Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Physical Diagnosis > Lecture Three (HEENT)- Exam 1 > Flashcards

Lecture Three (HEENT)- Exam 1 Flashcards

1
Q

What do you inspect with: Skull, hair, scalp and face?

A
  • Skull: abnormalities, trauma
  • Hair: quality, distribution, texture, and patterns of hair loss (balding, chemo, alopecia)
  • Scalp: Scaliness, lumps, nevi, lesions, nits and part in multiple places, various locations
  • Face: symmetry, expression, invol mvt, edema, masses, abnormal facies, facial hair and eyebrows
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What do we check in neck?

A
  • Symmetry
  • Masses
  • Trachea midline
  • Visible LN
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What do we do for the TMJ in examination?

A
  • Inspect: swelling, redness
  • Palpate: place tips of index fingers just in front of the tragus and ask pt to open and close mouth. Fingers should drop into joint spaces.
  • Asses: tenderness, ROM, snapping/clicking/smoothness of mvt
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are all the different LN we need to know?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Where is the submental, submandiblar, tonsillar, preauricular and posterior auricular LNs?

A
  • Submental: in the midline a few centimeters behind the tip of the mandible
  • Submandiblar: midway between the angle and the tip of mandible
  • Tonsilar: at the angle of the mandible
  • Preauricular: in front of ear
  • Posterior auricular: superficial to the mastoid process
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Where is the occipital, anterior superficial cervical, posterior cervical, deep cervical chain, and supraclavicular LNs?

A
  • Occipitals: at the base of the skull posteriorly
  • ASC: superficial to the SCM muscle
  • Post cervical: along the anterior edge of the trapezius
  • Deep cervical chain: deep to the scm muscle and often inaccessible to examination
  • Supraclavicular: deep in the angle formed by the clavicle and the SCM muscle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What do you document about LNs?

A
  • Size
  • Shape
  • Mobility
  • Consistency
  • tenderness
  • Skin changes: erthema, induration (larger than norm+dense), drainage, breakdown
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are shotty nodes?

A

Small, mobile, discrete, nontender nodes, noted in normal people. Can be normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

For LNs: what does tender mean?

A

Suggests inflammation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

For LNs: hard or fixed LN means what?

A

Malignancy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What do you do for the trachea?

A

Palpate for tracheal deviation: palpate on each side of the tracea and SCM, compare

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What do you do for the thyroid?

A

Ask the patient to swallow:
* Observe upward mvt of thyroid gland
* Note contour and symmetry

Palpate the gland:
* Confirm with swallow test
* Posterior: places hands to either side from behind
* Notes: size, shape, consistency->soft, firm, hard, nodules, symmetry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What do we use to test visual acuity?

A

Hand-held chart rosenbaum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you use Hand-held chart rosenbaum?

A
  • Well lit room
  • have pt hold 14 inches away
  • Should wear glasses/contacts if prescribed
  • Cover one eye, switch, both eyes together
  • Read smallest print
  • Must identify more than half the letters to get line correct
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the three eye descriptors?

A
  • OD (right eye)
  • OS (left eye)
  • OU (both eyes)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How do you do the visual field: confrontation

A
  • Stand about arm’s length away in front of patient
  • Have pt cover on eye
  • Close your opposite eye (same anatomical eye) to mimic field of vision
  • Place your hands about 2 ft. apart, aprox lateral to the patient’s ear
  • Ask if patient can see your fingers!!!!!!
  • Wiggle fingers and move in an arc (as if over a ball) towards the front
  • Close your opposite eye as switching sides
  • DO NOT GO TOO FAST
  • note where they can see your fingers
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is protrusion, esotropia, exotropia, hypertropia, hypotropia?

A
  • Protrusion: proptosis
  • Esotropia: inward deviation
  • Exotropia: outward deviation
  • Hypertropia: upward deviation
  • Hypotropia: downward deviation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What do we inspect for the eyelides?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is this?

A

Ectropion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is this?

A

Entropion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is this?

A

Exanthelasma: cholesterol issue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What is this?

