head, ears, eyes, nose, throat Flashcards
size of thyroid or presence of nodules does not…
reveal anything about thyroid function
HEENT should be assessed as…
one system
the presence of an endocrine disorder…
is a risk for another endocrine disorder
knowing lymphatic drainage patterns help to…
determine an underlying problem
sudden onset neck or jaw pain…
should be treated as cardiac until proven otherwise
subjective data of the eye
pain is never normal
trauma
vision change, acuity, field of vision
vision difficulty
eye discharge
strabismus/diplopia/amblyopia
redness, swelling
use of corrective devices
inspection of the eyes
eyelids and lashes
eyeballs
conjunctiva and sclera
cornea and lens
iris and pupils
conjunctivae inspection
inspect lower portion by pulling down the lower lid
upper lid is inspected only if the foreign body is in the eye
triangular thickening of the conjunctiva is called
pterygium
what should you look for when inspecting the conjunctiva
color, lesions, exudate
inspection of the cornea
examine clarity by shining a light
test sensitivity by touching with a cotton whisp
inspect for arcus senilis in elderly patients
iris and pupil inspection
inspect iris for pattern, color, shape
test for direct and consensual response to light
test pupils for accommodation to near and far
testing for visual acuity
test for far vision with each eye individually
always note presence of corrective lenses or contacts
normal vision is 20/20
near vision test with Jaeger card
vision scale (what does 20/20 stand for)
top number is distance in feet patient is standing from chart
bottom number is distance at which a normal person can read the line on the chart
visual fields
screened by confrontation testing extraocular muscles
if one eye does not move with the other…
consider extra ocular muscle weakness or cranial nerve dysfunction
ear subjective data
pain
discharge
hearing loss
dizziness/vertigo
tinnitus
tympanic membrane
eardrum, inspect with otoscope
nose subjective data
discharge
frequent cold symptoms
sinus pain
trauma
epistaxis
allergies
altered smell
mouth and throat subjective data
sores or lesions
sore throat
bleeding gums
toothache
hoarseness
dysphagia
altered taste
function of the nose and sinuses
odor identification
passage of inspired and expired air
humidification, filtration, and warmth of inspired air
resonance of laryngeal sounds
head and neck subjective data
headache
head injury
dizziness
neck pain
limitation in ROM
lumps or edema
TMJ
temporomandibular dysfunction
cervical lymph nodes
pre-auricular
post auricular
occipital
tonsilar
submandibular
submental
anterior cervical
posterior cervical
supraclavicular
thyroid
midline structure in neck consisting of isthmus and two lobes
moves up and down with swallowing
frequently not palpable
thyroid exam
requires a light touch
HEENT red flags(11)
- drainage from ears (possible TM rupture or skull fracture)
- cellulitis around eyes (could spread to meninges)
- eye pain
- hyphema (blood in anterior chamber of eye)
- restricted ability to open mouth (trismus or tonsilar abscess)
- swallowing difficulty (possible abscess)
- foreign body in nose, or ear canal
- sudden vision loss
- persistent, hard, non tender, immovable lymph node
- palpable supraclavicular node
- lump on thyroid
common diagnostic tests
- eye exam by optometrist or opthalmologist
- audiogram
- tympanogram (TM rupture)
- rapid strep test
- throat culture
- ultrasound/CT/MRI of neck structures
- TSH, T4, T3 evaluate the function of thyroid
common ear abnormalities
middle ear effusion(fluid)
perforated TM
pressure equalization tubes
acute otitis media (ear infection)
common mouth/oropharynx abnormalities
tonsilitis with exudate
pharyngitis
oral cavity abnormalities
leukoplakia, oral cancer, oral candidiasis (thrush)
aphthous ulcer
fissured geographic tongue
external eye abnormalities
entropion
ectropion
conjuctivitis
exopthalmos
strabismus
both eyes do not focus on an object simultaneously (EOM)
neck abnormalities
cervical adenitis, goiter
