HEENT/Neck Flashcards
What are you looking for when inspecting the optic disc? (3)
- clarity of disc outline
- normal yellowish/orange-pink color
- symmetry between eyes
Swelling of the optic disc indicating increased pressure due to meningitis, subarachnoid bleed, trauma or mass lesions is called _____
papilledema
What are you looking for when looking at the blood vessels of the retina?
- thin, bright red arteries that have a brighter reflection
- venous pulsations normal
- Points of AV crossing (normally you’ll see both vessels distinctly where they cross each other)
How do blood vessels of the retina look different in hypertensive patients?
- there is medial hypertrophy of the arterial walls so the walls of the artery partially conceal the crossing vein. This appearance is called “A-V nicking”
Where would you look for “cotton-wool” spots?
- fovea and macula (lateral to the optic disc)
What are the 2 ways to inspect the sinuses (ethmoid, frontal, maxillary, sphenoid)
- palpation
- transillumination
What are the key physical findings associated with a normal tympanic membrane?
- clear, gray and thin with the outline of the malleus and incus
What does a concave eardrum suggest?
- nothing, this is normal (but apparently a “retracted” eardrum is pathological?)
What does a bulging eardrum suggest?
- pathology
CN XII lesion results in the tongue deviating away or towards the lesion?
- towards the lesion
CN IX/X lesion results in the uvula deviating away or towards the lesion?
- away from the lesion
Weber test
- tests lateralization of hearing
- place buzzing tuning form on the vertex of head or in mid forehead and ask the patient which ear it’s loudest in
- if the sounds are equal this is normal
When there’s inadequate neural transmission of sound during the weber test and the sound lateralizes to the normal ear this indicates ______
- sensorineural hearing loss
when there’s a problem conducting the sound into the cochlea, (usually due to increased fluid, obstruction or perforation of the tympanic membrane) during the weber test so the sound is louder in the affected ear, this indicates _______
conductive hearing loss
Rhine test
air vs. bone conduction of sound
- tuning fork on mastoid process until the patient can’t hear the sound and then moving it in front of the ear and seeing how long it takes them to not hear the sound
- normally: air conduction is twice as long as the bone conduction
