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IDC School > HEENT Physical Examination > Flashcards

HEENT Physical Examination Flashcards

1
Q

The skull is comprised of how many bones?

A

7

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2
Q

The skull is comprised of what 7 bones?

A
  • 2 Frontal
  • 2 Parietal
  • 2 Temporal
  • 1 Occipital
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3
Q

Facial muscles are innervated by what cranial nerves?

A
  • CN V
  • CN VII
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4
Q

Which cranial nerve assists with chewing and which for taste?

A

Chew - CN V
Taste - CN VII

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5
Q

What aids in chewing, digesting, and lubrication?

A

Salivary glands

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6
Q

What begins at the clavicles and sternum inferiorly and ends at the base of the skull superiorly?

A

The neck

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7
Q

The thyroid has how many lobes?

A

2

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8
Q

Which lobe of the thyroid is larger and by how much?

A

The right by 25%

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9
Q

The two lobes of the thyroid are joined by what?

A

Isthmus

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10
Q

The two lateral lobes of the thyroid are what shaped?

A

Butterfly

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11
Q

Where does the isthmus join the two lobes of the thyroid?

A

Lower aspect

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12
Q

What are expressions that depict characteristics of a clinical condition or syndrome?

A

Facies

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13
Q

A tugging sensation of the trachea suggests the presence of what?

A

Aortic aneurysm

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14
Q

What is the approximate size of the thyroid?

A

4 cm

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15
Q

What do you do if the thyroid is enlarged?

A

Auscultate for bruits

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16
Q

Tracheal deviation is associated with what?

A

Displacement by mass in the chest

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17
Q

What is a result of displacement by mass in the chest?

A

Tracheal deviation

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18
Q

Bruits over the eye and occiput is associated with what?

A

Cerebral aneurysm

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19
Q

Bruits over the temporal arter is associated with what?

A

Temporal arteritis

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20
Q

What is a result of cerebral aneurysm?

A

Bruits over the eye and occiput

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21
Q

What is a result of temporal arteritis?

A

Bruits over the temporal artery

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22
Q

What facies is associated with cushing syndrome?

A

Moon-shaped face

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23
Q

What diagnosis is a moon-shaped face associated with?

A

Cushing syndrome

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24
Q

What facies is myxedema associated with?

A
  • Puffy, dulled yellowed skin
  • Coarse, sparse hair
  • Prominent tongue
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25
Q

Puffy, dulled yellowed skin, coarse, sparse hair, and a prominent tongue are faces associated with what diagnosis?

A

Myxedema

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26
Q

What facies are associated with acromegaly?

A

Prominence of zygomatic arches

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27
Q

Prominent zygomatic arches are facies associated with what diagnosis?

A

Acromegaly

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28
Q

What facies are associated with down syndrome?

A

Mongoloid slant of eyes

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29
Q

Mongoloid slant of eyes are facies associated with what diagnosis?

A

Down syndrome

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30
Q

Lupus is associated with what facies?

A

Butterfly rash

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31
Q

A butterfly rash is a facies associated with what diagnosis?

A

Lupus

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32
Q

What facies is associated with a branchial cleft cyst?

A

Congenital lesion

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33
Q

Congenital lesions are facies associated with what diagnosis?

A

Branchial cleft cyst

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34
Q

What provides oils to the tear film?

A

Meibomian glands

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35
Q

What do meibomian glands provide?

A

Oils to the tear film

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36
Q

What are the two types of conjunctiva?

A
  • Palpebral
  • Bulbar
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37
Q

What conjunctiva coats the inside of the eyelids?

A

Palpebral

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38
Q

What conjunctiva is aka ocular and protects the anterior surface of the eye except for the cornea?

A

Bulbar

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39
Q

Tears flow over the ______, drain via the __________ to the lacrimal sac and duct, and then into the _____ ______.

A

Tears flow over the cornea, drain via the canaliculi to the lacrimal sac and cut, and then into the nasal meatus.

