HEENT Assessment Flashcards
Common Head and Neck Symptoms
Headache, neck pain, limited neck movement, facial pain, lumps or masses, hypothyroid, hyperthyroid
inspect head for
symmetry
facial asymmetry may indicate
damage to CN VII or a stroke, acromegaly, cushing’s syndrome, periobital edema
inspect hair for
texture and color (male pattern baldness, endocrine disorders, nits, lesions, masses)
inspect neck for
lesions and limited movement
auscultation of the thyroid to
listen for bruit (might hear if enlarged)
inspect external eye structures
inspect eye brows, lashes, and eyelids; note shape and symmetry; conjusctiva, sclera, eversion of the eyelid, cornea and lens, iris, pupils
inspect internal eye structures
fundus, red reflux, anterior ocular structures, retinal structures, optic disc, blood vessels, macula
for the eye palpate
the lacrimal apparatus
distance vision
snellen’s chart documented in two numbers, with reference to what a person with normal vision sees 20 ft from the test. a large number on the bottom and 20/60 indicates diminished distance vision
near vision
usually patients older than 40 years; often have a decreased ability to accommodate; therefore they move the card further away to read
color vision
tested using ishihara cards - a patient who incorrectly identifies the embedded figures or color bars may have color blindness
corneal light reflex
instruct pt to stare straight ahead at the bridge of your nose. stand in front of the pt and shine a penlight at the bridge of pts nose, note where the light reflects on the cornea of each eye
corneal light reflex results
light reflection is in exactly the same spot in both eyes. abnormal findings indicate improper alignment and appear as asymmetric reflections
testing CN III
assess pupil
Testing CN III, IV, VI
carinal fields of gaze, pupil response, and accommodation/converge, vision testing
inspection of ears
inspect ears. ears are symmetrical, equal size, and fully formed, inspect the face. facial tone is uniform with the ears. skin is intact.
palpation of the ears
palpate the auricle. ears are firm without lumps, lymph tissue is not palpable, ears are nontender, and no pain is elicited with palpation or manipulation of the auricle. no pain occurs with palpation of the mastoid process
otoscopic evaluation in children
gently grasp the child’s ear and pull downward
otoscopic evaluation in adults
hold patient’s ear at the helix and lifting up an back to align the canal for best visualization of the TM
Normal TM is
intact and translucent and allows visualization of the short process of the malleus
a diffuse cone of light
otitis media with effusion. a perforated TM may allow for direct visualization onto the middle ear
hearing tests CN VIII
whisper test, rinne’s test, weber test
acute assessment of the nose, sinuses, mouth, and throat
epistaxis, allergens, abrupt loss of smell (brain tumor), airway obstruction, risk for aspiration
