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Physical Diagnosis (Lauren) > HEENT > Flashcards

HEENT Flashcards

1
Q

What cranial nerve is tested with hearing

A

CN VIII

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2
Q

What CN is tested with sharp/dull face touching

A

CN V sensory

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3
Q

What CNs are tested with saying AH

A

CN IX and X

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4
Q

What CN is tested with palpating masseter muscles while clenching teeth?

A

CN V motor

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5
Q

What CN is tested with making funny faces

A

CN VII

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6
Q

What 4 motions do you ask pt to do to assess CN VII

A
  1. Raise eyebrows
  2. Squeeze eyes shut
  3. Puff out cheeks
  4. Smile with teeth
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7
Q

Which eye chart do you use from 20 ft away

A

Snellen

You want the snell family to stay at a distance

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8
Q

What is myopia

A

Impaired far vision

like MY vision.i wear glasses to see far away

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9
Q

What eye chart do you use from 14 inches away

A

Rosenbaum

You like smelling roses close up

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10
Q

What is presbyopia

A

Impaired near vision

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11
Q

The larger the denominator in someone’s vision the _____

A

Worse the vision

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12
Q

What is the direct pupillary light reflex

A

Pupil constricts on same side as light

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13
Q

What is the consensual pupillary light reflex

A

Eye without the light in it still constricts

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14
Q

What is the word for excessive pupil dilation

A

Mydriasis

myDriasis Dilation

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15
Q

What is the word for excessive pupil constriction

A

Miosis

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16
Q

What can nystagmus indicate

A

A variety of neurological conditions

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17
Q

How do you test extraocular muscles

A

BIG H pattern, stopping at upward and lateral gazes looking for nystagmus

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18
Q

When focusing on something close up do pupils get bigger or smaller

A

Constricts with near

Narrows with near

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19
Q

What do pupils do when focusing on something far away?

A

Dilate

Dilate distance

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20
Q

What CN does the lateral rectus

A

CN VI abducens

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21
Q

What CN does Superior oblique

A

CN IV trochlear

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22
Q

What CN does all the other eye muscles

A

CN III oculomotor

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23
Q

Ptosis is seen when which CN is messed up

A

CN III (levator palpebrae superioris)

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24
Q

Incomplete closure of the eye is seen when which CN is messed up?

A

CN VII

Orbicularis oculi

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25
Q

Main features of chalazion?

A

Nontender
Inside lid
Meibomian gland obstruction

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26
Q

Main features of a Hordeolum

A

Hurts
On eyelid margin
Infection of eyelash

HORdeolum HORRible

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27
Q

What is the dx: patient was sick with inclreasing congestion and pressure for 2 weeks and now has a low fever, pain, swelling and inability to open eye

A

Periorbital/preseptal cellulitis

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28
Q

What is entropion

A

Eyelid curling in. Irritates eye bc of eyelashes

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29
Q

What is ectropion?

A

Eye lid curling out… excessive tearing since puncta is not draining effectively

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30
Q

What side of the eye is a pingueculum on

A

Either side

Penguins are great on both sides of you

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31
Q

What side of the eye is a pterygium on?

A

Stretches from medial corner to cornea

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32
Q

What might be causing someone to lose the outer 1/3 of eyebrows

A

Hypothyroidism

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33
Q

What eye condition is seen with Grave’s disease (thyroid dysfunction)

A

Exopthalmos
Eyeballs popping out

Nancy Reagan had this and now she is in the grave

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34
Q

How might you tell the difference between conjunctivitis and Uveitis

A

No discharge with uveitis

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35
Q

What is a hypopyon

A

Line of inflammatory cells in anterior chamber of eye

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36
Q

What condition is associated with getting a hypopyon?

A

Uveitis

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37
Q

Does uveitis hurt

A

YES

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38
Q

Does uveitis/iritis risk vision loss?

A

Yes

39
Q

Which is worse: subconjuctival hemmorhage or hyphema?

A

Hyphema is way worse. Must refer.

You don’t have to do anything to subconjuntival hemmorhageh

40
Q

What should the cup:disc ratio be

A

<1:2

41
Q

What should the AV ratio be

A

2:3

42
Q

What side of the eye are you looking at when you look at the macula

A

Temporal

43
Q

What are hypertensive vascular changes you might see in the eyes of a HTN or DM patient

A

Copper wire

Silver wire

A-V nicking

HTN and DM patients need to wire their fridges shut

44
Q

What two things might be seen with hypertensive retinopathy?

A

Cotton wool patches

Hemorrhages

45
Q

What are 3 things you might see with diabetic retinopathy?

A

Hemorrhages
Hard exudates
Neovascularizations that are more numerous and tortuous than regular blood vessels in eye

46
Q

What would a cup:disc ratio greater than 1:2 indicate

A

Glaucoma

47
Q

What causes papilledema

A

Increased intracranial pressure

Emergency

48
Q

What is papilledema

A

Optic disc swelling due to increased ICP

49
Q

What would indicate macular degeneration during your opthalmosopic exam

A

Light reflection decreased when you ask pt to look directly at light

50
Q

What side of visual field crosses over at optic chiasm?

