HEENT DECK 2 Flashcards
Middle/Internal EarPhysical Exam
Pull auricle
Up and back for adults
Down and back from
pediatric pts
Identify
Boney landmarks
Cone of light
Umbo
B=red and bulging TM-
signs of acute otitis media
For peds
perform otoscope and ophthalmoscope exam at the end. pts will be more corporative.
Weber Test
hold tuning fork. strike it. place it on the midline of pts head. should hear/feel ti equally in both ears
Rinne Test
tuning fork is place aginst right mastoid bone. pt tells you when it is no longer heard. THEN PLACE NEAR EAR. air conduction should be greater than bone conduction. Ac greater than bc. measured in seconds
NosePhysical Exam
Inspect
Size, shape, color, symmetry
Palpate bridge and soft tissue
Tenderness or masses
Place speculum into nares Mucosa Turbinates swelling Septum Alignment Perforation Bleeding Crusting Color
Palpate
Frontal sinuses
Maxillary
Sinus Infection
Maxillary toothache
Purulent nasal drainage
Poor response to decongestants
NoseInfant
Observe for congenital malformations Ears Pull down, out and back for children Nose/sinuses Newborns are nose breathers Paranasal sinuses are poorly developed Mouth Check for cleft lip or palate Tongue blade can be a challenge, ask toddler’s if you can see their teeth
Mouth and Oropharynx
Inspect and palpate lips Symmetry Color Edema Abnormalities Cheilitis Deep cracked lips
Mouth/ThroatPhysical Exam
Inspect Teeth 32 teeth Clench teeth and smile CN VII-facial nerve Gums Parotid Stensen’s gland
Wharton’s gland
Submaxillary
Tongue
CN XII-hypoglossal nerve
Wharton’s gland
Submaxillary
drains saliva
Oropharynx (Throat)
Inspect Hard palate Tonsils Note size of tonsils Motion of uvula CN X Gag Reflex CN IX and X Do not need to assess if patient is swallowing
Tonsils size
+1 visibile
+2
+3 almost touching uvula
+4 touching uvula
HEENT pregnant
Increased nasal mucous secretions
HEENT Elderly
Decline in vision and hearing
Nasal mucosa may appear dryer
Dryer mucosa of mouth
