HEENT Flashcards
what ranges in Hz should you use with a tuning fork?
256-512
test places base of fork against the mastoid process and count how long until the patient can’t hear and then is placed .5 to 1 inch from ear canal
rhinne test
air should be conducted how many times longer than bone conduction?
2 X
air conduction is longer than 2:1 ratio
sensorineural
<2:1 ratio indicates?
conduction
this test places fork on midline of head or forehead. tests for hearing equality
weber
normal hearing hears ___ in weber test
equally
sensorineural hears best in ___ ear
normal
conduction hears best in ___ ear
imparied
acute otitis media
perforation
otitis media with effusion
ability to see smal details
visual acuity
For distant vision, use a …
Snellen chart
Both eyes move parallel to each other and in six directions.
Extraocular movements
Face the patient from 2 ft away and hold out your finger 6 to 12 in. from their eyes. Have them keep their head fixed and facing forward, then direct them to follow your finger using just their eyes. Move your finger slowly and smoothly, left, right, and diagonally up and down to left and right. Watch the parallel eye movement, position of upper eyelid in relation to iris, and for abnormal movements. The upper eyelid should only slightly cover the iris as they move
extraocular movement test
is an involuntary, rhythmic oscillation of the eyes
nystagmus
caused by local eye injury or damage to cranial nerves of muscles
nystagmus
Assessing the patient’s ability to see objects in their periphery
visual fields
Have them sit or stand 2 ft. away at eye level and close one eye (left). Have them look at your directly opposite eye. You close your opposite eye. (right). Move your finger equally distant between you and the patient outside the field of vision then bring it back into the field of vision. Pt reports when they can see the finger.
test for visual fields
If you see it before them, part of their visual field is reduced
visual fields test
is common eye issue in older adults
reduced visual field
Inspect Position of the eyes in relation to one another. Should be parallel. Bulging (exophthalmos) indicates ?
hyperthyroidism
bulging of eye is called
exophthalmos
is crossed eyes, inherited or from neuromuscular injury
strabismus
protrusion of the eye indicates?
tumors or inflammation of eye orbit
course hair that doesnt go past outer canthus indicates
hypothyroidism
lid eyes turn outward
ectropion
lid edges turn inward
entropion
how many times per minute should you blink?
20 times per minute
what does PERRLA stand for?
pupils equal, round, reactive to light, accommodation
arcus senilis
white ring around iris
arcus senilis is found in ?
those over 40
what is normal pupil diameter size?
3 to 7 mm
cloudy pupil
cataracts
dilated pupil indicates
glaucoma, trauma, neuro disorders, eye meds, opioid withdrawal
is a sign of opioid intoxication
pinpoint pupils
opthalmoscope
sinuses become inflamed and swollen because?
allergies or infection
what sinus areas do you palpate?
frontal and maxillary facial areas
place a finger on the side of pts’ nose and occlude one nostril. Ask pt to breathe with mouth closed. Repeat for other side. Air should normally pass freely through the nose. what is this assessment?
patency of nares
what is normal color of nares?
pink/light red with no lesions or polyps
to view the septum ?
tip head back a bit, assess for alignment perforation bleeding. should be thicker on anterior side
pale mucosa w/clear discharge indicates?
allergies
yellow or green discharge indicates?
infection
causes puffiness and increased vascularity of mucosa
habitual nasal cocaine and opioids
can inferfere with NG tube placement
deviated septum
repeated intransal cocaine use can cause?
perforation of the septum
pallor of lips can indicate?
anemia
cherry colored lips can indicate?
carbon monoxide poisoning
brown/black discoloration of teeth indicates?
caries
yellow stains on teeth indicates?
tobacco use
brown stains on teeth indicate?
coffee, tea, cola drink staining
Heavy smokers or alcoholics may have ___ on their mucosa?
thick white patches (leukoplakia)
common site for oral cancer lesions
undersurface of tongue
is whitish and dome shaped
hard palate
is normal light pinkk, smooth in the mouth
soft palate
t/f: a bony growth between the palates is common?
true
is small spots of lymphatic tissue or blood vessels normal in the throat ?
yes, that is normal
yellow or green exudate indicates?
infection
Ask pt to flex neck with chin to chest, hyperextend neck backward, and move head laterally to each side, then sideways with ear moving toward shoulder. This tests the ______ and _____ muscles
sternocleidomastoid and trapezius
what is lymphadenopathy?
enlarged lympth nodes
are lymph nodes normally visible?
no theyre not
the trachea is part of what system?
upper respiratory system
Where is the trachea located?
midline superior to suprasternal notch
having a patient swallow can help visualize ….
an enlarged thyroid
is the thyroid gland normally able to be visualized?
no
when does the anterior fontanel close on an infant?
18 months
when does the posterior fontanel close on an infant?
8 weeks
when can babies begin to gze at and follow bright objects?
1 month
bulging of fontanels in infant could mean?
excess CSF
sunken fontanels can indicate ?
dehydration
epicanthal folds are seen in ?
infants with genetic disorders
Asian people
what is presbycusis?
gradual hearing loss
is common with age
how do you palpate the TMJ space?
fingers just anterior to the tragus of the ear
what are you palpating the skull for?
nodules or masses
where should prominences on the skull be?
frontal and occipital areas
what are normal findings with symmetry?
should have overall symmetry with slight asymetry of features
what can a head tilt to one side indicate?
hearing loss, visial loss, muscle weakness
what can horizontal jerking or bobbing of the head indicate?
tremor
if feature is asymmetrical, what can this indicate?
neurological disorder
what can infants with large heads indicate?
congential abnormalities or buildup of CSF
enlarged jaws and facial bones may indicate?
acromegaly
clicking, grating, or snapping of the TMJ possibly indicates?
degenerative joint disease
What should the upper point of the ear be even with?
outer canthus of eye
what color should the ears be?
same as face
yellow earwax normal?
yes
low set ears or unusual angles may indicate?
chromosomal abnormalities
increased pain of the external ear may indicate?
external ear infection
what should you do if pain is present around ear?
pull auricle, press tragus, palpate behind ear and on mastoid process
what color should the tympanic membrane be?
translucen, shiny pearl grey
interruption of the sound waves traveling through the ear in the outer and middle ear structures. can be caused by swelling or tears in tympanic membrane
conduction
involves the inner ear, auditory nerve, or hearing center of the brain, with transmission of sound interrupted after the point of the bony ossicles
sensorineural
is a combination of both conduction and sensorineural hearing impairment
mixed
is whitish and dome shaped
hard palate
