HEENT Physical Examination Flashcards
1
Q
The skull is comprised of how many bones?
A
7
2
Q
The skull is comprised of what 7 bones?
A
- 2 Frontal
- 2 Parietal
- 2 Temporal
- 1 Occipital
3
Q
Facial muscles are innervated by what cranial nerves?
A
- CN V
- CN VII
4
Q
Which cranial nerve assists with chewing and which for taste?
A
Chew - CN V
Taste - CN VII
5
Q
What aids in chewing, digesting, and lubrication?
A
Salivary glands
6
Q
What begins at the clavicles and sternum inferiorly and ends at the base of the skull superiorly?
A
The neck
7
Q
The thyroid has how many lobes?
A
2
8
Q
Which lobe of the thyroid is larger and by how much?
A
The right by 25%
9
Q
The two lobes of the thyroid are joined by what?
A
Isthmus
10
Q
The two lateral lobes of the thyroid are what shaped?
A
Butterfly
11
Q
Where does the isthmus join the two lobes of the thyroid?
A
Lower aspect
12
Q
What are expressions that depict characteristics of a clinical condition or syndrome?
A
Facies
13
Q
A tugging sensation of the trachea suggests the presence of what?
A
Aortic aneurysm
14
Q
What is the approximate size of the thyroid?
A
4 cm
15
Q
What do you do if the thyroid is enlarged?
A
Auscultate for bruits
16
Q
Tracheal deviation is associated with what?
A
Displacement by mass in the chest
17
Q
What is a result of displacement by mass in the chest?
A
Tracheal deviation
18
Q
Bruits over the eye and occiput is associated with what?
A
Cerebral aneurysm
19
Q
Bruits over the temporal arter is associated with what?
A
Temporal arteritis
20
Q
What is a result of cerebral aneurysm?
A
Bruits over the eye and occiput
21
Q
What is a result of temporal arteritis?
A
Bruits over the temporal artery
22
Q
What facies is associated with cushing syndrome?
A
Moon-shaped face
23
Q
What diagnosis is a moon-shaped face associated with?
A
Cushing syndrome
24
Q
What facies is myxedema associated with?
A
- Puffy, dulled yellowed skin
- Coarse, sparse hair
- Prominent tongue
25
Puffy, dulled yellowed skin, coarse, sparse hair, and a prominent tongue are faces associated with what diagnosis?
Myxedema
26
What facies are associated with acromegaly?
Prominence of zygomatic arches
27
Prominent zygomatic arches are facies associated with what diagnosis?
Acromegaly
28
What facies are associated with down syndrome?
Mongoloid slant of eyes
29
Mongoloid slant of eyes are facies associated with what diagnosis?
Down syndrome
30
Lupus is associated with what facies?
Butterfly rash
31
A butterfly rash is a facies associated with what diagnosis?
Lupus
32
What facies is associated with a branchial cleft cyst?
Congenital lesion
33
Congenital lesions are facies associated with what diagnosis?
Branchial cleft cyst
34
What provides oils to the tear film?
Meibomian glands
35
What do meibomian glands provide?
Oils to the tear film
36
What are the two types of conjunctiva?
- Palpebral
- Bulbar
37
What conjunctiva coats the inside of the eyelids?
Palpebral
38
What conjunctiva is aka ocular and protects the anterior surface of the eye except for the cornea?
Bulbar
39
Tears flow over the ______, drain via the __________ to the lacrimal sac and duct, and then into the _____ ______.
Tears flow over the cornea, drain via the canaliculi to the lacrimal sac and cut, and then into the nasal meatus.
40
Eye muscles are innervated by what cranial nerves?
- CN III Oculomotor
- CN IV Trochlear
- CN VI Abducens
41
What is the outer layer of the internal eye? Anteriorly and Posteriorly...
- Sclera (posteriorly)
- Cornea (anteriorly)
42
What is the middle layer (uvea) of the internal eye? Anteriorly and Posteriorly...
- Choroid (posteriorly)
- Ciliary body + iris (anteriorly)
43
What is the inner layer of the internal eye?
Retina
44
What is composted by the iris, ciliary body, and choroids?
Uvea
45
What transforms light impules into electric impulses?
Retina (rods and cones)
46
What should be inspected when looking at the eyelid?
Ability to close completely and open widely
47
What is ectropion?
Eyelid is turned away from the eye
48
What is it called when the eyelid is turned away from the eye?
Ectropion
49
What is it called when the eyelid is turned inward toward the globe?
Entropion
50
What is entropion?
When the eyelid is turned inward toward the globe
51
What is a stye known as?