A

Hordeolum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is this?

A

Chalazion usually points inside rather than lid margin

Not the same as a hordeolum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is this?

A

Blepharitis

Head and shoulder shampoo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What happens when the conjuctiva is white?

A

anemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What do you do for the conjunctiva and sclera in examination?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What do you do for the cornea, lens, iris for the examination?

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What do you inspect and measure with pupils?

A
  • Inspect: size, shape and symmetry
  • Measure the pupils with card or reference (side of pen light)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is miosis and mydriasis?

A
  • Miosis: constriction
  • Mydriasis: dilation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How do you text the light reaction of the pupils

A

Test light reation both direct and consensual
* Dim light
* Ask pt to look in distance
* Shine light into each pupil in turn
* Direct reaction: pupillary constriction in the same eye
* Consensual reaction: pupillary constriction in the opposite eye

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How you check accommodation and convergence?

A
  • Hold finger or pencil about 10cm from patient’s eye
  • Ask patient to look alternately at it and into distance directly behind it
  • Watch for pupillary constriction with near effort and convergence of the eyes
  • Accommodation is the patient’s ability to focus on both far and away
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is PERRLA?

A

Pupils are equal, round and reactive to light and accommodation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How do you test extraocular movements?

A

Use the letter H

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What do you look for and note for extraocular movements?

A

Looks for conjugate mvts of the eyes in each direction
Note:
* Deviation from normal (strabismus)
* Dysconjugate gaze
* Nystagmus: a few ticks can be normal on extreme lateral gaze; bring finger back into within field of binocular vision and look again
* Lid lag: if suspected, check up and down in midline position

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How many cardinal directions are there?

A

6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is this?

A

Convergence: bring to nose and see if eyes come together

37
Q

How do you do the convergence test?

A
38
Q

How do you eversion the lid?

A
  • Use a small stick (tongue depressor of cotton swab) to push down as you raise the edge of the lide, thus everting the eyelid
  • Do not press on the eyeball itself
  • Then secure the upper laskes against the eyebrow with thumb as you inspect
39
Q

What are the different adjustments on the ophthalmoscope?

A

Apeture wheel: light and shape
Focus wheel: diopter

40
Q

How do you use a standard ophthalmoscope?

A
41
Q

How do you use panoptic?

A
42
Q

What do you note for a ophthalmoscopic exam?

A
  • Sharpness or clarity of the disc outline
  • Color of the disc: yellowish-orange to creamy pink. White or pigmented crescents may ring disc, normal finding
  • Size of central physiologic cup. Yellowish-white: Horizontal diameter is usually less than half the horizontal diameter of the disc
43
Q

How do an ophthalmoscopic exam

A
44
Q

What does the papilledema signals? What does it look like?

A

Increased intracranial pressure

45
Q

What is AV nicking? Seen in who?

A
  • The vein appears to stop abruptly on either side of the artery: arterial walls lose their transparency
  • Seen in patients with hypertensive retinopathy
46
Q

Superficial retinal hemorrhages:
* Seen in who?
* What does it look like?

A
  • Severe HTN
  • Papilledema
  • Occlusions of the retinal artery
47
Q

What is soft exudate: cotton wool spots? What is the txt?

A
  • HTN
  • DM
  • HIV
  • Other viruses
  • Txt: Figure out why they have it
48
Q

What is drusen?

A
  • Normal aging
  • age related macular degeneration
49
Q

What is this?

A

Cotton wool spots

50
Q

What is this?

A

drusen

51
Q

What is this?

A

Retinoblastoma

52
Q

What is retinoblastoma? What type of reflex?

A
  • Congenital malignant tumor occuring in first two years of life
  • White “cat’s eye” reflex
  • Chalky-white areas of calcification
53
Q

What are the key components of the ear examination?

A
54
Q

For ear canals and TM, waht do you inspect?

A
  • Inspect the ear canal (cerumen, discharge, foreign bodies, redness of the skin or swelling)
  • Inspect the TM and amlleus (color, contour, perforations, mobility
55
Q

If hearing loss or difficulty is present, determine sensorineural or conductive via what?