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40
Q

Eye muscles are innervated by what cranial nerves?

A
  • CN III Oculomotor
  • CN IV Trochlear
  • CN VI Abducens
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41
Q

What is the outer layer of the internal eye? Anteriorly and Posteriorly…

A
  • Sclera (posteriorly)
  • Cornea (anteriorly)
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42
Q

What is the middle layer (uvea) of the internal eye? Anteriorly and Posteriorly…

A
  • Choroid (posteriorly)
  • Ciliary body + iris (anteriorly)
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43
Q

What is the inner layer of the internal eye?

A

Retina

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44
Q

What is composted by the iris, ciliary body, and choroids?

A

Uvea

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45
Q

What transforms light impules into electric impulses?

A

Retina (rods and cones)

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46
Q

What should be inspected when looking at the eyelid?

A

Ability to close completely and open widely

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47
Q

What is ectropion?

A

Eyelid is turned away from the eye

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48
Q

What is it called when the eyelid is turned away from the eye?

A

Ectropion

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49
Q

What is it called when the eyelid is turned inward toward the globe?

A

Entropion

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50
Q

What is entropion?

A

When the eyelid is turned inward toward the globe

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51
Q

What is a stye known as?

A

Hordeolum

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52
Q

What is an acute inflammation of the follicle of an eyeliash that form an erythematous or yellow lump?

A

Hordeolum (stye)

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53
Q

What is crusting along the eyelashes?

A

Blepharitis

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54
Q

What does firm or resistance to palpation of the eyelid signify?

A
  • Severe glaucoma
  • Tumor
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55
Q

How do you palpatethe palpebral conjunctiva?

A

Pull lower eyelid down while the patient looks up

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56
Q

Which conjunctiva is palpable?

A

Palpebral

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57
Q

How do you palpate the upper tarsal conjunctiva?

A

Evert the lid

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58
Q

What are normal findings for conjunctiva?

A

Translucent and free of erythema

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59
Q

Allergic conjunctivitis presents with what appearance?

A

Erythematous or cobblestone

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60
Q

Bright red blood in a sharply defined area surrounded by healthy-appearing conjunctiva is defined as a what?

A

Subconjunctival hemorrhage

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61
Q

What occurs with violent coughing, sneezing, straining (bowel movement), vomiting, pregnancy labor, trauma, foreign objects, and aggressive rubbing of the eye?

A

Subconjunctival hemorrhage

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62
Q

How do subconjunctival hemorrhages resolve?

A

Spontaneously

63
Q

What may cause miosis?

A

Drugs and trauma

64
Q

What is pupillary constriction to less than 2 mm?

A

Miosis

65
Q

What is pupillary dilation of more than 6 mm?

A

Mydriasis

66
Q

What is anisocoria?

A

Inequality of pupillary size

67
Q

What is the inequality of pupillary size?

A

Anisocoria

68
Q

What is present if the sclera is yellow or green?

A

Liver or hemolytic disease

69
Q

How is liver or hemolytic disease represented in the sclera?

A

Yellow or green in color

70
Q

What do you do if the temporal aspect of the upper lid feels full?

A

Evert the lid and inspect the gland

71
Q

What is nystagmus?

A

Involuntary rhythmic movements of the eye

72
Q

What is involuntary rhythmic movements of the eye?

A

Nystagmus

73
Q

What may a lid lag indicate?

A

Thyroid eye disease

74
Q

When performing a corneal light reflex, if it is not symmetrical what do you do next?

A

Perform a cover-uncover test

75
Q

Where do you direct the light source when performing a corneal light reflex?

A

At the nasal bridge

76
Q

What is a normal finding for a corneal light reflex?

A

The light should be reflected symmetrically from both eyes

77
Q

Are aerterioles or venules smaller?

A

Arterioles

78
Q

For the cover-uncover test what is outward (away from the midline?