Hordeolum
52
What is an acute inflammation of the follicle of an eyeliash that form an erythematous or yellow lump?
Hordeolum (stye)
53
What is crusting along the eyelashes?
Blepharitis
54
What does firm or resistance to palpation of the eyelid signify?
- Severe glaucoma
- Tumor
55
How do you palpatethe palpebral conjunctiva?
Pull lower eyelid down while the patient looks up
56
Which conjunctiva is palpable?
Palpebral
57
How do you palpate the upper tarsal conjunctiva?
Evert the lid
58
What are normal findings for conjunctiva?
Translucent and free of erythema
59
Allergic conjunctivitis presents with what appearance?
Erythematous or cobblestone
60
Bright red blood in a sharply defined area surrounded by healthy-appearing conjunctiva is defined as a what?
Subconjunctival hemorrhage
61
What occurs with violent coughing, sneezing, straining (bowel movement), vomiting, pregnancy labor, trauma, foreign objects, and aggressive rubbing of the eye?
Subconjunctival hemorrhage
62
How do subconjunctival hemorrhages resolve?
Spontaneously
63
What may cause miosis?
Drugs and trauma
64
What is pupillary constriction to less than 2 mm?
Miosis
65
What is pupillary dilation of more than 6 mm?
Mydriasis
66
What is anisocoria?
Inequality of pupillary size
67
What is the inequality of pupillary size?
Anisocoria
68
What is present if the sclera is yellow or green?
Liver or hemolytic disease
69
How is liver or hemolytic disease represented in the sclera?
Yellow or green in color
70
What do you do if the temporal aspect of the upper lid feels full?
Evert the lid and inspect the gland
71
What is nystagmus?
Involuntary rhythmic movements of the eye
72
What is involuntary rhythmic movements of the eye?
Nystagmus
73
What may a lid lag indicate?
Thyroid eye disease
74
When performing a corneal light reflex, if it is not symmetrical what do you do next?
Perform a cover-uncover test
75
Where do you direct the light source when performing a corneal light reflex?
At the nasal bridge
76
What is a normal finding for a corneal light reflex?
The light should be reflected symmetrically from both eyes
77
Are aerterioles or venules smaller?
Arterioles
78
For the cover-uncover test what is outward (away from the midline?
Exotropic
79
For the cover-uncover test what is inward (toward the nose)?
Esotropic
80
Lazy eye or cross eyed is known as what?
Strabismic
81
The optic disc is typically what color?
Yellow to creamy pink
82
What is the location of the macula in relation to the optic disc?
Approximately 2 disc diameters temporal to the optic disc
83
The macula is AKA what...?
Fovea centralis
84
What is the site of central vision?
Macula
85
What are ill-defined yellow areas that may result from a vascular disease such as hypertension?
Cotton wool spots
86
Glaucomatous cupping may present with...?
IOP
87
What external eye abnormality can present bilaterally or unilaterally and is typically a result of Grave's disease?
Exophthalmos
88
What external eye abnormality would present with inflammation of superficial layers of sclera (anterior), autoimmune disorders, Chron's disease, and RA?
Episcleritis
89
What external eye abnormality would present with calcium deposition and horizontal grayish bands?
Band keratopathy
90
What external eye abnormality is most common with contact lens wearing?
Corneal ulcer
91
What internal eye abnormality has denaturation of the lens protein with age?
Cataracts
92
Dot hemorrhages and cotton wool spots typically present with what internal eye abnormality?
Non-proliferative diabetic retinopathy
93
What interntal eye abnormality presents with the development of new vessels?
Proliferative diabetic retinopathy
94
What internal eye abnormality presents with a creamy white appearance of retinal vessels and has serum Triglyceride level greater than 2000 mg/dL?
Lipemia retinalis
95
What has the "cupping" characteristic of the optic nerve?
Glaucoma
96
Glaucoma has what specific characterisitic?
"Cupping"
97
What abnormality is defined by an inflammatory process involving both the choroid and the retina?
Chorioretinitis
98
What visual field defect presents with defective vision or blindness in 1/2 of the visual field?
Hemianopia
99
What is the loss of visual fields closest to the temples?
Bilateral hemianopia
100
A defective vision or blindness in 1/2 the visual field is known as what?
Hemianopia
101
What is the loss of half the field of view on the same side in both eyes?
Homonymous hemianopia
102
Loss of 1/2 the field of view on the same side in both eyes is known as what?
Homonymous hemianopia
103
What drains mucus into the back of the nose turbinate by ciliary action?
