus & antitragus triangular fossa lobule external auditory canal
Structures of inner ear to visualize
cone of light umbo malleus manubrium pars tensa pars flaccida chorda tympani nerve
How to examine inner ear of adult?
pull up, out & posterior
How to examine inner ear of child?
pull down, out & posterior
How does a normal tympanic membrane appear?
translucent & pearly
What is the umbo?
where eardrum meets tip of malleus (from where cone of light fans downward & anteriorly)
What is the pars tensa?
portion of drum that is inferior to pars flaccida
Where is the pars flaccida?
superior to malleus
Where is the chorda tymapni N located?
runs in superior part of inner ear near pars flaccida
Conductive hearing loss
external or middle ear problem
Sensorineural hearing loss
inner ear, cochlear N, or central brain connections problem
When do you perform the Weber & Rinne test?
if pt fails the whisper test
Normal whisper test
stand behind pt, have pt occlude 1 ear, dr exhales fully & whispers combo of #s & letters
normal: pt correctly repeats sequence or after 2 sequences, can identify 3 of 6
What is normal finding for Weber test?
sound lateralizes to both ears equally
What does abnormal finding for Weber test indicate?
if sound lateralizes to 1 ear, it is either conduction loss in that ear or sensorineural loss in opposite ear
What does a normal Rinne test indicate?
Normal AC>BC (heard sound in front of ear for longer)
abnormal Weber test
sensorineural hearing loss in opposite ear
What does an abnormal Rinne test indicate?
Abnormal BC>AC or AC=BC
abnormal Weber test
conductive loss to that ear
Structures to visualize on external nose
ala nasi
columella
vestibule
bridges
note lesions, masses, nasal obstruction, tenderness
Structures to visualize on internal nose
septum
vestibule
turbinates
How does viral rhinitis present?
internal nasal mucosa is red or swollen (edema)
What is septal perforation associated with?
cocaine, meth, trauma, surgery
What is the function of turbinates?
covered by highly vascular mucous membranes & protrude into nasal cavity
cleanse, humidify & temperature controllers of inspired air
Order to palpate lymph nodes
preauricular
posterior auricular (superficial to mastoid process)
occipital (base of skull posteriorly)
tonsillar (@ angle of mandible)
submandibular
submental
superficial cervical (superficial to SCM)
posterior cervical (anterior edge of trapezius)
deep cervical chain (deep to SCM)
supraclavicular
Normal lymph nodes
pea-sized round/regular shape spongy consistency non-tender mobile overlying skin is normal
Abnormal lymph nodes
large irregular shape hard consistency tender fixed (not mobile) overlying skin is red, warm & edematous
How to palpate frontal & maxillary sinuses
frontal: press up under bony brows
maxillary: press up on location of maxillary sinuses
Structures to visualize on external mouth
lips
philtrum (distance btwn nose & mouth)
vermillion border
What is cheilitis associated with?
red cracks & corners of mouth
B12 or iron deficiency
What are aphthous ulcers?
canker sores
What is gingivitis?
swelling or ulcerations on gums
What is torus palatinua?
benign lump on hard palate
Finding for paralyzed hard/soft palate
uvula deviates to opposite side & soft palate does not rise w/ saying “Ah”
