Examination of the Head, Ears, Nose, Throat, and Neck

Question 1

Inspection of the Head

Answer 1

Position - Upright and centered

Skull - size, shape, symmetry

Question 2

Palpation of the Head

Answer 2

Skull - front to back

Scalp - moves freely over skull

Question 3

Inspection of the Face

Answer 3

eyelids, eyebrows, palpebral fissures, nasolabial folds, mouth

Question 4

Palpation of the Face

Answer 4

Temporal Arteries - swelling or tenderness

TMJ - open and close, side to side

Question 5

Inspection of Hair

Answer 5

Texture, Color, Distribution

Question 6

Palpation of Hair

Answer 6

Part hair, look for lesions scars or nits
Front to back
Behind ears

Question 7

Inspection of the Ear

Answer 7

Auricle - shape, size, symmetry
External Auditory Canal - discharge
Mastoid - Red or swollen

Question 8

Palpation of the Ear

Answer 8

Auricles - firm, mobile, recoil, nontender

Mastoid - Non tender

Question 9

Examination of the Ear

Answer 9

Pull auricle up and back
Insert speculum - discharge, scaling, erythema, cerumen, foreign body
Tympanic Membrane

Question 10

Tympanic Membrane

Answer 10

Translucent / pearly grey

Visible Landmarks: umbo, handle of malleus, light reflex

Question 11

Conductive Hearing Loss

Answer 11

defect in mechanism by which sound is transformed and conducted to the cochlea (wax obstruction, thickening of TM from infection)

Question 12

Sensorineural Hearing Loss

Answer 12

Due to disease / damage to cranial nerve VIII

Question 13

Weber Test

Answer 13

• unilateral hearing loss

- tuning fork on top of head, both ears should hear equally.

Question 14

Rinne Test

Answer 14

Does patient hear better by air or bone conduction?

- air conducted sound should be heard twice as long as bone

Question 15

Inspection of the Nose

Answer 15

same color as face
tip midline
oval symmetrical nares

Question 16

Palpation of the Nose

Answer 16

nasal bridge to tip

patency of nares

Question 17

Examination of Nose

Answer 17

Nasoscopy
Insert speculum, don’t touch septum
Inspect color, discharge, swelling, polyps

Question 18

Examination of the Sinuses

Answer 18

Inspect - swelling
Palpate - Frontal, maxillary
Percuss - Tap over sinus with index finger
Transilluminate

Question 19

Inspection of Mouth and Oropharynx

Answer 19

Lips - pink, symmetric, vermillion border, free of lesions
Gingiva - pink 
Buccal Mucosa - pink smooth moist
Fordyce Spots
Dentition
Tongue
Floor of mouth
Soft Palate
Hard Palate
Oropharynx

Question 20

Palpation of the Mouth

Answer 20

Gloves
Gums should be free of lesions, masses, tenderness
Palpate floor of mouth

Question 21

Inspection of Salivary Glands

Answer 21

Parotid - stensen ducts, buccal mucosa

Submandibular - wharton ducts on each side of frenulum

Question 22

Inspection of the Neck

Answer 22

SCM and traps symmetrical
no tracheal shift
no JVD
no visible nodes
no visible thyroid

Question 23

Palpation of the Neck

Answer 23

vertebrae, musculature, trachea, thyroid exam

Question 24

Thyroid Exam

Answer 24

Displace SCM or trachea
SCM relaxed
palpate while patient swallows water.
Size, shape, consistence, tenderness, nodules

Question 25

Head and Neck Lymph Nodes

Answer 25

occipital, post auricular, pro auricular, tonsillar, submandibular, submental, anterior cervial, posterior cervical

Question 26

Palpating Lymph Nodes

Answer 26

Use pads, light circular motion, check for size, mobility and tenderness, healthy adults usually DO NOT HAVE easily palpable nodes