Lab Final Flashcards
When performing argyrol sinus drainage procedure, where is the applicator with the argyrol placed exactly?
Middle nasal meatus
How long is it recommended to keep the applicator in place during argyrol sinus drainage?
60 mins
What treatment frequency is recommended for argyrol sinus drainage?
3x.
Repeat procedure 2 consecutive days, skip a day and repeat on the fourth day
What are the contraindications for argyrol sinus drainage?
Nose bleeds
Can’t sit still (children)
In a PARQ consultation with the patient for argyrol sinus drainage, what risks would you report?
No known risks
Incorrect usage or over utilization = generalized or local argyria (grey/blue or blue-violet discoloration)
List the structures you evaluate as part of the external eye exam (11)
Gross evaluation of eyes and surrounding area Gross alignment of the eyes Cornea Pupil Iris Lacrimal apparatus: Gland AND duct Eyelid position Eyelid and eyelid margins Conjuctiva Sclera
When performing the opthalmoscopic exam, your beginning position relative to the patient is
6-18” away
15-20 degrees angled nasally
What are the 4 steps of the fundoscopic exam in correct order?
Red Reflex
Cup to disc (1:2)
Four quadrants
Anterior Chamber
Indications to test a patient’s visual acuity include(4)
Head/neck trauma
Changes in vision
HA associated with eye use
Amblyopia
If your patient’s vision is 20/10, is that better or worse than “normal”?
Better. Means individual can see at 10 ft what normal would see at 20 ft.
If your patient fails the whisper test when testing their right ear, and weber test is R>L, what hearing deficit is this patient most likely to have?
Conductive hearing loss.
Weber test is the thing on the forehead.
Normal: midline
*Note if you do one, you must do the other.
If the sound lateralizes to the involved ear = conductive hearing loss.
If the sound lateralizes away from the involved ear = sensorineural hearing loss
What is a normal finding for Rinne’s test?
AC>BC
the instrument is placed on mastoid
Name 6 clinical scenarios in which an ophthalmoscopic exam is indicated
pt with hx of head trauma/concussion/MVA/sports injury New severe HA Severe HA with N/V HA unresponsive to Tx Eye pain or injury to eye Visual Changes Diabetic patients Patients with HTN
What 6 structures are observed and/or palpated when evaluated the outer ear?
Whole external eye, including lymph nodes
Light behind ear and bend pinna forward, light to evaluate superior edge of the ear
palpate whole pinna
pull on pinna to traction the skin in canal
push on tragus
observe and palpate/tap mastoid process
3 key exam findings for otitis externa
localized ear pain that increases with traction of pinna
erythema and swelling of external canal
otorrhea from external auditory canal
What 5 things do we assess when evaluating the tympanic membrane?
Gross appearance of tympanic membrane (perforation, mass)
Position of tympanic membrane (neutral, retracted, bulging?)
Color of membrane (normal = pearly gray)
degree of translucency of membrane
Landmarks: pars flaccida, malleus, manubrium, umbo, light reflex
6 contraindications to performing ear irrigation on a patient
current, recent or suspected pseudomonas aeruginosa infection
Otitis externa
Prior ear surgery
Perforation
External auditory canal cholesteatoma or keratosis obturans
Myringotomy tubes
What 4 categories of treatment are available to address excess cerumen?
cerumenolytic-wax softening agents applied to the ear
Irrigation
Manual removal other than irrigation (ear curettes, probes, hooks, forceps)
ENT specialists = manual removal under microscope mag and special tools for suction, etc.
What are the 4 primary reasons to attempt to remove cerumen from the ear?
Improve hearing Improve sight for doc decrease pressure remove debris/foreign substances blocking hearing aid evaluation and placement
When performing Dix-hallpike test, what are the findings for a positive test?
Nystagmus
BPPV stands for
Benign Paroxysmal Positional Vertigo
What are the contraindications for performing Dix-Hallpike test or Epley’s maneuver?
Vertebral Artery Insufficiency
Neck Disease
Carotid Stenosis
Heart Disease/Unstable angina
When performing Dix-Hallpike test, how long do you hold the patient in final position before you determine the test is negative?
45 seconds
When performing epley’s maneuver, how long do you hold the patient in each position throughout treatment?
Hold until sx have ceased before moving on
or!
45 seconds
What important patient instruction is given with the speculum nasal exam?
Patient must be instructed to hold their breath durin the exam!
List 7 findings we check during speculum nasal exam
swelling trauma lesions polyps color of membrane discharge/sputum/congestion septum postion (deviation)
During the mouth & throat exam we retract the patients cheek/lips all the way around and check which structures?
Mucosa-buccal and labial, gingivae, teeth
Which teeth do we tap and why?
Tap upper molars to evaluate maxillary sinuses
What areas of the tongue do we examine?
Top, both sides and underside (have patient first stick out tongue to examine top and sides, then lift tongue to roof of mouth)
Which sinuses do we evaluate?
Maxillary and Frontal
What order of the meati do you perform the nasal specific procedure?
Inferior bilaterally, Middle, Superior, Repeat
What are 7 contraindications, absolute and relative, for performing the nasal specific procedure?
bleeding disorders
on anticoagulant meds
prior nasal surgery
recent (
In a PARQ consultation with the patient for nasal specific procedure, what risks would you report?
Nose bleeds hemorrhage of ruptured veins minor soreness of face and teeth HAs Throat soreness for a few days from increased sinus drainage increased temporary stuffiness
