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health assessment exam 2 > head, eyes, ears, nose and throat > Flashcards

head, eyes, ears, nose and throat Flashcards

1
Q

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

A

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

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2
Q

what techniques should be used for assessment

A

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

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3
Q

head and neck contain multiple structures

A

-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

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4
Q

expected findings of skull after inspection, palaption, and ausculation

A

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

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5
Q

expected findings for face

A 
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
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6
Q

expected findings of neck

A

muscles of the neck symmetric

shoulders equal in hight and with average muscle mass

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7
Q

range of motion (ROM) of neck

A

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

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8
Q

lympth nodes

A

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
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9
Q

assessing trachea

A

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

  • masses in neck or mediastinum and pulmonary abnormalities cause lateral displacement
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10
Q

what are parts of the eyes are included when examining eyes

A

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

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11
Q

what is the primary technique for examination of the eyes

A

inspection, with a limited amount of palpation that require gloves

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12
Q

unexpected findings of the eyes

A

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

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13
Q

equtment for inspecting the eye

A

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

extraocular movements (EOMS)
- penlight
opthalmoscope
eye cover
gloves
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14
Q

what chart do you use if client can read

A

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

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15
Q

inspecting eyes for seeing charts

A

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

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16
Q

what do you inspect to determine coordination of the eye muscle

A

assess external ocular movements

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17
Q

what to test for eye

A

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
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18
Q

expected findings of outside of eyes

A

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

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19
Q

expected findings of conjunctiva

A

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

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20
Q

expected findings for corneas, lenses, irises

A

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

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21
Q

how to examine eye

A

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

22
Q

expected findings of eyes of internal eyes

optic, retina, inside the pupil

A

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

23
Q

palpation of eye

A

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)

24
Q

PERRLA

A

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

25
Q

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

A

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

26
Q

what techniques should be used to assess ENMT

A

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

27
Q

what are you assessing the mouth for

A

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

28
Q

equitment for ENMT

A 
otoscope
wrist watch
tuning fork
nansal speculum
tongue blade
penlight
guaze square
cotton-tipped applicators
29
Q

external ears expected findings

A

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

30
Q

expected findings for internal ears

A

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

31
Q

whipser test

A

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

32
Q

rinne test

A

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

33
Q

weber test

A

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

34
Q

expect findings for outer nose

A

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

35
Q

expected findings of inner nose

A

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

36
Q

what do you use to examine internal structures of nose

A

nasal speculum

37
Q

expectd findings of lips

A

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

38
Q

expectd findings of lip color

A

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

39
Q

expectd findings of gums

A

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

40
Q

expectd findings of mucous membranes

A

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

41
Q

expectd findings of mouth

A

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

42
Q

expectd findings of teeth

A

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

43
Q

expectd findings of hard palate

A

whitish, intactm symmetric firm, and concave

44
Q

expectd findings of soft palate

A

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

45
Q

uvula

A

pink, midline, intact, and movs with vocalization

46
Q

tonsils

A 
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
47
Q

gag reflex

A

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

48
Q

speech

A

clear and artculate

49
Q

technique for palpating sinuses

A

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

50
Q

againg with eyes

A 
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

health assessment exam 2 (5 decks)

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