A

Tuning fork tests
* Test lateralization if unilateral hearing loss or difficulty (weber’s) is present
* Compare air conduction vs bone conduction (Rinne)

56
Q

How do you inspect the ear? and Palpation?

A
57
Q

What are otoscope exam techniques?

A
58
Q

With the otoscope, what do you inspect? (ear)

A

Discharge, foreign bodies, redness of the skin, swelling and cerumen

59
Q

For the otoscope exam: what do you need to inspect of the TM

A
  • Note color and contour
  • Cone of light
  • Look for red bulging TM
  • Fluid behind TM: serous effusion
60
Q

For the otoscope exam: what do you identify?

A

The handle of the malleus and short process of the malleus

61
Q

What does short process and prominent handle suggest?

A

retracted membrane

62
Q
  • For the otoscope exam, what do you scan and observe?
  • What do you check for?
A

Scan and observe:
* Pars flaccida superiorly
* Margins of the pars tens

Check for perforation

63
Q

What is the whisper test?

A
64
Q

What are tuning fork tests for? What may it help determine?

A
  • For patients that fail the whisper test
  • May help determine if the hearing loss is conductive or sensorineural in origin
65
Q

What is the weber test?

A
66
Q

Failed weber test suggests what?

A

Otosclerosis, otitis media, perforation of the eardrum, cerumen

67
Q

What is the rinne test?

A
68
Q

For the rinne test: what is normal, conductive and sensorineural hearing loss?

A
69
Q
A
69
Q

For the nose and paranasal sinus exam: what do you inspect, and test for?

A
  • Inspect the ant. and inferior surfaces of the nose (asymmetry, deformities, tenderness)
  • Test for nasal obstruction of each nostril (if indicated)
  • Inspect the nasal muscosa, nasal spetum, inferior and middle turbinate, and corresponding meatuses with a light source or otoscope with large speculum (deviation, marked asymmetry, polyps, ulcers)
70
Q

For the nose, paranasal sinus exam, what do you palpate?

A
  • Palpate the frontal sinuses (tenderness, pressure, fullness)
  • Palpate the maxillary sinuses (tenderness, presure, and fullness)
71
Q

How do you palpate sinuses?

A
  • Press up on the frontal sinus from under the bony brows
  • Press on the maxillary sinuses
72
Q

For the external nose, what do you insepct?

A

inspect the ant. and inf. surfaces of the nose: asymmetry, deformities and lesions

73
Q

For the external nose: what do you check for?

A

Patency (if indicated)
* occlude one nostril at a time
* Ask to breathe in

74
Q

For the interior nose, what should you do? With thumb and otoscope

A
75
Q

Inspection of nose with otoscope: what do you inspect of the nasal mucosa?

A
  • Swelling
  • Bleeding
  • Exudate: note character (clear, muscopurulent, purulent)
76
Q

Inspection of nose with otoscope: what do we inspect with the septum?

A
  • Deviation
  • Inflammation
  • Perforation
  • Polyps
  • Ulcers
77
Q

How many teeth do we have?

A

32

78
Q

What are the key components of an mouth exam?

A
79
Q

What do we inspect of the lips?

A
80
Q

What do we inspect of the oral mucosa?

A
  • Discolaration
  • Ulcers
  • White patches
  • nodules
81
Q

What should you palpate and scrape with the oral mucosa?

A
  • Palpate any concerning lesions
  • Scrape white patches to determine candidiasis from leukoplakia
82
Q

What is this?

A

Aphthous ulcer (canker sore): from stress or virus

83
Q

What are you looking for with inspection of the hard palate and floor of mouth?

A
84
Q

What should you do when examining the tongue?

A
85
Q

What is this?

A

Carcinoma of the tongue

86
Q

What is the examation of the pharynx?

A
87
Q

What should you note about the tonsils

A
88
Q

What is a fissured tongue, candidasia, black hairy tongue, smooth tongue, oral hairy leukoplakia

A

Physical Diagnosis (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions