HEENT Assessment

Question 1

Common Head and Neck Symptoms

Answer 1

Headache, neck pain, limited neck movement, facial pain, lumps or masses, hypothyroid, hyperthyroid

Question 2

inspect head for

Answer 2

symmetry

Question 3

facial asymmetry may indicate

Answer 3

damage to CN VII or a stroke, acromegaly, cushing’s syndrome, periobital edema

Question 4

inspect hair for

Answer 4

texture and color (male pattern baldness, endocrine disorders, nits, lesions, masses)

Question 5

inspect neck for

Answer 5

lesions and limited movement

Question 6

auscultation of the thyroid to

Answer 6

listen for bruit (might hear if enlarged)

Question 7

inspect external eye structures

Answer 7

inspect eye brows, lashes, and eyelids; note shape and symmetry; conjusctiva, sclera, eversion of the eyelid, cornea and lens, iris, pupils

Question 8

inspect internal eye structures

Answer 8

fundus, red reflux, anterior ocular structures, retinal structures, optic disc, blood vessels, macula

Question 9

for the eye palpate

Answer 9

the lacrimal apparatus

Question 10

distance vision

Answer 10

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

Question 11

near vision

Answer 11

usually patients older than 40 years; often have a decreased ability to accommodate; therefore they move the card further away to read

Question 12

color vision

Answer 12

tested using ishihara cards - a patient who incorrectly identifies the embedded figures or color bars may have color blindness

Question 13

corneal light reflex

Answer 13

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

Question 14

corneal light reflex results

Answer 14

light reflection is in exactly the same spot in both eyes. abnormal findings indicate improper alignment and appear as asymmetric reflections

Question 15

testing CN III

Answer 15

assess pupil

Question 16

Testing CN III, IV, VI

Answer 16

carinal fields of gaze, pupil response, and accommodation/converge, vision testing

Question 17

inspection of ears

Answer 17

inspect ears. ears are symmetrical, equal size, and fully formed, inspect the face. facial tone is uniform with the ears. skin is intact.

Question 18

palpation of the ears

Answer 18

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

Question 19

otoscopic evaluation in children

Answer 19

gently grasp the child’s ear and pull downward

Question 20

otoscopic evaluation in adults

Answer 20

hold patient’s ear at the helix and lifting up an back to align the canal for best visualization of the TM

Question 21

Normal TM is

Answer 21

intact and translucent and allows visualization of the short process of the malleus

Question 22

a diffuse cone of light

Answer 22

otitis media with effusion. a perforated TM may allow for direct visualization onto the middle ear

Question 23

hearing tests CN VIII

Answer 23

whisper test, rinne’s test, weber test

Question 24

acute assessment of the nose, sinuses, mouth, and throat

Answer 24

epistaxis, allergens, abrupt loss of smell (brain tumor), airway obstruction, risk for aspiration

Question 25

common symptoms of nose, sinuses, mouth, and throat

Answer 25

facial pressure, pain, headache, snoring and sleep apnea, obstructive breathing, nasal congestion, epistaxis, halitosis, pharyngitis, dysphagia, dental pain, voice changes, oral lesions

Question 26

inspect nose for

Answer 26

integrity. inspect with otoscope (want moist and pink)

Question 27

inspect the sinuses

Answer 27

tranillumination

Question 28

inspect the mouth

Answer 28

inspect lips, noting color, moisture, lesions, and oral competence, uvula, hard and soft palate (CN IX, X )

Question 29

Inspect buccal mucosa

Answer 29

opening of the parotid duct, papilla

Question 30

inspect tongue

Answer 30

CN XII

Question 31

inspect wharton ducts and

Answer 31

salivary flow

Question 32

inspect the throat

Answer 32

if throat cancer pt will be hoarse, strep - blisters, oral cancer - irregular white patching appearance on tongue

Question 33

palpate the nose

Answer 33

tenderness and crepitus suggest fracture

Question 34

palpate the sinuses maxillary, ethmoid, and frontal sinus areas

Answer 34

tenderness or fullness on palpation suggest infection

Question 35

palpate neck to access

Answer 35

inflammatory and other changes that may occur in the throat

Question 36

anterior and posterior cervical chain lymph nodes and submental areas are

Answer 36

palpated

Question 37

for nose, sinuses, mouth, and throat percuss

Answer 37

over the maxillary, ethmoid, and frontal sinus areas