HEENT evaluation Flashcards
for exam may need:
gloves, tongue depressor, otoscope,
IAPP
Inspect
Auscultate
Palpate
Percuss
if get stuck during quiz
Ask self: “Do I need to inspect, auscultate, palpate, and/or percuss And have I done it?”
Before ear exam:
ask about pain when: pull auricle up and down, push on tragus/ mastoid process, palpate lymph nodes (just anterior, inferior, and posterior to ear)
For otoscopic exam
pull auricle up, out, and back
Ear exam if clear
canal is patent (see all the way to TM)
Ear exam if impacted
“canal is obstructed by cerumen”
If you see something
ask about it– (white TM may indicate ear infections as child)
Don’t use peroxide if
can’t visualize TM integrity
For TM record
color, mobility, light reflex, visibility of boney landmarks
nose exam
externally palpate cartilage and bones (nose is symmetrical, with/out evidence of trauma, no pain w/ palpation)
have pt occlude each nostril and breath in
patency
Inspection of nasal passage
insert otoscope short way and visualize septum and turbinates (lower and middle)
Nasal mucosa is
pink (blue tinge if pt has allergies) and moist, septum is intact, turbinates normal as visualized”
when doing nasal exam
have pt hold breath so no fog–hold breath with pt
also palpate
frontal and maxillary sinuses (up and under firmly)
for mouth exam (outside)
color of lips and perioral tissue
inside mouth (palpate)
lips, buccal mucosa, tongue, mouth floor
percuss teeth
w/ tongue blade–ask about pain (sinuses or teeth)
when person says ahhhh
make sure uvula rises
soft palate rising tests
CN X
ask pt to stick tongue out straight (like kid)
note symmetry
for tongue
grab with gloves and gauze to look for cancer at corners
palpate–counter pressure with other hand
lips, buccal surface, tongue, underneath tongue (for pain or anything not soft)
