HEENT Exam

Question 1

Observe head and face for symmetry and general shape or any fasiculations

Answer 1

Durrrrrhhhh

Question 2

Inspect Scalp

Answer 2

Visually inspect scalp for lesions or deformities, then symmetrically palpate scalp from front to back using rotary movements

Question 3

Palpate TMJ on both sides

Answer 3

Durrrrhhhh

Question 4

Palpate the parotid and submandibular glands on both sides

Answer 4

Parotid on cheek, submandibular below mandible

Question 5

Inspect neck for swelling, symetry or masses

Answer 5

Durrrhhhhhh

Question 6

Examine neck range of motion

Answer 6

Have Pt. look R, L, U, D, Ear-to-shoulder both sides

Question 7

Palpate bony and cartilaginous structures of neck

Answer 7

Durrrhhhhh

Question 8

Inspect the neck (all steps)

Answer 8

Visually inspect for asymmetry, swelling or masses, check movement, palpate bony and cartilaginous structures

Question 9

Exam LNs

Answer 9

Palpate on both sides the preauricular, postauricular, occiptial, tonsilar, submandibular, submental, superficial cervical, deep cervical, posterior cervical (anterior border of SCM), and in then in supraclavicular fossa. DON’T FORGET THE AXILLARY LNs!

Question 10

Inspect the thyroid gland, all steps

Answer 10

Visually inspect thyroid, have patient look up slightly if it helps, hand Pt cup of water, have Pt swallow. Stand behind Pt, place 3 fingers on either side of throat, have Pt. swallow, inspect isthmus, then have Pt. swallow and push against one side and then the other to inspect R and L lobes.

Question 11

Inspect the ear, all steps

Answer 11

Look at auricles on both sides, flip forward and look behind ear. Palpate gently looking for masses or tenderness.

Question 12

Inspect the mastoid process, all steps

Answer 12

Visually inspect the mastoid process on both sides, then palpate bilaterally

Question 13

Perform otoscopic exam of ears

Answer 13

Hold otoscope properly, L hand for L ear, R hand for R ear. Visually insert tip, pull ear up and back, w other hand, then advance scope

Question 14

Examine CNVIII, both sides (all steps)

Answer 14

Friction Test, Rhinne test (fork to mastoid process) Weber test (fork to forehead)

Question 15

Inspect nose (all steps)

Answer 15

Visually inspect nose for asymmetry, lesions or masses. Anterior and inferior surfaces. Palpate bridge and soft tissue of nose. Assess nasal patency.

Question 16

Examine nasal cavity via otoscope

Answer 16

Ask Pt to tilt head back. Hold scope in R hand, Use left to move nose up, visually insert tip, then look through viewer and advance. DO NOT TOUCH THE SEPTUM.

Question 17

Examine sinuses

Answer 17

Examine maxillary sinuses by pressing UNDER the bony ridge on each side. Exam frontal sinuses by the top of the nose.

Question 18

Visually examine lips, teeth and gums

Answer 18

Inspect lips with Pt mouth closed, look for lesions, swelling symmetry or masses. Ask Pt to clench teeth and smile, inspect teeth. Ask Pt to move lips up to inspect gums, pull lips down to inspect gums.

Question 19

Palpate gums & lips with gloved hand

Answer 19

Durrrrhhhh

Question 20

Visually inspect the oral mucosa

Answer 20

Use penlight to look inside mouth, inspect cheeks and dorsum of tongue, then ask Pt. to place tongue on roof of mouth to look at ventral surface. Don’t forget to look at roof of mouth

Question 21

Examine tongue directly

Answer 21

Grasp tongue w/ gauze and move from side to side.

Question 22

Palpate tongue and floor of mouth

Answer 22

Durrrhhhhh

Question 23

Assess CN XII function

Answer 23

Stick out tongue

Question 24

Visually inspect palate and uvula

Answer 24

Say Ahhhh