A

Exotropic

79
Q

For the cover-uncover test what is inward (toward the nose)?

A

Esotropic

80
Q

Lazy eye or cross eyed is known as what?

A

Strabismic

81
Q

The optic disc is typically what color?

A

Yellow to creamy pink

82
Q

What is the location of the macula in relation to the optic disc?

A

Approximately 2 disc diameters temporal to the optic disc

83
Q

The macula is AKA what…?

A

Fovea centralis

84
Q

What is the site of central vision?

A

Macula

85
Q

What are ill-defined yellow areas that may result from a vascular disease such as hypertension?

A

Cotton wool spots

86
Q

Glaucomatous cupping may present with…?

A

IOP

87
Q

What external eye abnormality can present bilaterally or unilaterally and is typically a result of Grave’s disease?

A

Exophthalmos

88
Q

What external eye abnormality would present with inflammation of superficial layers of sclera (anterior), autoimmune disorders, Chron’s disease, and RA?

A

Episcleritis

89
Q

What external eye abnormality would present with calcium deposition and horizontal grayish bands?

A

Band keratopathy

90
Q

What external eye abnormality is most common with contact lens wearing?

A

Corneal ulcer

91
Q

What internal eye abnormality has denaturation of the lens protein with age?

A

Cataracts

92
Q

Dot hemorrhages and cotton wool spots typically present with what internal eye abnormality?

A

Non-proliferative diabetic retinopathy

93
Q

What interntal eye abnormality presents with the development of new vessels?

A

Proliferative diabetic retinopathy

94
Q

What internal eye abnormality presents with a creamy white appearance of retinal vessels and has serum Triglyceride level greater than 2000 mg/dL?

A

Lipemia retinalis

95
Q

What has the “cupping” characteristic of the optic nerve?

A

Glaucoma

96
Q

Glaucoma has what specific characterisitic?

A

“Cupping”

97
Q

What abnormality is defined by an inflammatory process involving both the choroid and the retina?

A

Chorioretinitis

98
Q

What visual field defect presents with defective vision or blindness in 1/2 of the visual field?

A

Hemianopia

99
Q

What is the loss of visual fields closest to the temples?

A

Bilateral hemianopia

100
Q

A defective vision or blindness in 1/2 the visual field is known as what?

A

Hemianopia

101
Q

What is the loss of half the field of view on the same side in both eyes?

A

Homonymous hemianopia

102
Q

Loss of 1/2 the field of view on the same side in both eyes is known as what?

A

Homonymous hemianopia

103
Q

What drains mucus into the back of the nose turbinate by ciliary action?

A

Eustachian tube

104
Q

Where are the receptors for smell located?

A

Olfactory epithelium

105
Q

Which sinuses lie along the lateral wall of the nasal cavity?

A

Maxillary

106
Q

Which sinuses are superior to the nasal cavities?

A

Frontal

107
Q

Gentamicin is an example of what type of medication?

A

Ototoxic

108
Q

What is an example of an ototoxic medication?

A

Gentamicin

109
Q

What important past medical history should be obtained regarding the throat?

A

Frequent documented streptococcal infections

110
Q

What important personal/social history should be obtained regarding the nose?

A

Intranasal cocaine use

111
Q

What test helps assess unilateral hearing loss?

A

Weber

112
Q

What does the Weber test help assess?

A

Unilateral hearing loss

113
Q

When performing the Weber test, you ask the patient whether the sound if heard equally in both or better in one for what reason?

A

Lateralization of sound

114
Q

What does a positive Rinne test signifiy?

A

Normal findings

115
Q

Ratio for air to bone during the Rinne test?

A

2:1

116
Q

Flaring nostrils is associated with what?

A

Respiratory distress

117
Q

What does narrowing (on inspiration) of the nares indicative of?

A

Chronic nasal obstruction and mouth breathing

118
Q

How can chronic nasal obstruction and mouth breathing present in the nares?

