HEENT Flashcards
-irritation, burning, itching
-involves the lid skin, eyelashes, and associated glands
-eyes are “redrimmed”
-scales or granulations can be seen clinging to the lashes
-Crusting around the eyes upon awakening
-Greasy frothy tears
-mild entropion
Blepharitis
-localized red, swollen, acutely tender bump on the upper or lower lid
Hordeolum
-chronic
-hard, non-tender swelling on the upper or lower lid
-redness and swelling of the adjacent conjunctiva
Chalazion
- usually unilateral
-Redness of conjunctiva - No effect on vision
- Mild pain
-watery discharge
-infection easily spread
Viral Conjunctivitis
-Usually bilateral
-Itching, watery discharge,
-history of allergies
Allergic Conjunctivitis
-Redness, foreign body sensation, discharge;
-itching is much less prominent
-Purulent white-yellow discharge of mild to moderate degree
-wipe away purulent exudate in the morning
-No blurry vision, mild discomfort
Bacterial Conjunctivitis
-visible blood underneath the conjunctiva
-Red eye, foreign body sensation
-usually asymptomatic
-often in one sector
-entire view of sclera may be covered by blood
-caused by coughing, sneezing, vomiting, bearing down, constipation, or straining
Conjunctival Hemorrhage
-Caused by sunlight exposure, chronic inflammation and oxidative stress
-Wing shaped fold of fibrovascular tissue
-arising from the interpalpebral conjunctiva and extending onto the cornea
-usually nasal side of the conjunctiva
Pterygium
-Foreign body sensation
-tearing
-history of trauma
-with or without a rust ring
Ocular Foreign Body
-Severe pain, tearing, and photophobia
-History of trauma to the eye
-commonly involving a foreign object (fingernail, piece of paper, or contact lens)
Corneal Abrasion
-Pain
-Photophobia
-Tearing
-Reduced vision
-Cornea reveals a round or irregular ulcer opacity or infiltrate
-Severe ocular pain, photophobia, or blurred vision
-Risk factor contact lens wearers
Corneal Ulcer
-Hx of trauma, injury to the eye or recent ocular surgery common risk factors
-Blood or clot or both in the anterior chamber that may be black or red
-Pain
-sensitivity to light
-blurred
-clouded or blocked vision
Hyphema
-Pain
-redness
-photophobia
-vision loss
-Hypopyon (WBC pool) and fibrin within the anterior chamber
-caused by autoimmune disease or infection
Uveitis/Iritis
-Fever
-bulging eyes
-Hx of recent sinus infection, dental infection, orbital trauma
-edema and erythema of the lids
-warmth, tenderness, periorbital swelling, tooth pain
-Restricted extraocular motility with pain with eye movement
Orbital Cellulitis
-Hx of blunt force trauma to the eye
-Ecchymosis and edema of the orbital structure
-Pain on attempted eye movement and local tenderness
-Crepitus (particularly after nose blowing)
-Step off deformity along frontal sinus
-Restricted eye movement especially in upward or lateral gaze or both,
-subcutaneous or conjunctival emphysema, point tenderness
Orbital Fracture
-transient vision returns to normal within 24 hours
-Sudden, painless loss
-usually within 1 hour
-Greater than 24 HOURS
-Gradual, painless loss
Acute Vision Loss
-loss of vision in one eye that is usually rapid
-“curtain” spreading across field of vision
-no pain or redness
-recent onset of floaters
-flashes of light
-detachment seen by ophthalmoscopy
Retinal Detachment
-Numerous, microdots on the corneal surface after staining
-Usually bilateral
-Caused by sunlamp without eye protection
-Exposure to welding arc, Snow blindness
Flash Burn
-Risk factors job exposure
-Improper PPE use
-Excessive tearing
-severe eye pain
-photophobia
-inability to open eyelids
Chemical Burn
-Pain
-decreased vision
-loss of fluid from eye
-Hx of trauma, fall, or sharp object entering globe
-Low intraocular pressure
Penetrating wound to the eye
-Photophobia, pain, eye redness, and decreased vision
-History of oral or genital herpes
-Dendritic keratitis branching on stain
-Eyelid may have typical herpetic vesicular eruptions
-Palpable preauricular node
Herpetic Lesion of the Eye
-Earache, pruritus
-Painful erythema and edema of the ear canal skin
-Purulent exudate
-History of water exposure (swimmers ear) or mechanical trauma (scratching, Qtips)
