head, eyes, ears, nose and throat

Question 1

what body parts are included in an examination of head and neck

Answer 1

includes the skull, face, hair, neck shoulders, lymph nodes, thyroid gland, trachea position, carotid arteries, and jugular veins

Question 2

what techniques should be used for assessment

Answer 2

inspection, palpation, and ausculation to examine the head and neck and the use of a stethoscope

Question 3

head and neck contain multiple structures

Answer 3

-skill encloses the brain
- facial structures include eyes, ears, nose, and mouth
- neck structures include:
the upper portion of the spine
esophagus
trachea
thyroid gland
arteries
veins
lymph nodes

Question 4

expected findings of skull after inspection, palaption, and ausculation

Answer 4

size (normocephalic)
no depressions, deformities, masses, tenderness
overall contour and symmetry

Question 5

expected findings for face

Answer 5

symmetry of facial features
symmetry of expressions
no involuntary movements 
able to clench teeth
client close their eyes
feel touch when touches
fasical movements and symmetry

Question 6

expected findings of neck

Answer 6

muscles of the neck symmetric

shoulders equal in hight and with average muscle mass

Question 7

range of motion (ROM) of neck

Answer 7

moving the head smoothly and without distress in the following directions:

• chin to chest (flexion)
• ear to shoulder bilaterally (lateral flexion)
• chin up (hyperextension)

place your hands not he client shoulders and ask them to shrug their shoulders against resistance
turn the head against resistance of your hand

Question 8

lympth nodes

Answer 8

chains of lympth nodes extend from the lower half of the head down into the neck
- palpate each node for enlargement, in the following sequence:

1. supraclavicular nodes: above the clavicles
2. lympth nods are usually difficult to palpate and not tender or visible
3. evaluate any enlarged nodes for location, tenderness, size, shape, consistency, mobliltiy, and warmth

Question 9

assessing trachea

Answer 9

inspect and palpate for any devisation from midline above the suprasternal notch

• masses in neck or mediastinum and pulmonary abnormalities cause lateral displacement

Question 10

what are parts of the eyes are included when examining eyes

Answer 10

external and internal anatomy of the eye, visual pathways , fields, visual acuity, extraocular movements, and reflexes

Question 11

what is the primary technique for examination of the eyes

Answer 11

inspection, with a limited amount of palpation that require gloves

Question 12

unexpected findings of the eyes

Answer 12

loss of visual fields, asymmetric corneal light refelx, periorbital edema, conjunctivtis, and corneal abrasion

Question 13

equtment for inspecting the eye

Answer 13

snellen and rosenbaum charts
eye cover
ishihara test: for color blindness

extraocular movements (EOMS)
- penlight
opthalmoscope
eye cover
gloves

Question 14

what chart do you use if client can read

Answer 14

snellen chart, rosenbaum chart, or newspapers to measure visual acuity

Question 15

inspecting eyes for seeing charts

Answer 15

make sure glasses and contacts are on for test
ensure reading material is in clients language
have client read smallest line of print visible
note smallest line read

Question 16

what do you inspect to determine coordination of the eye muscle

Answer 16

assess external ocular movements

Question 17

what to test for eye

Answer 17

assess for parallel eye movemnts, postion of the upper eyelid , and the presence of abnormal eye movement when client looks in each direction

test the corneal light reflex by directing a light onto the eyesand look to see if the reflection is symmetric on the corneas

screen for strabismus- abnormal eyes shaking

• cover one eye, ask client to look in one direction, remove cover and expect both eyes to be gazing in same direction

Question 18

expected findings of outside of eyes

Answer 18

eyes parallel to eachother without bulging
eyebrows symmetric from inner to outer canthus: can raise and lower symmetrically
eyelds close completely and open
eyeslahses curving outward with no inflammation
no edema or redness in the area of the lacrimal gland s

Question 19

expected findings of conjunctiva

Answer 19

palperbal pink
bulbar transparent
scelerae will be white in those who have fair skin, light yellow with brown macules in clients who have dark complexion

Question 20

expected findings for corneas, lenses, irises

Answer 20

corneas clear, shinny, and smooth
lenses clear, cloudy, with cataracts
irises round and illuminating fully when u she a light across from side to side
partially illuminated iris indicated glacoma. note colors of irises

Question 21

how to examine eye

Answer 21

eyes should be examined in a dark room
with opthalmoscope-use the lens selctor disc to find large white disc
use your right eye to examine clients right eye
instrct client to state at a point somewhere behind u

Question 22

expected findings of eyes of internal eyes

optic, retina, inside the pupil

Answer 22

optic disc is light pink or more yellow than the surrounding retina

the retina is without lesions. th ecolor will be dark pink in those with dark complexion and light pink in those who have fair skin

without pupil dilation, you might only glimpse the macula when the client looks directly at the light