A

Narrowing on inspiration

119
Q

What is purulent dischage associated with?

A
  • URI
  • Sinusitis
  • Foreign body
120
Q

How would the nasal cavity present when indicating allergies?

A

Bluish gray or pale pink with a swollen, boggy consistency

121
Q

What does a bluish gray or pale pink, swollen, boggy consistency in the nasal cavity indicative of?

A

Allergies

122
Q

A rounded, elongated mass projecting into the nasal cavity from boggy mucosa may indicate what?

A

A polyp

123
Q

What is performed if sinuses are tender? What may be present?

A
  • Transilluminate the frontal and maxillary sinuses
  • Infection is suspected
124
Q

What is chelitis?

A

Dry, cracked lips

125
Q

Pallor is associated with…?

A

Anemia

126
Q

What are thick, white patch lesions that cannot be wiped away?

A

Leukoplakia

127
Q

What is leukoplakia?

A

Precancerous oral lesions

128
Q

What is a precanerous/premalignant oral lesion known as?

A

Leukoplakia

129
Q

What cranial nerve is associated with teeth occlusion?

A

CN VII

130
Q

How does the anterior portion of the mouth and oropharynx present?

A

Should have a smooth, yet roughened surface with papillae and small fissures

131
Q

What portion of the mouth and oropharynx has a smooth, yet roughened surface with papillae and small fissures?

A

Anterior portion

132
Q

What portion of the mouth and oropharynx has a rugae or a smooth, slightly uneven surface with a thinner mucosa?

A

Posterior portion

133
Q

How does the posterior portion of the mouth and oropharynx present?

A

A rugae or a smooth, slightly uneven surface with a thinner mucosa

134
Q

What cranial nerves are being tested when the soft palate rises symmetrically with the uvula remaining in the midline?

A

CN IX and X

135
Q

How are CN IX and X tested regarding movement of the soft palate?

A

Soft palate should rise symmetrically with the uvula remaining in the midline

136
Q

What is inflammation of the middle ear resulting in the collection of serous, mucoid, or purulent fluid (effusion) when the TM is intact?

A

Otitis media with effusion

137
Q

How does otitis media with effusion present?

A

Inflammation of the middle ear resulting in the collection of serous, mucoid, or purulent fluid (effusion) when the TM is intact

138
Q

What is inflammation in the middle ear, associated with middle ear effusion that becomes infected by bacterial organisms?

A

Acute otitis media

139
Q

What type of hearing loss has reduced transmission of sound to the middle ear?

A

Conductive hearing loss

140
Q

What type of hearing loss has reduced transmission of sound in the inner ear?

A

Sensorineural hearing loss

141
Q

When inspecting the cornea with magnification, what type of light source should be used?

A

Cobalt blue

142
Q

Abraded areas of the cornea are highlighted with what?

A

Fluorescein

143
Q

Rivulets of florescein is known as what sign?

A

Seidel sign

144
Q

What should be performed before provided an eye stain to a patient?

A

Perform visual acuity in both eyes

145
Q

What do the majority of nosebleeds occur?

A

Anteriorly

146
Q

Anterior bleeds account for what percent of epistaxis?

A

90%

147
Q

What percent of nasal bleeds occur at the Kiesselbach plexus?

A

95%

148
Q

What is used to cauterize a nasal bleed?

A

Silver nitrate stick

149
Q

How do you apply a silver nitrate stick?

A

Gentle pressure for 3-10 seconds

150
Q

How do you lubricate a nasal sponge?

A

Coat all but the distal tip in petroleum jelly

151
Q

How do you layer the gauze for an anterior nose bleed packing?

A

Accordion fashion

152
Q

After packing an anterior nose bleed what is performed next after 48 hours?

A

Place the patient on antibiotics

153
Q

Anterior nasal packing patients get placed on antibiotics that cover common nasal pathogens such as what?

A

Staphylococcus aureus

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