HENT

Question 1

What to examine in HENT exam?

Answer 1

hair
scalp
skull
face
skin

Question 2

What are the 4 cardinal signs of inflammation?

Answer 2

redness
pain
swelling
heat

Question 3

What is the difference primary/secondary headache?

Answer 3

• primary: without identified underlying disease (more likely benign)
• secondary: due to underlying disease such as bleed in brain (could be more lethal)

Question 4

What are possible associated symptoms with headache?

Answer 4

fever
vertigo
visual changes
neurological changes
neck pain
n/v

Question 5

What are the terms to describe normal head exam?

Answer 5

normocephalic
atraumatic head
hair with normal texture and distribution

Question 6

What is hematoma?

Answer 6

• ecchymosis/edema (collection of blood)

Question 7

What to palpate on face for exam?

Answer 7

temporal arteries
TMJ
frontal and maxillary sinuses
parotid gland
sensation

Question 8

What is acromegaly?

Answer 8

Enlarged and elongated jaw and head

due to too much growth hormones

Question 9

What is cranial nerve 7 palsy and how to differentiate it from stroke?

Answer 9

• bell’s palsy
• asymmetric face with facial droop and one side of forehead wrinkled
• stroke: facial droop but all of forehead involved (wrinkled)

Question 10

How to identify down’s syndrome?

Answer 10

almond faced eyes
small ears
flat and round face

Question 11

How to identify mumps?

Answer 11

• facial salivary glands swelling (neck, cheeks) due to viral infection

Question 12

how to identify cushing’s syndrome?

Answer 12

moon facies (round) in adults
erythema

Question 13

how to identify myxedema?

Answer 13

• hypothyroidism
• hair loss
• swelling around eyes
• facial edema

Question 14

What is mask facies?

Answer 14

• no movement in facial expression
• scleroderma (harding of skin)
• parkinson

Question 15

What structure make up the external ear?

Answer 15

auricle
helix
antihelix
tragus
lobule
mastoid process

Question 16

What structures make up middle ear?

Answer 16

tympanic membrane
mellus
incus
stapes

Question 17

What structures make up inner ear?

Answer 17

semicircular canals
cochlea
vestibular nerve 
cochlea nerve
eustachian tube

Question 18

What to observe on tympanic membrane?

Answer 18

• tympanic membrane should be translucent, mobile
• malleus process (right top)
• cone light (bottom of malleus)
• incus
• pars flaccida

Question 19

What are the types of hearing loss?

Answer 19

conductive
sensorineural
mixed

Question 20

What is conductive hearing loss?

Answer 20

• loss results from problems in external or middle ear (due to earwax, perforation of TM, fluid, infection)

Question 21

What is sensorineural hearing loss?

Answer 21

• loss results from problems in inner ear, cochlear nerve or brain (age-related)

Question 22

What is mixed hearing loss?

Answer 22

• both conductive and sensorineural hearing

Question 23

What is tinnitus?

Answer 23

ringing in the ear

Question 24

Whats the difference between dizziness and vertigo?

Answer 24

• dizziness: lightheadedness

- vertigo: spinning

Question 25

What is cranial nerve 1?

Answer 25

-olfactory nerve

Question 26

What is otitis externa?

Answer 26

infection of ear canal

Question 27

What is pneumoscopy?

Answer 27

- air puff test on TM | - performed to evaluate the mobility of TM

Question 28

What conduction is greater in normal ear? air or bone?

Answer 28

air conduction is greater (2x) than bone conduction

Question 29

What is the rinne test?

Answer 29

- Put the tuning fork on mastoid process - good test for conductive hearing loss - not a good test for sensory hearing loss - AC BC

Question 30

What is webber's test?

Answer 30

- put tuning fork on top of the head - vibration should lateralize to both ears equally - Vibration lateralize to bad ear (conductive) - Vibration lateralize to good ear (sensorineural)

Question 31

What are the 4 sinuses?

Answer 31

Frontal ethmoid (can't examine, deep structure) maxillary sphenoid (can't examine)

Question 32

What is nasal patency test?

Answer 32

close one nostril, and sniff in

Question 33

What turbinate would you see in nose exam?

Answer 33

- inferior turbinate and middle turbinate

Question 34

What is epistaxis?

Answer 34

nose bleed

Question 35

How to differentiate between viral and allergic rhinitis (inflammation of the nose)?

Answer 35

Viral: red and swollen turbinates Allergic: pale, bluish, boggy turbinates

Question 36

what do tonsils sit behind?

Answer 36

pillar sandwich - anterior pillar - tonsils - posterior pillar

Question 37

What are the mouth salivary glands?

Answer 37

parotid (stenson's ducts found here) submandibular (wharton's duct) sublingual

Question 38

What cranial nerves are responsible for gag reflex and tongue position in midline?

Answer 38

- IX and X for gag reflex | - XII for tongue

Question 39

How to grade tonsil?

Answer 39

0= tonsils absent | 1 - 4 (4 being both tonsils touching each other)

Question 40

What makes up the neck?

Answer 40

``` hyoid bone thyroid cartilage cricoid cartilage trachea clavicle thyroid organ SCM muscle ```

Question 41

What makes up the anterior triangle?

Answer 41

SCM, mandible, midline of neck

Question 42

What makes up the posterior triangle?

Answer 42

trapezius muscle SCM muscle clavicle

Question 43

What do palpate for in neck?

Answer 43

``` lymph nodes thyroid cartilage cricoid cartilage thyroid gland isthmus (connects two thyroid lobes, between 2 and 4th tracheal ring) ```

Question 44

What does enlarged vs tender lymph nodes mean?

Answer 44

enlarged/hard = chronic condition, malignancy/cancer tender = infection shotty: in normal conditions (pebble like bumps)

Question 45

What are the lymph nodes?

Answer 45

1. pre-auricular 2. posterior auricular 3. occipital 4. tonsillar 5. submandibular 6. submental 7. superficial cervical 8. posterior cervical 9. deep chain cervical 10. supraclavicular (indicates lung/abdominal cancer)

Question 46

What is bruit sound?

Answer 46

abnormal whooshing sound over carotid

Question 47

What are the signs of hypothyroidism?

Answer 47

- cold intolerance, wt gain, dry skin, slow HR, course hair

Question 48

What are the signs of hyperthyroidism?

Answer 48

- exophthalmos (bulging of eyes) heat intolerance, wt loss, moist velvety skin, fine hair

Question 49

What nerve test shoulder shrug and neck turn against resistance?

Answer 49

cranial nerve 11