A

Temporal field (hits nasal side of eyeball and then crosses over)

51
Q

What would happen to vision if you had a lesion at the optic chiasm?

A

You would lose temporal vision. You would have tunnel vision (bitemporal hemianopsia)

52
Q

What could cause bitemporal hemianopsia? (Tunnel vision)

A

Pituitary tumor damaging the optic chiasm

53
Q

What would happen to vision if there was a lesion on the Right optic tract?

A

You would lose the vision on the Left half of each eye field
Left homonymous hemianopsia

54
Q

What might the conver-uncover test reveal?

A

Muscle imbalance like strabismus

55
Q

What do you do if you notice strabismus in a patient

A

Refer

56
Q

What is esotropia v exotropia?

A

Exotropia- eye drifts out laterally
Esotropia- eye drifts inward

(Ectropion and entropion involves eyelid)

57
Q

What is the difference between the corneal reflex and the corneal light reflection?

A

Corneal reflex- touching eye with rolled up cotton

Corneal light reflection- twinkle in eyes

58
Q

if BC>AC, what kind of hearing loss

A

Conductive

59
Q

if AC>BC what kind of hearing?

A

Normal OR sensorineural

60
Q

What does the Weber test tell you?

A

Which ear is better (lateralization or hearing)

61
Q

In conductive loss, which ear hears the sound in the Weber test?

A

Bad ear hears it better

62
Q

In sensorineural hearing loss, the sounds lateralizes to which ear during the Weber test?

A

Good ear

63
Q

What is a normal test result of Weber test

A

Both ears hear equally

64
Q

What is a normal Rinne test

A

AC>BC

65
Q

Weber: lateralize to R
Rinne: BC>AC in R
What type of hearing loss?

A

Conductive hearing loss in R ear

66
Q

Weber: lateralizes to L
Rinne: AC>BC in R

A

Sensorineural loss in R ear

67
Q

What quadrant of tympanic membrane do you find the cone of light?

A

Anterior and inferior quadrant

68
Q

What can cause tympanosclerosis (chalky white scarring on TM)

A

Recurrent otitis media or history of tubes or perforation

69
Q

What can cause a bulging red eardrum

A

Acute otitis media

70
Q

What can cause the eardrum to popping out and have bubbles behind it

A

Viral URI/barotrauma usually involving Eustachian tube

71
Q

WHat must be ruled out in EVERY nasal exam?

A

Septal hematoma

72
Q

What would a septal hematoma look like on exam

A

Soft tender swelling on nasal septum

73
Q

Where do 90% of all nose bleeds happen

A

Kiesselbach’s plexus

74
Q

What would cause swollen pale blue boggy turbinates

A

Allergic rhinitis

75
Q

What can cause erythematous turbinates

A

Sinusitis and URI

76
Q

Where is Whartons duct

A

Under tongue for submandibular gland

77
Q

Where is stensen’s duct

A

Behind 2nd molar up top for parotid gland

78
Q

What CN is tested when you stick tongue out and wiggle

A

CN XII hypoglossal

79
Q

What is the most common cause of lip carcinoma

A

SCC

80
Q

What can cause angular cheilitis

A

Vitamin deficiency
Excessive salivation
Dentures that don’t fit

81
Q

What does “brush the thrush” mean?

A

If you brush off the white oral lesion and its red and irritated under, you have thrush

82
Q

What is leukoplakia?

A

White spots in mouth that are possibly precancerous

83
Q

How would you tell the difference between thrush and leukoplakia?

A

Try to brush it off, and if it comes off leaving a red part underneath, it’s thrush. Leukoplakia does not brush off.

84
Q

What is the majority of oral cancer

A

SCC

85
Q

What is torus palantinus?

A

Big benign mass in middle of hard palate

86
Q

In what condition might you find numerous tonsillar crypts?

A

Tonsillar hypertrophy

87
Q

Is hairy tongue a bad thing

A

No its benign

88
Q

In what two conditions would you find bilateral exudative tonsillitis?

A

Group A Strep Exudative Tonsillitis

Mono

89
Q

What condition causes a hot potato voice

A

Peritonsillar abscess

90
Q

What would you see when you look into the throat of someone with a peritonsillar abscess?

A

UNi lateral tonsil swelling
Shifted uvula

+hot potato voice
+drooling

91
Q

What lymph nodes suggest metastasis from lung or GI cancers

A

Supraclavicular

92
Q

When do you auscultate the thyroid

A

If its enlarged. Bruits may be present in hyperthyroidism or goiter

93
Q

When palpating the thyroid for a goiter, what must you ask the patient to do

A

Swallow

Physical Diagnosis (Lauren) (3 decks)

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