Eustachian tube
104
Where are the receptors for smell located?
Olfactory epithelium
105
Which sinuses lie along the lateral wall of the nasal cavity?
Maxillary
106
Which sinuses are superior to the nasal cavities?
Frontal
107
Gentamicin is an example of what type of medication?
Ototoxic
108
What is an example of an ototoxic medication?
Gentamicin
109
What important past medical history should be obtained regarding the throat?
Frequent documented streptococcal infections
110
What important personal/social history should be obtained regarding the nose?
Intranasal cocaine use
111
What test helps assess unilateral hearing loss?
Weber
112
What does the Weber test help assess?
Unilateral hearing loss
113
When performing the Weber test, you ask the patient whether the sound if heard equally in both or better in one for what reason?
Lateralization of sound
114
What does a positive Rinne test signifiy?
Normal findings
115
Ratio for air to bone during the Rinne test?
2:1
116
Flaring nostrils is associated with what?
Respiratory distress
117
What does narrowing (on inspiration) of the nares indicative of?
Chronic nasal obstruction and mouth breathing
118
How can chronic nasal obstruction and mouth breathing present in the nares?
Narrowing on inspiration
119
What is purulent dischage associated with?
- URI
- Sinusitis
- Foreign body
120
How would the nasal cavity present when indicating allergies?
Bluish gray or pale pink with a swollen, boggy consistency
121
What does a bluish gray or pale pink, swollen, boggy consistency in the nasal cavity indicative of?
Allergies
122
A rounded, elongated mass projecting into the nasal cavity from boggy mucosa may indicate what?
A polyp
123
What is performed if sinuses are tender? What may be present?
- Transilluminate the frontal and maxillary sinuses
- Infection is suspected
124
What is chelitis?
Dry, cracked lips
125
Pallor is associated with...?
Anemia
126
What are thick, white patch lesions that cannot be wiped away?
Leukoplakia
127
What is leukoplakia?
Precancerous oral lesions
128
What is a precanerous/premalignant oral lesion known as?
Leukoplakia
129
What cranial nerve is associated with teeth occlusion?
CN VII
130
How does the anterior portion of the mouth and oropharynx present?
Should have a smooth, yet roughened surface with papillae and small fissures
131
What portion of the mouth and oropharynx has a smooth, yet roughened surface with papillae and small fissures?
Anterior portion
132
What portion of the mouth and oropharynx has a rugae or a smooth, slightly uneven surface with a thinner mucosa?
Posterior portion
133
How does the posterior portion of the mouth and oropharynx present?
A rugae or a smooth, slightly uneven surface with a thinner mucosa
134
What cranial nerves are being tested when the soft palate rises symmetrically with the uvula remaining in the midline?
CN IX and X
135
How are CN IX and X tested regarding movement of the soft palate?
Soft palate should rise symmetrically with the uvula remaining in the midline
136
What is inflammation of the middle ear resulting in the collection of serous, mucoid, or purulent fluid (effusion) when the TM is intact?
Otitis media with effusion
137
How does otitis media with effusion present?
Inflammation of the middle ear resulting in the collection of serous, mucoid, or purulent fluid (effusion) when the TM is intact
138
What is inflammation in the middle ear, associated with middle ear effusion that becomes infected by bacterial organisms?
Acute otitis media
139
What type of hearing loss has reduced transmission of sound to the middle ear?
Conductive hearing loss
140
What type of hearing loss has reduced transmission of sound in the inner ear?
Sensorineural hearing loss
141
When inspecting the cornea with magnification, what type of light source should be used?
Cobalt blue
142
Abraded areas of the cornea are highlighted with what?
Fluorescein
143
Rivulets of florescein is known as what sign?
Seidel sign
144
What should be performed before provided an eye stain to a patient?
Perform visual acuity in both eyes
145
What do the majority of nosebleeds occur?
Anteriorly
146
Anterior bleeds account for what percent of epistaxis?
90%
147
What percent of nasal bleeds occur at the Kiesselbach plexus?
95%
148
What is used to cauterize a nasal bleed?
Silver nitrate stick
149
How do you apply a silver nitrate stick?
Gentle pressure for 3-10 seconds
150
How do you lubricate a nasal sponge?
Coat all but the distal tip in petroleum jelly
151
How do you layer the gauze for an anterior nose bleed packing?
Accordion fashion
152
After packing an anterior nose bleed what is performed next after 48 hours?
Place the patient on antibiotics
153
Anterior nasal packing patients get placed on antibiotics that cover common nasal pathogens such as what?
Staphylococcus aureus
