HEENT Flashcards
eyes are red rimmed and scales or granulations can be seen clinging to the lashed
Anterior Blepharits
eyelid margins are hyperemic with telangiectasia and the meibomian gland and their oriflces are inflamed
posterior blepharitis
acute infection
localized eyelid tenderness
may also not “pointing of mucopurulent material”
Hordeolum
chronic focal granulomatous inflammation within the eyelid tissue
hard and nontender nodule in the eyelid
chalazoin
inching, burning, tearing, gritty, or foreign body sensation
Hx if URI or contact within someone with viral conjunctives
unilateral
watery discharge, red and edematous eyelids
viral conjunctivitis
itching watery discharge and a Hx of allergies
Bilateral
allergic conjunctivitis
redness, forehin body sensation, discharge itching much less prominent
purulent white yellow discharge of mild to moderate degree
complain of having to wipe purulent exudate in the morning
Bacterial Conjunctivitis
Severe purulent discharge
hyperacute onset (within 12 to 24 hours)
Usually acquired through contact with infected genital secretions
Exam findings:
Tender palpable preauricular lymph node
Gonococcal Conjuctivitis
Red eye, foreign body sensation, usually asymptomatic unless there is associated chemosis
Red eye, foreign body sensation, usually asymptomatic unless there is associated chemosis
Conjuctival 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 in location
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
Cornea reveals a round or irregular ulcer opacity or infiltrate
Severe ocular pain, photophobia, or blurred vision
Risk factor contact lens wearers
Corneal Ulcer
Trauma or recent ocular surgery are the most 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, history of blunt trauma
Hyphema
Pain, redness, photophobia, visual loss
hypopyon (WBC pool) and fibrin within the anterior chamber
Uveitis/Iritis
Risk factors:
Paranasal sinus infection, dental infection, orbital trauma
eyelid edema, erythema, warmth, tenderness, periorbital swelling, tooth pain
restricted extraocular motility with pain with eye movement
Orbital Cellulitis
Pain on attempted eye movement and local tenderness, eyelid edema, 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, usually within 1 hour
Acute Vision Loss
Flashes of light, floaters, a curtain or shadow moving over the field of vision, peripheral or central visual loss, or both
Risk factors
50 y/o
Nearsightedness
Cataracts
Retinal Detachment
Caused by use of a sunlamp without eye protection, exposure to a welding arc, or snow blindness
Numerous, microdots on the corneal surface after staining
Flash Burns
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 eye
Photophobia, pain, eye redness, and decreased vision
History of oral or genital herpes infection
Dendritic keratitis branching
Eyelid may have typical herpetic vesicular eruptions
Palpable preauricular node
Herpetic Lesion of the eye
History of auricular trauma in subparicondural space
loss of normal cartilaginous
landmarks caused by trauma
Auricular Hematoma
Muffled sounds
Severe pain, and
hearing loss
Specific MOI
Foreign Body of the Ear
Decrease in hearing, and/or sensation of pressure or fullness
Often precipitated by the use of cotton tipped applicators
(conductive hearing loss)
Cerumen Impaction
Complication from acute otitis media (ask medical Hx)
Postauricular pain and erythema accompanied by a spiking fever
Edema, tenderness, protruion of the auricle and the obliteration of the post auricular crease
Mastoiditis
Painful erythema and edema of the ear canal skin accompanied by purulent exudate
History of water exposure
(swimmers ear) or mechanical trauma (scratching, Qtips)
Otitis Externa
Decreased hearing, fever, and history of URI
Erythema and hypomobility of tympanic membrane
Severe - TM bulging (rupture imminent), mastoid tenderness
Common causes are and influenza
Otitis Media
Severe ear pain
Fullnes or “underwater sensation”, hearing loss or “muffled hearing”
Tinnitus
“Popping or snapping noises”
Eustachian Tube Dysfunction
Can occur secondary to middle ear infections, or as a result of 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)
TM Perforation
Common cause prolonged eustachian tube dysfunction
Examination will reveal an granulation tissue
Benign tumor made of stratified squamous epithelium that slowly destroys bone tissue
Cholesteatoma
Damage to the tympanic membrane caused by rapid changes in pressure
most common etiology is flying
Severe inner pain, conductive hearing loss, possible vertigo, specific MOI to include symptoms associated with changes in inner ear pressure
TM may be bulging in appearance
Fluid in the ear canal
Barotrauma
Hx of being around industrial machinery, weapons, loud music
Difficulty hearing, hearing loss, ear fullness, dizziness or vertigo, tinnitus
Noise Induced Hearing loss
hearing loss, headache, noise intolerance, vertigo, TMJ dysfunction
“ringing noise”
Tinnitus
Acute , unilateral bleeding from the anterior nasal cavity is the most common presentation
Epistaxis
Commonly seen in PTs with allergic rhinitis, asthma. Alcohol intolerance, aprin, and cystic fibrosis
Nasal Polyps
Crepitus, black eye
Epistaxis, pain, soft tissue hematomas (black eye)
Possible palpable step-off of the infraorbital rim
Nasal Fracture
Clear rhinorrhea, post nasal drip
conjunctival erythema, excessive tearing
Environmental allergen
exposure in the presence of allergen specific IgE
Allergic Rhinitis
Purulent yellow-green nasal
discharge or expectoration
Upper jaw tenderness
Facial pain or pressure over the affected sinus or sinuses
cough, malaise, fever and headache
Sinusitis
Rapidly developing sore throat or difficulty swallowing is out of proportion to findings
Epiglotitis
White painless lesion that cannot be scraped or removed
May have wrinkled “wet finger” appearance
most common tobacco and alcohol users
Leukoplakia
swallowing,
muffled “hot potato” voice
trismus (lockjaw), inferior and medial displacement of the infected tonsil, swollen uvula,
Uvula will be deviated, drooling, dehydration
Peritonsillar Abscess
Sudden onset of sore throat, painful swallowing, chills, fever, headache, nausea, and vomiting
Fever >100.4
Tender anterior cervical lymphadenopathy
NO cough
pharyngotonsillar exudates
petechial pattern
Pharyngitis/Tonsilitis
Acute swelling of the 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
Sialadenitis
Halitosis
White debris
Bad taste in the back of the throat
Tonsiloliths
