ENT Physical Exam Lecture Powerpoint

Question 1

HPV is one of the leading causes of ___ cancers alongside cervical

Answer 1

Head and neck (oral)

Question 2

Autophony

Answer 2

Being able to hear self talking or breathing, a question to ask during ENT history

Question 3

Tullio phenomenon

Answer 3

Physical manifestation of dizziness following exposure to loud sounds, typically an issue of the semicircular canals requiring CT

Question 4

Kiesselbach plexus

Answer 4

Located in the anterior nasal septum, this highly vascular arterial area is formed from terminal branches anastamosing of the internal and external carotids and is the most common cause of anterior epistaxis (this is why you hold the lower part of the nose during a nosebleed and not up at the bridge)

Question 5

Dental occlusion measurement

Answer 5

Either normal occlusion, overbite (class II), underbite (class III), open bite (cannot bring teeth together no matter what, can make it impossible to eat things like yummy carrots :’((((( )

Question 6

Weber and rinne hearing tests

Answer 6

Weber test that doesn’t lateralize is normal.
Weber test that lateralizes to one side has either conductive loss of the same ear or sensorineural loss of the opposite ear, rinne test with air conduction greater than bone is normal or confirmatory of contralateral sensorineural loss, and bone conduction greater than air conduction is confirmatory of conductive loss

Question 7

Turbinate vs polyp

Answer 7

Often middle turbinate is mistaken for it but a polyp is white and shiny and doesn’t match the color of the surrounding tissue

Question 8

Base of tongue sweep is very important for detecting ___ especially in ___

Answer 8

cancer, smokers

Question 9

Level of lymph nodes

Answer 9

Groups within the lymph node chains used to describe specifically by radiologists or during physical exam to specify location of a mass

Question 10

Uvula with deviate away from a ____ (not referring to neurology we are referring to ENT)

Answer 10

Peritonsilar abscess

Question 11

Reticulated white lesion on the buccal mucosa or tongue might be…

Answer 11

….lichen planus (inflammatory condition thought to be autoimmune sometimes brought on by medication

Question 12

Torus palentine

Answer 12

A form of exostosis (which can be seen in the ear), hard lumps on the roof of mouth that if present for long time then not problematic as it is just overgrowth of the palate bone

Question 13

Most lumps that grow in the mouth that are cancers appear as ___ opposed to hard and bony

Answer 13

Ulcerative

Question 14

Mucosal melanoma

Answer 14

A type of melanoma that occurs in the mucosa of the mouth nose or anus and is highly aggressive with poor prognosis

Question 15

Ramsay hunt syndrome

Answer 15

Herpes zoster that exists in the mouth, will only be one sided and can eventually cause facial paralysis or hearing loss

Question 16

Ranula

Answer 16

Cyst or obstruction of submandibular or sublingual duct that will enlarge upon eating and occasionally pop with clear salty drainage, benign and may require surgical incision

Question 17

Angular cheilitis in adults

Answer 17

Inflammation in the corners of mouth often associated with a fungal infection in adults

Question 18

Squamous cell carcinoma

Answer 18

Most often seen with smoking or chewing tobacco, treated often with surgical excision of tongue which is life altering surgery as they can no longer talk or eat after

Question 19

Benign migratory glossitis/fissured tongue

Answer 19

Thought to be autoimmune, benign and common in 5% of healthy pop

Question 20

Hairy tongue and treatment

Answer 20

Removable dark plaque growth often on smokers surface of tongue that grows back, treated with nystatin

Question 21

Untreated septal hematoma often resultant from trauma cases will result in….

Answer 21

….septal perforation

Question 22

Septal perforation complications (4)

Answer 22

Saddle nose malformation, whistling noise when breathing, epistaxis, and foul smell

Question 23

Auricular hematoma

Answer 23

Large masses on the auricle of the ear that if left untreated can result in cauliflower ear

Question 24

Mastoiditis

Answer 24

Resultant from ottitis media that is left untreated or in countries that do not have good infrastructure, sees ears sticking out away from head at a downward angle with soft red tissue, requires tubal drainage immediately to prevent development of meningitis or epidural abscess

Question 25

Otitis externa that is not treated with multiple rounds of antibiotics may be ___ in origin

Answer 25

fungal

Question 26

Otitis media with effusion will have a distinct __ color defining the diagnosis on physical exam, hemotympanum will have a distinct __ color

Answer 26

Amber yellow, purple

Question 27

Cholesteatoma

Answer 27

Collection of epithelialized skin debris in the middle ear that will erode the ossicles over time that will locally grow and destroy hearing, eventually causing facial paralysis but requires surgical intervention

Question 28

Removal of bugs from the ears should be done with….

Answer 28

….oil or lidocaine, NOT water as that will cause swelling