Head and Neck Exam Flashcards
Inspection Points on Head
(5 regions, 2/2/2/2/4 specifics)
- Hair - distribution, quantity
- Scalp – scaling, nevi
- Skull – size, contour
- Face – expression, contours
- Skin – color, pigmentation, hair distribution, lesions
Head Palpation
(4 regions, what to look for in each)
- Hair - texture
- Skull – lumps
- Face – sinuses
- Skin – texture, temperature
External Ear Canal Inspection
(2 regions 8/4 specifics)
Pinna
- size
- position
- deformity
- inflammation
- symmetry
- nodules
- scars
- lesions
**External Auditory Canal, for presence of ear discharge **
- color
- consistency
- clarity
- presence or absence of any odor
Palpation, External Ear
(3 regions)
Check for tenderness, nodules, and pn
- Pinna
- Perauricular area
- Mastoid process
Auditory Acuity Testing
(list 3 tests)
- Whisper Test
- Weber Test
- Rinne Test
Whisper Test
(function, 5 step process)
Function: assessment of hearing impairment
Procedure:
- Have patient occlude one ear.
- Stand 1-2 feet behind patient, softly say “ninety-four” or “baseball”
- Ask patient to repeat what you whispered into the non-occluded ear.
- Repeat on other ear.
- If patient can’t hear increase the volume of your voice until it is heard
Weber Test
(purpose, 2 step procedure, result interpretation)
Purpose: assess seound lateralization
Procedure:
- Place the base of the tuning fork on midline of the patient’s skull
- Ask the patient if they hear the sound louder on one side or if it is equal on both sides
Results:
- Normal hearing = no sound lateralization, patient hears sound or feels vibration in middle
- Conductive hearing loss = sound lateralization to AFFECTED ear
- Sensorineural hearing loss = sound lateralization to NON-AFFECTED ear
Rinne Test
(purpose, 3 step process, results)
Purpose: assess air vs. bone conduction in the auditory system
Procedure:
- Apply the base of the tuning fork against the patient’s mastoid process until they no longer hear the sound
- Place it, still vibrating, next to the patient’s ear canal
- Repeat with opposite ea
Results:
- normal = air > bone conduction
- **conductive hearing loss **= bone > air conduction
Otoscopic Exam
(2 structures, 4/6 specifics)
Auditory meatus
- Foreign body
- Cerumen
- Inflammation
- Discharge
Tympanic Membrane (see chart)
External Nose Inspection
(5 points to note)
- Swelling
- Trauma
- Deviation
- Congenital abnormalities
- Nare symmetry (have pt extend neck)
Palpation, External Nasal Exam
(2)
- Test airway patency: occlude one nostril and ask the patient to sniff then exhale and look for mirror fogging or movement of cotton wisp
- Palpation of sinuses: frontal and maxillary
Internal Nasal Exam
(3 regions to observe c 6/3/2 specifics)
Mucosa –
- color
- swelling
- bleeding
- exudate
- ulcers
- polyps
Septum –
- deviation
- inflammation
- perforation
Turbinates – use otoscope to view middle and inferior turbinates
What structure is not visible in the nose during otoscopic exam?
Superior tubercle
Mouth/Pharynx Observation
(6 regions, descriptors of each)
- Lips - Note color, moisture, lumps, ulcers, cracking, or scaliness
- Oral mucosa - Note color, ulcers, and nodules
- Gums and teeth - Note color, presence, and position of teeth
- Roof of mouth - Note color
- Tongue and floor of mouth - Note color and texture, ulcers, nodules
-
Pharynx: soft palate, anterior and posterior pillars, uvula, tonsils, and pharynx
- Note color, symmetry, presence of exudate, swelling, ulceration, or tonsillar enlargement
Neck Inspections
(3 general, 2 regions)
General:
- Masses
- Scars
- “Enlarged glands,” lymph nodes
Trachea:
- Position
- Alignment
Thyroid gland:
- Symmetry