-Manipulation of the auricle elicits pain
Otitis Externa
-Earache
-Usually occurs w/ URI
-Erythema and hypomobility of TM
-TM may have air bubbles in the middle ear
-Decreased hearing
-Fever
-TM bulging (rupture imminent), mastoid tenderness
Otitis Media
-Hx of recent viral URI
-Aural fullness
-Fluctuating hearing
-Mild to moderate hearing impairment
-Discomfort w/ barometric pressure change
-Swallowing or yawning may elicit a popping or crackling sound
-Retracting of TM and decreased motility
-Severe ear pain
-Fullness or “underwater sensation”,
-hearing loss or “muffled hearing”
Eustachian Tube Dysfunction
-Can occur from impact injury, acoustic trauma, middle ear infections, barotrauma, blunt, penetrating, acoustic trauma, or lightning strikes
-Acute onset of pain and hearing loss; associated vertigo or tinnitus
-Nausea and vomiting, and history of recurrent ear infections
-Otorrhea (pus, blood, or clear fluid from canal)
Tympanic Membrane Perforation
-Common cause prolonged eustachian tube dysfunction or ear infection
-Examination will reveal granulation of tissue
-Benign tumor made of stratified squamous epithelium that slowly destroys bone tissue
Cholesteatoma
-Recent air travel, rapid altitudinal change, or underwater diving
-Damage to the tympanic membrane caused by rapid changes in pressure
-TM may be bulging
-Severe inner pain
-conductive hearing loss
-possible vertigo
-Fluid in the ear canal
Barotrauma
-History of auricular trauma in subparicondural space
-Loss of normal cartilaginous landmarks caused by trauma
Auricular Hematoma
-Muffled sounds
-Severe pain
-hearing disturbances/changes
-Specific MOI
Foreign Body of the ear
-Decrease in hearing
-sensation of pressure or fullness
-Often precipitated by the use of cotton tipped applicators
-conductive hearing loss
Cerumen Impaction
-Following unresolved otitis media
-Postauricular pain and erythema
-Fever
-Edema, tenderness, protrusion of the auricle and the obliteration of the post auricular crease
-Postauricular TTP
Mastoiditis
-Hx of being around industrial machinery, weapons, loud music
-Difficulty hearing, hearing loss, ear fullness,
-Dizziness or vertigo, tinnitus
Noise induced hearing loss
-Perception of abnormal ear or head noises
-Persistent ringing of the ears
-May indicate sensory hearing loss
-Sensation of sound in the absence of noise
Tinnitus
-bleeding from unilateral anterior nasal cavity
-Nasal trauma (nose picking, foreign bodies, forceful nose blowing)
-dry low humidity
Epistaxis
-Benign nasal tumors
-Commonly seen in PTs with allergic rhinitis, asthma, alcohol intolerance, aspirin, and cystic fibrosis
-pale, edematous, mucosally covered masses
Nasal Polyps
-Crepitus
-Palpably mobile bony segments
-soft tissue hematoma “Black eye”
-Racoon eyes
-Epistaxis
-Pain of the nasal bridge
Nasal Fracture
-Clear rhinorrhea
-Sneezing
-Post nasal drip
-Conjunctival erythema
-Excessive tearing
-Eye irritation and itching
-Environmental allergen exposure
-Associated sx cough, bronchospasm, eczematous dermatitis
Allergic Rhinitis
-Purulent yellow-green nasal discharge or expectoration
-Upper jaw tenderness
-Facial pain or pressure over the affected sinuses
-Cough, malaise, fever and headache
Sinusitis
-Rapidly developing sore throat
-painful swallowing out of proportion to minimal findings
-Enlarged epiglottis
Epiglottitis
-White painless lesion that cannot be scraped or removed
-May have wrinkled “wet finger” appearance
-Most common in tobacco and alcohol users
Leukoplakia
-Severe sore throat
-difficulty swallowing
-Muffled “hot potato” voice
-trismus (lockjaw),
-medial deviation of the soft palate, peritonsillar fold, infected tonsil
-Uvula will be deviated
-drooling, dehydration
Peritonsillar Abscess
-Sore throat
-Fever
-Tender anterior cervical adenopathy
-Tonsillar exudate
-Sudden onset of sore throat
-Dysphagia
-chills
-headache
Pharyngitis/Tonsillitis
-Affects parotid or submandibular glands
-Increased pain and swelling with meals
-tenderness and erythema of the duct opening
-Pus can often be massaged from the duct
-Associated with dehydration or chronic illness
Sialadenitis
-Halitosis
-White spots seen in the tonsils
-Bad taste in the back of the throat
Tonsilloliths
