Lecture VIII: Examination of the Head and Neck

Question 1

Examine external ear for…

Answer 1

• location
• shape
• trauma

Question 2

Examine external ear canal for…

Answer 2

• patency
• cerumen
• drainage
• foreign body
• avoid hitting bony part
• Pull up and back to evaluate adult

Question 3

Eardrum

Answer 3

Check for color, perforations, cholesteatoma:
o	Pearly grey – normal
o	Red/bulging – acute otitis media
o	Yellow or Amber – serous otitis media
o	Blue or purple – hemotympanum
o	White plaques - tympanosclerosis

Question 4

What structures to check?

Answer 4

• external ear
• external auditory canal
• eardrum
• middle ear
• buccal mucosa, gingiva
• hard and soft palate
• tongue
• uvula
• nasal mucosa
• major lymph node chains

Question 5

Nasal mucosa

Answer 5

Look for masses, mucosal abnormalities, characteristics of secretions, airway patency, mucosal congestion, character of mucus

Question 6

Major Lymph node chains

Answer 6

• preauricular
• postauricular
• occipital
• submandibular
• submental,
• anterior and posterior cervical chain
• supraclavicular

Question 7

Rule of 80s

Answer 7

80% of neck masses in adults are neoplastic

80% in children are infectious or congenital

Question 8

Weber Test

Answer 8

Tuning fork on forehead, nasal bridge, incisor teeth

a) normal-same in both ears
b) unilateral conductive hearing loss-sound heard in impaired ear??
c) unilateral sensorial loss-sound is heard in good ear

Question 9

Rinne Test

Answer 9

Hold on mastoid tip and then just outside auditory canal

a) normal-should be louder by auditory canal because air conduction should be greater than bone conduction
b) Conductive hearing loss-sound heard through bone as long as or longer than through air
c) Sensorial hearing loss-sound heard longer through air just like in normal adults