Normal findings for HEENT exam

Question 1

Head inspection

Answer 1

hair, scalp, skull, face, skin

Question 2

Head palpation

Answer 2

deformities, nodules, hair texture, tenderness (make sure to tell patients to let you know if they feel any tenderness as you do this) lymph nodes

Question 3

Head normal statement

Answer 3

Scalp symmetric w/o deformity, nodules or tenderness; even hair distribution; face with good symmetry; skin w/o discoloration; warm and w/o lesions; no nodules or tenderness to palpation

Question 4

Eyes inspection

Answer 4

lashes, sclera, cornea, pupil drainage swelling

Question 5

Eyes exam

Answer 5

visual acuity, light reaction, ocular motion

Question 6

Eyes normal

Answer 6

eye inspection w/o sign of asymmetry or discharge, periobrital palpation non-tender, pupils equally reactive to light, acuitye R: 20/20, L: 20/20, B: 20/20 (or whatever they are)

Question 7

Nose inspection

Answer 7

symmetry, deviation, swelling

Question 8

Nose palpation

Answer 8

tenderness

Question 9

Nose exam

Answer 9

patency septum, discharge, mucosal color, turbinates, polyps, smell, transillumination in dark room

Question 10

Nose normal

Answer 10

nares symmetric w/o swelling or septal deviation; non tender; nares patent bilaterally w/o septal perforation, clear discharge, pink mucosa, w/o turbinate swelling. No polyps

Question 11

Ears inspection

Answer 11

Pinna (make sure to hold this when you check tympanic membrane), lobes symmetry, architecture, nodules, size

Question 12

Ears palpation

Answer 12

tenderness, nodules, lymph nodes

Question 13

Ears exam

Answer 13

canal, TM (tympanic membrane)

Question 14

Ears normal

Answer 14

pinna normal size, symmetry and architecture, non-tender to palpation w/o mass or preauricular adenopahty. Canal fully patent w/o lesions; TM grey, well shaped w/o perforation and moves normally to insulfflation. Hears finger rug equally bilaterally, Weber w/o localization, Rinne AC>BC bilaterally

Question 15

Mouth, lips, and pharynx normal

Answer 15

Lips moist, w/o lesions, buccal mucosa pink w/o lesions and moist; tongue w/o nodules and pink. Teeth in good repair, non-tender and tight. Floor of mouth w/o lesion or nodules. Good moisture noted

Question 16

Neck inspection

Answer 16

symmetry, masses, thyroid (from behind) pulsations, trachea

Question 17

Neck palpations

Answer 17

trachea and thyroid from behind, (make sure they swollow and you feel it) lymph nodes

Question 18

Neck exam

Answer 18

auscultate carotids, ROM, thyroid, lymph nodes

Question 19

Neck normal

Answer 19

neck structures symmetric to inspection, trachea midline, thryoid lobes symmetric, anodular, non tender with intact isthmus, no dysphagia (difficulty swallowing). No anterior/posterior cervical, submental, submandibular or supraclavicular lympadenopahty, carotid pulse

Question 20

HEENT exam to-do’s

Answer 20

full history, focused ROS, general, detailed HEENT, DO exam!, assessment (3DDx, one somatic dysfunction), plan (treatment/test, medication, OMM chosen, patient education, follow u)