Module 9 Flashcards
consequences, after effects
Sequelae
Sensation of faintness
dizziness
Sensation of spinning
vertigo
Nosebleed
epistaxis
Decreased sensitivity to taste
Hypogeusia
-geusia
taste
unpleasant taste
Dysgeusia
Double vision
diplopia
beating of the heart so vigorously that the person is aware of it
palpitations
equipment for head and neck
Light source, Tongue blade, Cotton balls, Tape measure, Stethoscope, Otoscope , Snellen Eye Chart or Pocket Vision Card , Ophthalmoscope
techniques for head and neck
inspection and palpation
is the head and neck a single, fixed sequence
no
what is the most efficient way to examine
examine the ears, nose and throat in one smooth sequence
what is normal head position
upright, midline and still
jerking of the head may indicate what
tremor
nodding of the head may indicate what
aortic stenosis
what do you inspect the scalp for
size, shape, symmetry, and leisons
how do you inspect facial features
shape and symmetry
Cranial Nerve V (Trigeminal)
Cranial Nerve VII (facial)
unusual features
how do you inspect the Trigeminal nerve
Motor:
Jaw opening and clenching
Mastication (chewing)
Sensory: Sensation over the face
how do you inspect the facial nerve
Motor: Raise eyebrows Smile, frown, and show teeth Puff out cheeks Close eyes tightly Sensory: Taste: anterior 2/3 of tongue
what unusual features of the face do you inspect for
edema, prominent eyes, sunken eyes, hirsutism, alopecia, tics
tissue swelling
edema
Hyperthyroidism
prominent eyes
Dehydration, malnutrition
sunken eyes
excessive hair growth
hirsutism
hair loss
alopecia
Spasmodic muscular contractions
tics
An expression or appearance of the head and neck that, when taken together, are characteristic of a clinical condition or syndrome
facies
how do you palpate the head
Palpate using a gentle rotary motion
Proceed from front to back
Palpate for lymph nodes
what do you palpate the skull and scalp for
Contour: smooth, Symmetry, Tenderness, Scalp movement, Hair
what are the lymph nodes
Preauricular, Postauricular, Occipital, Tonsillar, Submandibular, Submental, Anterior Cervical Chain, Posterior Cervical Chain, Supraclavicular
what should be done if a problem in the sinuses is suspected
Transillumination
how do you examine the sinues
Inspect the area over the frontal and maxillary sinuses
Palpate over the frontal and maxillary sinuses
Percuss over the frontal and maxillary sinuses
what do you inspect the neck in
Usual anatomic position
Slight hyperextension
As the person swallows with neck hyperextended
movement that increases the angle of a joint to 180°; straightening the joint
extension
exaggerated extension
> 180°
hyperextension
what do you inspect the neck for
Symmetry, Alignment of trachea, Fullness, Masses, webbing, skin folds, Jugular vein distention, Carotid artery prominence, Cranial Nerve XI (Spinal Accessory)
how do you inspect the Cranial Nerve Spinal Accessory
Ability to shrug shoulders with and without resistance and turn head
what do you palpate on the neck
Trachea for Position and Tugging
what type of vison are you interested in on a patient
person’s best corrected and uncorrected vision
If the person has contacts in
they do not need to remove them
If the person is wearing glasses
visual acuity needs to be done with an without them
what cranial nerve is related to visual acuity
cranial nerve II (optic)
visual acuity is reported as…
as a pair of numbers (e.g., 20/20)
the first number in visual acuity is
how far the person is from the chart
the second number in visual acuity is
the distance from which the “normal“ eye can read a line of letters
nearsightedness
myopia
20/40 on the Snellen chart means that
that at 20 feet the person can only read letters a “normal” person can read from twice that distance
20/40 on the Rosenbaum chart means
that at 14 inches the person can only read letters a “normal” person can read from twice that distance
farsightedness
hyperopia
due to aging
presbyopia
how to perform a visual acuity test
Have the person cover one eye at a time with a card
Ask the person to read the smallest line possible without straining
Repeat with the other eye
Repeat with both eyes
what do you inspect the eyes for
ptosis, exophthalmos, lesions, deformities, or asymmetry
full inspection of the eyes
Ask the person to look up and pull down both lower eyelids to inspect the conjunctiva and sclera
Next spread each eye open with your thumb and index finger
Ask the person to look to each side, upward and downward to expose the entire bulbar surface.
Note any discoloration, redness, discharge, or lesions
Note any deformity of the iris or lesion cornea
how do you test peripheral vision
Stand two feet in front of the person and have them look into your eyes
Hold your hands to the side half way between you and the person
Wiggle the fingers on one hand
Ask the person to indicate which side they see your fingers move
Repeat two or three times to test both temporal fields
how do you check for neglect in the visual fields
wiggle your right and left fingers simultaneously
The person should see movement in both hands
if abnormality of visual fields is suspected..
use the confrontation test
how do you check visual fields by confrontation test
Asking the person to cover one eye with a card
You cover your opposite eyes with a card
Have the person look directly into your eyes
Bring in your wiggling fingers from each quadrant and ask the person to tell you when your fingers are seen
how do you check corneal reflections
Shine a light from directly in front of the person
what should the corneal reflections be near
the center of the pupils
what does asymmetry of the corneal reflections indicate
extraocular muscle pathology
