HEENT Exam Flashcards
Testing CN V Sensory and Motor
Motor: palpate the masseter muscle and have them clench their jaw
Sensory: light touch forhead, cheek, chin bilaterally with cotton tip applicator
Acromegaly
Caused by excessive growth hormone
- large hands and feet
- excessive facial bone growth, enlarged jaw
Bells palsy
Idiopathic facial nerve paralysis on one side of the face
- difficulty closing eye and flattening nasolabial fold
Testing CN II
visual acuity
Testing CN III, VI, IV
EOM
VI- lateral rectus
IV- superior oblique
CN VII
facial expressions
CN IX and X
Glossopharyngeal and Vagus
say “ah” and look for sym
CN XII
movement of the toungue
CN XI
movement of the head and shoulders
Measuring eye accuity
Snellen chart- 20ft
Rosenbaum- 14in away
the numurator is what a patient sees at 20 ft
the denomenator is the distance a normal person see that same line
20/40 a normal person could see that at 40ft
Miosis vs Mydriasis
Ansocoria
Miosis - is excessive constriction
Mydriasis- excessive dialation
Ansocoria- pupils are unequal in size
What cranial nerve keeps the eyes open and close
CN III keeps eye open so problems cause ptosis (droopy eye)
CN VII keeps eye open- problems would cause incomplete closure (seen in bells palsy)
Chalazion Vs. Hordeolum(stye)
Non tender blocked sebaceous gland that points inside the lid
tender red infection of eyelid. if on outside its from an eyelash follicle or tear gland. If on the inside its from a mribomian (sebaceous) gland
Dacryocystitis
Lacrimal sace inflammation
-inflammation or infection secondary to a blocked nasolacrimal duct.
Entropion vs ectropion
inversion of the eyelid vs eversion of the eylid
Pingueculum vs Pterygium
yellow triangle growth on bulbar conjuctiva on side of iris and it is harmless- no vision affects
thickening of bulbar conjunctivea that grows slowly across the cornea - can interfere with vision
Xanthelasma
raised yelllow well circumscribed cholesterol filled plaques
- usually because of hyperlipidemia
Episcleritis
localized occular inflammation of episcleral vessels
- central nodule with a radiation of vessels often benign and self limiting
- may be ass with autoimmune cond.
- different from injection which is just redness all over
Hyphema
vissible blood in the anterior chamber of the eye
- usually caused by trauma and it can threaten vision
Corneal abrasion
- will have foreign body sensation and possibly photophobia, increase lacrimation,
- will show up as yello spot with flourescein stain
Changes to the vasculature seen with hypertension
copper wire: vessels get full and tortuous so they are more red with a coppery luster upon reflection
Silver wire: if vessel walls have now become built up so you cannot see through them then. usually in smaller branches
A-V nicking: artery appears to break the vein (really its jist high pressure so its pushing down
Hypertensive Retinopathy
Cotton wool patches: soft exudates
- white/gray ovoid lesios with irregular borders from nerve infarction
Hemmorages caused by microaneurysms
Diabetic Retinopathy
- will see hemmorhanges with hard exudates ( creamy yellow and appear bright)
- neovascularization: the formation of new blood vessels from the disk due to abnormal permiability and vascular occlusion
Papilledema
optic disk swelling that is caused by intracranial pressure
- sharp cup and disk borders are no longer pressent
- pt may have HA and nausea
Macular degeneration
caused by the build up of drusen (cell debris)
bitemporal hemianopsia
cause defect in both temporal visual fields- problem with optic chiasm
L or R homonymous hemianopsia
lesion behind chiasm of the opposite side of the one that is affected
Esotropia, exotropia, hyertropia, hypotropia
All types of strabismus eso-eye going in exo- eye going out hyper-looking up hypo- eye looking down
Corneal light reflection tests what ?
where you touch the cornea with cotton to see a blink
- tests CN V (sensory) and VII (motor)
Gouty Tophi
deposits of uric acid chrystals after years of eleveated levels ( like in gout)
AC>BC
BC>AC
Normal or sensorineural (only if acuity is down)
Conductive hearing loss
Weber test
Put tunnin fork on head and note if there is a difference to which side is louder?
conductive- sound will lateralize to bad ear
sensorineural- sound will lateralize to good ear
