HENT - part one ppt

Question 1

For a focused exam, start with ___ questions, then perform ___ exam, and come up with ___ ___.

Answer 1

hx, physical, differential dx

Question 2

Moderate to intense pain and constant throbbing indicates ___ of ___ arteries.

Answer 2

dilation, cervical

Question 3

Steady, throbbing, usually on same side. Pain peaks in 3-4 hrs and can last for days indicates a ___.

Answer 3

migraine

Question 4

Pain increased during work, school, activities, or stressful situations and decreases w/rest indicates a ___ h/a

Answer 4

tension

Question 5

Orbital pain increased from ___ pressure.

Answer 5

intraocular

Question 6

Preorbital pain increases d/t ___ or ___ nerve pain.

Answer 6

sinusitis, trigeminal

Question 7

___ tends to be more frontal, temporal, and unilateral pain.

Answer 7

TMJ

Question 8

Vomiting w/out nausea most likely indicates a ___ ___.

Answer 8

brain tumor

Question 9

Photophobia occurs w/___, but not ___ h/a.

Answer 9

migraines, tension

Question 10

1/3 of pt’s w/ha get ___.

Answer 10

vertigo

Question 11

___ h/a are not familial, whereas ___ are.

Answer 11

Tension, migraines

Question 12

Retinal hemorrhages, could indicate ___.

Answer 12

abuse

Question 13

This h/a is ipsilateral, might see ptosis, and possible pupillary constriction.

Answer 13

Cluster

Question 14

When performing opthalmoscopy, you are looking for ___ and ___ mass.

Answer 14

papilloedema, intracranial

Question 15

Palpation of the head is only done if pt is ___. For example, head pain, trauma, etc.

Answer 15

symptomatic

Question 16

When performing PE, assess ___ strength, ___, ___, and ___.

Answer 16

motor, balance, gait, DTR

Question 17

Upon inspection of the head, observe pt’s ___ expressions and look for ___ mvmnts. Observe the ___ and ___.

Answer 17

facial, involuntary, hair, scalp

Question 18

Upon palpation, palpate w/___ pads. palpate the ___, temporal arteries for ___, and hair for ___, which may be present in thyroid dis or steroid conditions.

Answer 18

finger, skull, bruits, coarseness

Question 19

Tension, migraines with and w/out auras, mixed h/a, cluster, and benign exertional h/a are all ___ headaches.

Answer 19

primary

Question 20

___ h/a tend to be bilat and have hat-band distribution.

Answer 20

Tension

Question 21

___ h/a is typically unilateral.

Answer 21

Cluster

Question 22

___ ___ h/a last anywhere from several seconds to 30 mins and are d/t sneezing, coughing, running, orgasm, or other exertional exercises.

Answer 22

Benign exertional

Question 23

Sinusitis, dental disorders, pharyngitis, otitis media, and meningitis are all ___ h/a d/t ___ origin.

Answer 23

secondary, infection

Question 24

Trigeminal neuralgia, optic neuritis, cervical spinal disorders, and temporal arteritis are all ___ h/a d/t ___ origin.

Answer 24

secondary, neurogenic

Question 25

CO poisoning, hypoglycemia, drug withrawal, and dietary ingestion (aged cheese, MSG, processed meats) are all h/a d/t ___ origin.

Answer 25

metabolic

Question 26

IC tumor, hydrocephalus, brain abscess, intracerebral hemorrhage are all h/a d/t ___ origin.

Answer 26

cerebrovascular

Question 27

If infant under 3 months of age develops AOM, typically at ___ risk of dev again.

Answer 27

higher

Question 28

Infants using bottle while laying down ___ risk of ear inf.

Answer 28

increases

Question 29

Systemic dis such as DM, dermatitis, eczema, psoriasis, and non-repaired cleft palate ___ risk of ear infection.

Answer 29

increase

Question 30

Pain is elicited upon palpation of canal, tragus, or pinna and may see itching w/___ ___.

Answer 30

otitis externa

Question 31

Pain is unilateral and kids tug/pull at ear w/___ ___.

Answer 31

otitis media

Question 32

Discharge of ear is more likely w/___ ___ or ___ otitis media.

Answer 32

otitis externa, perforated

Question 33

Itching of ear presents in ___ ___ or ___ ___.

Answer 33

herpes zoster, otitis externa

Question 34

Suspect a ___ ___ is child has recent difficulty hearing.

Answer 34

foreign object

Question 35

Related body systems for ear infection include: ___ for sinuses and lymph nodes, ___ for jaw pain or h/a, and CN ___, ___, and ___.

Answer 35

HENT, TMJ, V, VII, IX

Question 36

Healthy TM appears pearly ___ and ___. Should see landmarks behind it, including handle of ___, ___, and ___ of light.

Answer 36

gray, translucent, malleus, umbo, cone

Question 37

Cone of light reflection will appear at ___ in Lt ear and ___ in Rt ear. (Runs along jaw line)

Answer 37

7:00, 5:00

Question 38

___ pressure should move TM when performing pneumatic otoscopy. ___ (fluid in middle ear) will hamper TM mobility.

Answer 38

Air, effusion

Question 39

A ___ assessment can be performed by asking pt to close eyes while you place your fingers a few cm from either ear and rub finger tips together, noting for ability to hear.

Answer 39

crude

Question 40

The ___ test if where you stand behind the pt and whisper a few single syllable words in one ear, then the other and have pt repeat back.

Answer 40

whisper

Question 41

2 tests to detect hearing deficit include ___ and ___.

Answer 41

Weber, Rinne

Question 42

The ___ tests for unilateralization, where the tuning fork is placed on top of head midline.

Answer 42

Weber

Question 43

The ___ tests for bone to air conduction, where tuning fork is placed on mastoid process behind ear.

Answer 43

Rinne

Question 44

The passage of sound from outside to the level of the 8th CN, including sound thru external canal and middle ears is ___.

Answer 44

conduction

Question 45

The transmission of sound thru the 8th nerve to the brain is ___.

Answer 45

senorineural

Question 46

OE, OM, serous otitis, cholesteatoma, mastoiditis, foreign bodies, cerumen impaction, trauma, cervical lymphadenitis, TMJ, and referred pain from cervical or cranial nerves can all be examples of ___ ___ for “earache”.

Answer 46

differential dx