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H&P Exam 2 > HEENT Exam > Flashcards

HEENT Exam Flashcards

1
Q

Headache “Red Flag” warnings

A

Progressively frequent or severe over 3-month period
Sudden “Thunderclap” or “Worst headache of my life!” (subarachnoid hemorrhage in 70% of cases)
New onset after the age of 50
Positional change helps or aggravates
Caused by Valsalva maneuver
With fever, night sweats, or weight loss
Patient hx of cancer, HIV, pregnancy
Recent head trauma
Associated papilledema, neck stiffness, focal neurologic deficits

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2
Q

Hair Physical Exam features

A

Quality
Distribution
Texture
Pattern of loss
Skin flaking or caking
Parasites

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3
Q

Scalp Physical Exam Features

A

Scaliness
Lumps
Nevi
Other lesions

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4
Q

Face Physical Exam Features

A

Expression
Symmetry
Involuntary movement
Edema
Masses

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5
Q

Skull Physical Exam Features

A

Observe general shape & size
Deformities
Tenderness

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6
Q

Skin Physical Exam Features

A

Color
Pigmentation
Texture
Thickness
Scars
Lesions

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7
Q

Lymph nodes on the Head/Neck:

A

Preauricular
Posterior auricular
Occipital
Tonsillar
Submandibular
Submental
Superficial cervical
Posterior cervical
Deep cervical chain
Supraclavicular

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8
Q

Neck physical exam features

A

Symmetry, masses, scars, enlarged glands or lymph nodes
Trachea – position, alignment
Thyroid gland - symmetry

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9
Q

Pupillary Reactions

A

Dilation

Constriction

Consensual reaction

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10
Q

_______ is decreased pupil size. Occurs in response to light or focusing on distant objects.

A

Constriction

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11
Q

_____ is increased size of the pupil. Occurs in the dark, when focusing on close objects, and emotional events

A

Dilation

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12
Q

The _____ is the opening between the eyelids.

A

palpebral fissure

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13
Q

Types of vision disturbances

A

HYPEROPIA - Farsightedness (Near objects appear blurry)
MYOPIA - Nearsightedness (distant objects appear blurry)
PRESBYOPIA - Farsightedness due to old age
SCOTOMA - Partially diminished or entirely degenerated area of vision. Can be a “blind spot” or a dark or distorted area

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14
Q

_____ is farsightedness

A

Hyperopia

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15
Q

______ is Nearsightedness

A

Myopia

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16
Q

Common eye presenting symptoms

A

Visual disturbances, spots (scotomas), flashing lights, pain, redness, excessive tearing, double vision (diplopia)

17
Q

Eye inspection includes what things

A
  • Position and alignment of eyes
  • Eyebrows - quantity, distribution
  • Lacrimal apparatus - Swelling of Lacrimal gland/sac
  • Eyelids: Width of palpebral fissures, Edema, color, lesions, Adequacy of closed eyelids
  • Conjunctiva and sclera: Color, vascular pattern
  • Cornea and lens - opacities
  • Iris - markings clearly defined
  • Pupils - size, shapy, symmetry, reaction to light
18
Q

How to test for visual acuity?

A

Central vision: Snellen eye chart; position patient 20 feet from the chart
Patients should wear glasses if needed
Test one eye at a time
20/20 is an average, so about 50% of population will have better vision
Near vision: hand-held card (can also use to test visual acuity at the bedside); Maxwell Quick Medical Reference has one on the back.

19
Q

What are we looking for with testing extraocular movements?

A
  • Abnormal conjugate movements
  • Nystagmus (When the eyes make repetitive, uncontrolled movements)
  • Lid lag
  • Convergence
20
Q

______ - Microinfarcts of the retinal nerve fiber layer.

A

Cotton-wool patches

21
Q

______ - Chronic hypertension causes stiffening and hardening of the arteries which displace the veins.
Causes a “nicked” appearance

A

Arterio-Venous (AV) Nicking

22
Q

_____ - Deterioration of the central portion of the retina (macula)

A

Macular Degeneration

23
Q

_____ - Swelling of the optic disc, due to ↑ intracranial pressure

A

Papilledema

24
Q

_____ Due to death of optic nerve fibers, from glaucoma

A

Optic Cupping

25
Q

Age related hearing loss is called

A

Presbycusis

26
Q

Conductive hearing loss vs. Sensorineural loss

A

Conductive loss
External or middle ear issue

  • Cerumen impaction
  • Otitis Externa
  • Otitis Media
  • Perforated TM

Sensorineural loss
Inner ear, cochlear nerve, or brain.

  • Presbycusis
  • Viral Infections
  • Meniere disease
  • Noise Exposure
27
Q

Peripheral vs. Central Vertigo

A

Peripheral: “I am spinning”
Increased nausea
Negative CNS exam
Position related changes
Horizontal nystagmus

Central: “Room is spinning around me”
Originates in the central nervous system.
Not position related
Abnormal neuro exam
Ex - lesions of cranial nerve VIII
Vertical nystagmus

28
Q

Weber Test evaluates for ____

A

Lateralization

29
Q

Rinne Test compares ____ vs _____

A

air (AC) ; bone conduction (BC)

30
Q

Hoarseness or _____ (change in voice quality)

A

Dysphonia

31
Q

Abnormal mouth and throat findings

A

Cobblestoning of Posterior pharynx
Aphthous ulcers
Oral candidiasis
Strep Pharyngitis
EBV pharyngitis
(Mono)

H&P Exam 2 (5 decks)

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