Exam of head and neck and ENT lecture Flashcards
What are the 4 cornerstones of a physical exam in general:
1 Inspection
2 palpation
3 percussion
4 auscultation
Exam of the head includes what cornerstones of physical exam?
Inspection
palpation
What are we looking for on inspection of the head?
symmetry
distribution of hair
areas of baldness
nits, flaking, rashes
what are we feeling for on palpation of the head?
masses
defects
tenderness
hair texture
What does thin hair indicate?
iron deficiency anemia, thyrotoxicosis
What does coarse hair indicate?
hypothyroidism
What cornerstones of physical exam are used in exam of the neck?
Inspection
Palaption
ausculation
Inspection of the neck looks for?
masses scars deformities swelling deviation of trachea enlargement of thyroid
Palpation of the neck looks for?
palpable thyroid for presence/absence of nodules
have pt swallow
Lymph nodes
What is an enlarged supraclavicular node on the L side a sign of?
Virchow’s node-ominous sign for gastric Ca.
What must you do prior to palpating the neck?
listen for carotid bruit
What cornerstones of physical exam are used when evaluated the carotids?
Inspection
palpation
auscultation *** auscultation first
What must you have pt do when auscultating the carotid artery?
have pt hold their breath
What cornerstones of physical exam are used when evaluating the ears?
Inspection
Palpation
(special test)
What are you looking for on inspection of the ears?
piercings
auricles
ear canal for redness, cerumen, d/c, FB
What should you do prior to palpating the pt’s ear?
Ask if they have pain.
Pt’s with otitis media will have ________ with the tug test.
No pain
tenderness of mastoid may indicate
mastoiditis or otitis media
What special test tests for lateralization?
Weber test
What special test tests for air vs. bone conduction
Rinne test
On Weber test what might be indicated if the pt. lateralized to 1 ear?
Unilateral conductive loss-tone will be percieved in the affected ear.
OR
Unilateral sensorineural loss-tone will be perceived in UNaffected ear.
On Rinne test what might be indicated if the pt lateralized to one ear and bone conduction is better than air conduction?
conductive hearing loss
One Rinne test what might be indicated if the pt lateralized to one ear and air conduction is better than bone conduction in the same ear?
Sensorineural hearing loss
Conductive hearing loss:
loss related to problems of the outer or middle ear (otitis media, cerumen,)
Sensorineural hearing loss:
Inner ear or auditory (CN8) problem (menieres dz, trauma, aging)
On otoscopic exam you should be looking for:
Cone of light
Handle and short process of malleus
Note color and position:
normal: pinkish color, neutral position
exam of the nose includes what physical exam cornerstones?
Inspection
palpation
What do you evaluate for on inspection of the nose?
nares for flaring Nasal bone for symmetry mucus membranes nasal septum turbinates nasal discharge
What are the cornerstones of physical exam for the nasal sinuses?
Inspection
palpation
percussion
