HEENT Flashcards
RESPECT MODEL
Rapport Empathy Support Partnership Explanations Cultural competence Trust
seven bones of head
2 frontal
2 Parietal
2 Temporal
1 Occipital
Head inspection elements
Tilt/tremor? Size Shape Symmetry Lesions Trauma Facial features Symmetry Shape Unusual features Tics Pallor or pigmentation variations
Head palpation elements
Symmetry Tenderness Hair texture, color, distribution Movement of scalp Sutures
Head when appropriate
When appropriate auscultate temporal arteries
Thickening
Hardness
Tenderness
HeadInfant
Measure head circumference
Compare with expected size for age and previous points on growth chart
Inspect scalp for scaling, crusting, birthmarks, dilated scalp veins, excessive hair or unusual hairline
Palpate suture lines and fontanels
Posterior fontanel closes 2 months
Anterior fontanel closes at 12-15 months
Infant head circumference is 2 cm > than chest circumference up to age 2 years
Palpate suture lines and fontanels
Posterior fontanel closes 2 months
Anterior fontanel closes at 12-15 months
Infant head circumference is
2 cm > than chest circumference up to age 2 years
Neck contains
Trachea Esophagus Internal and external jugular veins Common carotid, internal and external arteries Thyroid gland Spinal cord
NeckPhysical Exam - Inspection
Inspection Masses Webbing Excess skin folds SOB Distension of jugular veins or carotid arteries
Neck Physical Exam Palpation
Trachea Hyoid bone Thyroid cartilage Cricoid cartilage Size Shape Tenderness Masses/nodules
Thyroid GlandPhysical Exam
Inspect Palpate Anterior approach Posterior approach Displace to one side Have patient swallow Size, shape, symmetry and contour Approximately 4 mm at the broadest dimension Right lobe is 25% larger than the left Thyroid gland should move with swallowing.
Physical Characteristics of thyroid
Approximately 4 mm at the broadest dimension
Right lobe is 25% larger than the left
Thyroid gland should move with swallowing.
Thyroid should
move when the patient swallows
Older Adults - Neck
Decreased T4 production
Thyroid gland becomes more fibrotic
Pregnant - Neck
Maybe slightly enlarged as the mother provides thyroid hormone for fetus during first trimester
Eyelid
Distributes tears
Limits amount of light
Protects the eye
Conjunctiva
Clear, thin mucous membrane
Lacrimal gland
Produces tears
Eye muscles
6 muscles
Eye details
Transmits visual stimuli to the brain for interpretation 4 Rectus muscles 2 oblique muscles 3 layers Outer layer Sclera posteriorly Cornea anteriorly Middle layer/Uvea Choroid posteriorly Ciliary body/iris anteriorly Inner Layer Retina
Retina is the
Sensory nerve of the eye
Conjectiva should be
clear
red light reflex
look at something behind you. Bring the red light into each eye. If you don’t find the reflex could be due to opacity or catarax. You are testing retna
optic disc should be
1.5 mm
Internal EyePediatric
Newborn
Eyes develop during the first 8 weeks of gestation
Term infants are hyperopic
Check red light reflex
Wait until age 2-6 month for fundoscopic exam
Eyes older Adults
Presbyopia Cataracts Excessive tearing Dry eyes Tear production decreases Nocturnal eye pain Glaucoma Difficulty with perception
Eyes - Pregnancy
Occular complications due to Pregnancy induced HTN Diplopia Scotomata Blurred vision Amaurosis fugax Gestastional diabetes
Topical eye medications may cross the placental barrier
inflammation of the conjuctivea
pink eye
Conjunctivitis
Pink eye Inflammation Viral Most often viral 70% Adenovirus
Conjunctivitis - Bacteria
Bacterial
Most common is Peds
Allergic
exothalamus
bulging eyes
Xanthelasma
small odd shaped yellow colored plaques. Lipid depoists. eye lids
Pytergium
Abnormal growth of teh conjectiva. More commonly seen on the nasal side of the eye. Exposed to UV light. If growh goews over teh pupil it can effect vision. Wear sunglasses
Ptosis
dropping of upper eye lid. CN3
Strabismus
eyes do not focus silmultaniously. Lazy eye
Cataract
opacity on the lense
Cotton-wool spot
Fluffly whte spots on the retna. HTN and DIA
Auricle
visible part of the ear
Helix
prominent outer rim
Concha
Deep cavity, contains canal meatus
Tragus
Protuberance lying anterior to auditory canal
Lobule
Soft lobe on the bottom
ceruman inhibits
the growth of organisms
Middle Ear
Air filled cavity Three ossicles Malleus Incus Stapes Tympanic membrane
bones transmit sound from tympanic membrane to inner ear
typanic membrane seperates
external ear from the middle ear
Cochlea transmit sounds to the
8th cranial nerve
Semicircular cannel/vestibule has
equilibrium receptors that are involved in balance
