HEENT part 1 Flashcards
What position is indicated for HEENT exam?
Sitting up
You can still perform the assessment on someone with movement restriction (can’t sit up)
Is the atlas the first or second cervical vertebrae
Atlas on top (1), axis on the bottom (2)
What is lateral flexion of the neck
drop ear to shoulder
What is lateral rotation of the neck?
shaking head to no
What are the major skull sutures
Sagittal, coronal, lamboidal
Coronal is the frontal plane while sagittal divides into left and right
sutures are immovebale joints
What is the cranial vault
Large part of the skull that protects brain
consists of flat bones only
Where is submental lymph
under the chin
Never do what when palpating the carotid bilaterally
palpate them at the same time because they will faint
Which bone of the head is the MOST important, gives each person their face AND it protects the brain?
FRONTAL BONE
What scan is ordered when you need more detail of the brain, and what is its mechanism
CT
Uses special computers to create Xrays that make multiple images.
-diagnose stroke
-can use contrast w/ or w/o
What is contrast made of
iodine dye
What scan is ordered when you want detailed pictures of bone, organs, soft tissues, anything besides a brain? D/o you still need it for a brain?
MRI -
MOST SENSITIVE imaging test
uses MAGNETS, RADIO frequency waves, and a computer
You use it for a brain only if the CT scan doesn’t show pathology because its $$$
What are the 14 FACIAL bones? (not cranial)
- zygomatic X 2
- vomer
- palatine
- nasal X 2
- maxillae X 2
- lacrimal X 2
- inferior nasal conchae X 2
What is cardinal fields of gaze?
testing extra-ocular movement when creating the H pattern
how to remember eye movements cranial nerves
LR 6
SO 4
O 3
- lateral rectus is innervated by cranial nerve 6. movement is looking upwards (superiorly). Rectus means erect, like a muscle contracting.
superior oblique is innervated by cranial nerve 4, movement is looking down & out. this is abduction and rotation.
oculomotor (all the rest of the eye muscles) is innervated by cranial nerve 3.
Why does the eye rotate
because when you move your head via ear to shoulder, your eyes rotate slightly to stay in place while your body moves.
What is PERRLA
pearly white, equal in size and shape, Round and reactive means they get smaller/bigger when the lights turn on or off.
accomodation = converge and pupils CONSTRICT when looking at near object.
also the other pupil constrict if a light gets shown in the other eye.
you have to have the light to see if the eyes are pearly.
pupils are equal in size and shape, round and reactive to Light, accomod
How far away to assess for visual ACUITY
acuity means see how far away you can ready
must be 20 feet away, or 20 tiles in the classroom since each tile is 1 foot
What does 50/20 mean
what perfect vision can see at 50 feet is what the patient sees normally
How many cranial bones and name them
frontal
parietal X 2
temporal X 2
Occipital
ethmoid
sphenoid
How many bones in the skull
22
What are immovable joints in the skull called
Sutures
What test for visual acuity in our classroom lab checkoff
Snellen
What is the temporal artery
its a major artery of the head
The top of the ear should be in line with the
outer canthus
If its a little bit lower than thats indicative of down syndrome esp. on babies.
Where is the temporal artery palpable? What artery does it branch from
In front of the ear (anterior to the tragus)
AND above the zygomatic arch
it branches from the EXTERNAL carotid artery. EXTERNAL carotid artery means that it is on the OUTSIDE of the skull which is why you can PALPATE it.
dont forget to do what later
take the pictures that were unit conversations from ATI and put them into brainscape
also include my king henry unit conversions
whats the TMJ joint type? What is its function?
a hinge joint connecting the upper temporal bone (part of the skull) and the mandible, the lower jawbone; allows the jaw to move forward, backward, and side to side
What is the TMJ made of?
hint: think cartilage
an articular disc made up of fibrocartilaginous tissue is positioned between the two bones.
think cartilage frisbee stuck inside the jaw
What is a clear outline around the maxillary or frontal sinus?
transillumination (the technique of shining a light into the cavity) is bouncing light off of the mucus stick inside the cavity.
diffuse light is normal. clear outline is abnormal.
maxillary has a terrible drain system. mucus trapped in the maxillary is a nice, warm, comfy house for bacteria to grow.
Parotid glands do what? Where are they located?
They create saliva so that you can eat and food.