Question 23

palpation of eye

Answer 23

palpate the lacrimal apparatus to assess for tenderness and to express any discharge from the lacrimal duct

no tenderness, no discharge, and clear fluid (tears)

Question 24

PERRLA

Answer 24

P: pupils clear
E: equal and between 3 to 7 mm in diameter
RL: reactive to light both directly and consensually when you direct light into one pupil and then the other
A: accommodation of the pupils when they dilate to look at an object far away and then converge and constrict to focus on a near object

Question 25

what does the ears, nose, mouth, and throat (ENMT) examination include

Answer 25

external, middle, and internal ear; evaulation of hearing; nose and sinuses; and the mouth and throat

Question 26

what techniques should be used to assess ENMT

Answer 26

insepction, palpation to examine the ears, nose, sinueses, mouth, and throat

Question 27

what are you assessing the mouth for

Answer 27

soft palate and the gag refelx swallowing and speech quality tongue: movement and strength

Question 28

equitment for ENMT

Answer 28

``` otoscope wrist watch tuning fork nansal speculum tongue blade penlight guaze square cotton-tipped applicators ```

Question 29

external ears expected findings

Answer 29

the auricles should be of equal size and level with one another ear color matching face color no lesions, deformities, or tenderness no foreign bodies or discharge pull ear up and back

Question 30

expected findings for internal ears

Answer 30

typanic membranes are pearly gray and intact, tuat, and free from tears light reflex is visible and in a well-defined cone shape external ear canal can vary but is consistent with client's skin color cerumen might be present in ear canal moist cerumen is light brown to gray

Question 31

whipser test

Answer 31

occlude one ear and test the other to see if client can hear whispered sounds without seeing your mouth move expected finding: client can hear you whipser softly from 30 to 60 cm (1 to 2ft) away

Question 32

rinne test

Answer 32

place a vibrating tunning fork firmly against the mastoid bone have client state when they an no longer hear the sound note the length of time that the client heard the sound

Question 33

weber test

Answer 33

place a vibrating tunning fork on top of clients head ask whether the client can hear the sound best in the right, left or both eqally expect: client hears sound equally in both ears

Question 34

expect findings for outer nose

Answer 34

midline, symmetrial, same color notstril is patent withtout excessive flaring structure is firm and stable

Question 35

expected findings of inner nose

Answer 35

septum is midline and intact mucous membranesa are redder than the oral muscosa and moist with no discharge or lesions can identify smell

Question 36

what do you use to examine internal structures of nose

Answer 36

nasal speculum

Question 37

expectd findings of lips

Answer 37

darker pgimented skin than the face and are moist, symmetric, smooth, with no lesions, and nontender

Question 38

expectd findings of lip color

Answer 38

range from pink in clients who have pale skin to plum for clients who have dark skin

Question 39

expectd findings of gums

Answer 39

tight against teeth with no bleedingon gloves from palpation uniform: in pink color, dark- skinned clients can have bluish/brown patches of pigmintation

Question 40

expectd findings of mucous membranes

Answer 40

pink and moist with no lesions and some freckled brown pigmentation for dark-skinned clients hyperpigmentation can occur after age 50 years old

Question 41

expectd findings of mouth

Answer 41

dorsal surface is pink, presence of papillae and symmetric underside is smooth can move tongue up and down side to side tongue is midline, moist, free of lesions, and moves freely

Question 42

expectd findings of teeth

Answer 42

shiny, white and smooth no missing teeth yellow or darkned teeth are common in older adults

Question 43

expectd findings of hard palate

Answer 43

whitish, intactm symmetric firm, and concave

Question 44

expectd findings of soft palate

Answer 44

light pink, intact, smooth, symmestric, and moves with vocalization

Question 45

uvula

Answer 45

pink, midline, intact, and movs with vocalization

Question 46

tonsils

Answer 46

``` same color as surrounding muscosa and vary in size and visibility +1 barley visible +2 halfway to the uvula +3 touching the uvula +4 touching each other or midline ```

Question 47

gag reflex

Answer 47

elicit by using a tongue blade to stimulate the back of the throat

Question 48

speech

Answer 48

clear and artculate

Question 49

technique for palpating sinuses

Answer 49

palpat the frontal sinuses by pressing upward with the thumbs from just below the eyebrows on either side of the bridge of the nose palpate the maxillary sinueses by pressing upward at the skin crevices that run from the sides of the nose to the corner of the mouth shouldn't be tender

Question 50

againg with eyes

Answer 50

``` decrease visuals, accomondation difficulty distinguishing colors intolerance to glare delayed pupillary reaction to light yellowing of lesne thin gray rings surrounding the cornea loss of lateral third eyebrows decrease in lens opacity ```