HEENT PE Flashcards
What are the physical characteristics of
Down Syndrome?
-Depressed Nasal Bridge
-Epicanthal Folds
-Mongoloid Slant of Eyes
-Low-set Ears
-Large Tongue
How are Xanthelasma Lesions described?
Irregularly shaped, yellow-tinted lesions suggestive of abnormality of lipid metabolism
What is Ectropion?
Eyelid turned away from the eye (may result in excessive tearing).
What is Entropion
(Pg 1541)
Eyelid turned inward toward the globe (may cause irritation, increased risk of infection).
What is a Hordeolum (stye)?
(Pg 1541)
Acute supportive inflammation (staphylococcal) of the follicle of an eyelash that forms an erythematous or yellow lump.
What is Blepharitis?
(Pg 1541)
Crusting along the eyelashes caused by bacterial infection (seborrhea, psoriasis, rosacea or allergic response).
What is Pterygium?
(Pg 1542)
Abnormal growth of conjunctiva that extends over the cornea from the limbus.
What is the common cause of Pterygium?
(Pg 1542)
Common with heavily exposure to ultraviolet light.
What are Corneal Arcus (Arcus Senilis)?
(Pg 1543)
Lipid deposited in the periphery of the cornea. Complete circle is Circus Senilis.
Key Note: Lipid = Yellow-tinted
What is Miosis?
(Pg 1543)
Pupillary Constriction to less than 2 mm.
What is Miotic?
(Pg 1543)
Pupil fails to dilate in the dark.
What is the common cause of Miotic?
(Pg 1543)
Ingestion of narcotics (morphine) or drugs that control glaucoma (weed) or just being rad.
What is Myadriasis?
(Pg 1543)
Pupillary Dilation of more than 6 mm and failure of the pupils to constrict with light.
What could Myadriasis indicate?
(Pg 1543)
Coma (Due to diabetes, alcohol, uremia, epilepsy, or brain trauma).
What eye drop medications can cause Myadriasis?
(Pg 1543)
Glaucoma medications, atropine, or strabismus management.
What is Anisocoria?
(Pg 1543)
Inequality of pupillary size.
What does yellow or green pigmentation on the Sclera indicate?
(Pg 1544)
Liver or a Hemolytic disease is present.
What does dark or slate gray pigment on the Sclera indicate?
(Pg 1544)
Senile Hyaline Plaque
What is the Kiesselbach Plexus?
(Pg 1556)
Convergence of small fragile arteries and veins located on the anterior-superior portion of the septum.
What is the most common cause of ear pain?
(Pg 1558)
HMC Weber - Diving
HMC Daly - Flying
You - ?
What are examples of Ototoxic Medications?
(Pg 1559)
Aminoglycosides (Gentamicin)
Chemotherapy (Cisplatin)
Antimalarial (Quinine)
Salicylates
Furosemide
What is the cause of Cauliflower Ear?
(Pg 1564)
Results from blunt trauma and necrosis of the underlying cartilage.
What could a low-set position or unusual angle of the auricle indicate?
(Pg 1564)
Genetic Syndrome (Down Syndrome) or be a clue to look for renal anomalies.
When preforming the Rinne Test, what should be the ratio for air vs bone conduction?
(Pg 1567)
2:1 (Air vs Bone)
Air should be heard twice as long as Bone.
What is the anterior portion of the nasal septum called?
(Pg 1570)
Kiesselbach Plexus
Crusting over the Kiesselbach Plexus may indicate what?
(Pg 1570)
The location of Epistaxis (Nosebleed).
What is the Tonsil Grading scale?
0 = Removed
1+ = Visible
2+ = Halfway between Tonsillar Pillar & Uvula
3+ = Nearly Touching Uvula
4+ = Touching each other
What could red bulge adjacent to the tonsil, that extends beyond the midline indicate?
(Pg 1576)
Peritonsillar Abscess
When staining the eye, what color slight should be used for examination?
(Pg 1579)
Cobalt Blue light source
What are the 3 groups of Nosebleeds?
(Pg 1580)
Anterior
Posterior
Mixed
Anterior bleed account for approximately what percent of epistaxis?
(Pg 1580)
90%
What are the 2 main concerns with Posterior Epistaxis?
(Pg 1580)
- Bleeding can be life-threatening if uncontrolled
- Bleeding runs down the back of the throat.
Where does the blood supply for the Nasal Septum come from?
(Pg 1580)
Internal and External Carotid Arteries.
What is the branching of blood vessels that supply the Posteroinferior Septum? (big to small)
(Pg 1580)
External Carotid Artery
Branches to: Internal Maxillary Artery
Branches to: Sphenopalatine Artery
What is the branching of blood vessels that supply the uppermost Nasal Septum? (big to small)
(Pg 1580)
Internal Carotid Artery
Branches to: Anterior/Posterior Ethmoid Arteries
What blood vessel supplies blood to the Anterior Nasal Septum?
(Pg 1580)
Superior Labial Artery- which is indirectly a branch of the Internal Carotid Artery.
Where do all arteries anastomose at in the Nasal Septum?
(Pg 1580)
Kiesselbach Plexus
What is the estimated percent of epistaxis occur at the Kiesselbach Plexus?
(Pg 1580)
95%
What is the preferred method of cauterization during epistaxis?
(Pg 1581)
Silver Nitrate sticks
How long should nasal packing be left in place for? What medication should be given?
(Pg 1582)
48 hours, Oral Antibiotics
What type of forceps should be used for anterior nasal packing?
(Pg 1583)
Bayonet Forceps
During the test to remember to start screaming: “FROM THE HALLS OF MONTEZUMA……”
In what fashion do you pack nasal packing?
(Pg 1583)
Layer packing in Accordion Fashion
How long should nasal packing be left in place for? What medication should be given?
(Pg 1583)
48 hours, Antibiotics
Epistaxis is failed to be controlled by what percent of nasal packing?
(Pg 1584)
25%
Patients should be placed on antibiotics to protect against what pathogens?
(Pg 1585)
Staphylococcus Aureus
Streptococcus Pneumoniae
Moraxella Catarrhalis
Haemophilus Influenzae