Once the saliva is produced inside the gland, it travels down the duct like a tunnel, and empties inside the mouth into stensens ducts.
(not on test) if you have a dry mouth and if you feel around with your tongue and feel a hard spot next to your upper 2nd molar, you could have a blocked salivary gland.
How to remember that olfactory is smell? How to remember cranial nerve 1?
Paper factories are smelly.
you have ONE nose. cranial nerve ONE.
What to use to test smell
mint (hospitals carry), coffee grounds, alcohol swabs in the classroom
How to test for trigeminal CN V
Tri means BRANCHES (3)
but its cranial nerve 5.
how to remember cranial nerves?
Oh Oh Oh, to touch and feel virgin girl vaginas ah heaven
Oh, Oh, Oh, To Touch And Feel Very Good Velvet, ah heaven
i know its gross but its the only way i can remember, sorry XD
1 nose
2 eyes
3 eyes motor
4 trochlear eye movement
5 trigeminal
6 abducens eye movement
7 motor facial expressions
8 hearing
9 swallowing Glossopharyngeal
10 vagus (ahhhhh) and uvula rise
11spinal accessory shrug shoulders
12 stick tongue out. light tight dynamite?
How to test hypoglossal
tongue should be MIDLINE when they stick it out FIRST, and then go from left to right, up and down when instructed. if patient sticks tongue out to the side, there could be a nerve problem
Wharton’s ducts - where are they, what are they connected to
lower oral cavity, connected to the submandibular gland
underneath of tongue. only visible when patient lifts their tongue straight up
Sinuses function
- give voice resonance
- without sinuses, weight of skull would be too heavy.
Describe the paranasal sinuses
para = next to.
nasal = nose.
- frontal
- ethmoid
- sphenoids
- maxillary
which paranasal sinus is the largest
maxillary
located behind the cheekbones and below the eyes
which paranasal sinus are unable to be palpated
ethmoid and sphenoid
they are both deeper in the skull
ethmoid are between?
the eyes
what sinus is behind the nasal cavity
sphenoid
What imaging test is used to examine the sinuses?
CT.
to help dx infection, nasal polyps, birth defects, abnormalities of the sinuses
Is nose composed of bone or cartilage
both.
what is the primary function of the nose
smell
the secondary functions are inhaling, exhaling, moistening, and filtering the air.
that’s why mouth breathers are worse off
Where are the receptors for cranial nerve 1 located
upper part of the septum and nasal cavity
CN 1 is the nose, which is responsible for smell.
What is the nasal septum made of?
Blood vessels, cartilage
cartilage never stops growing which is why old people have big noses
cartilage needs blood vessels to grow so thats why it has them
What are turbinates for
the superior, middle and inferior turbinates
they are the BONE of the nose that creates the tunnels
- Cleanse air
- Moisten air
- Warm air
What adenoids for
Clusters of lymph behind the nose for IMMUNE system
What is the first portion of the alimentary canal
oral mucosa
What is oral mucosa for? functions
- ingestion
- digestion
What marks the transition of the mucous membrane of the mouth to the skin?
lips
what are buccal mucosa
Lateral walls of mouth
Soft palate location, function, and what its attached to
- soft palate is further back in the mouth while the hard palate is in the front of the mouth and is a part of the maxillary bone.
- soft palate acts as a door to close the mouth when you swallow (so that food doesnt go backwards)
- the uvula is an extension of the soft palate. its the punchbag in the back of the throat
Hard palate has what kind of epithelium
stratified squamous epithelium
stratified squamous because it has many layers so that when food is chewed, theres more layers underneath to protect the mouth
What is the largest and strongest bone of the face?
Mandible (jaw bone)
Name three salivary glands
parotid, submand, submental
What do the salivary glands do
secrete saliva which helps with DIGESTION and MOISTURE
In dark skinned people, what color is normal for Stensen’s ducts
darker is normal (can be light pink too like light skin patients)
How many permanent teeth do people have
32
if wisdom teeth are removed, its 28.
What are gingiva?
gums have insoluble protein mucosa.
its the area around the root of a tooth.
what is CEMENTUM vs
ALVEOLAR BONE
cementum is the surface area of the tooth root. (think hard cement is a foundation to a hard tooth)
alveolar bone contains the tooth socket.
gingiva attach to these
What purpose does tongue serve
- organ of taste. thousands of taste buds cover the surface of papillae.
- swallowing
- speech
