NSG 1610 - EENT

Question 1

What is the palpebral fissure?

Answer 1

open space between both eyelids

Question 2

What are the three layers of the eye and what structures do they contain?

Answer 2

1. outer fibrous layer - sclera and cornea
2. vascular middle layer - iris, ciliary body, choroids
3. inner neural layer - retina

Question 3

How do you properly perform the Snellen Chart exam? What is it testing for?

Answer 3

Testing for visual acuity

Pt. should be 20 ft away with chart at eye level, closing one eye at a time
Glasses (not reading glasses) stay on during exam

Question 4

How do you properly perform the Jaegar pocket screener test? What are we testing for?

Answer 4

Testing for near vision/accommodation

Hold card 35cm or 14 inches away from the pt
Have them close one eye and read the largest to smallest
Prescriptive lenses stay on

Question 5

What is protanopia?

Answer 5

difficulty distinguishing blue from green and red from green

Question 6

what is tritanopia?

Answer 6

difficulty distinguishing yellow from green and blue from green

Question 7

What is deuteranopia?

Answer 7

difficulty distinguishing red from purple and green from purple

Question 8

What is achromatopsia?

Answer 8

complete colour blindness (a rare condition, in which only shades of grey are visible)

Question 9

How do you perform the static confrontation test?

Answer 9

Arm length away
Eyes at same level as yours
Cover patient’s L eye
Close your R eye
Patient looks at your open eye
Show 1-4 fingers in each quadrant
Patient identifies how many without looking directly at them
Repeat for other eye

Question 10

How do you perform the kinetic confrontation test?

Answer 10

same as static but you wiggle your fingers from the distal point and move them towards the centre of each quadrant

Question 11

What are the external ocular structures?

Answer 11

conjunctiva, sclera, pupil, and iris

Question 12

How do you test corneal light reflex?

Answer 12

• pt. stares ahead at the bridge of your nose
• shine light at bridge of pt’s nose
• note where the light reflects on the cornea (should be in the same spot in both eyes)

Question 13

How do you perform the cover test?

Answer 13

• ask the pt. to focus on your nose
• cover one eye
• inspect for any movement of the uncovered eye that may indicate refutation of the gaze
• remove the cover and observe the previously covered eye for refixation

Question 14

Refixation during the cover test is often a result of what?

Answer 14

often due to muscle weakness of covered eye

Question 15

How do you assess for cardinal directions? What are we assessing for?

Answer 15

assessing for symmetrical movements of the eye and extra ocular muscle function

pt. holds their head steady and follow your finger with their eyes (use their shoulders as a guide)

Question 16

What does PERRLA stand for?

Answer 16

pupils are equal, round, reactive to light, and accomodating

Question 17

What is myopia?

Answer 17

nearsightedness - the pt. can see close up but has difficulty seeing far away

Question 18

what is hyperopia?

Answer 18

farsightedness - the pt. can see far away but has difficulty seeing close up

Question 19

what is presbyopia?

Answer 19

decreased ability to focus on near objects, a common occurrence with aging

Question 20

what is astigmatism?

Answer 20

blurred at any vision

Question 21

What is macular degeneration?

Answer 21

breakdown of cells in macula of retina, loss of central vision - lateral vision is unaffected

Question 22

what are cataracts?

Answer 22

lens opacity

Question 23

what is glaucoma?

Answer 23

results from increased intraocular pressure - causes damage to the optic nerve and gradual loss of peripheral vision

Question 24

what is cerumen? what is its function?

Answer 24

ear wax - helps keep foreign bodies from reaching the tympanic membrane

Question 25

How do you perform the whisper test? what are we assessing?

Answer 25

assessing for loss of high frequency sounds

pt. plugs the opposite ear, you stand behind them, whisper a two-syllable word 30-40cm away from the pt., have them repeat the word they heard

Question 26

How do you perform the Weber test? what are we assessing?

Answer 26

we are assessing unilateral hearing loss, conductive hearing loss (middle ear), or unilateral sensorineural hearing loss (inner ear)

place tuning fork on top of pt’s head and ask if they hear it equally on both side

Question 27

What is epistaxis?

Answer 27

nose bleed

Question 28

what are the functions of sinuses? which ones are palpable?

Answer 28

hollow, air-filled cavities within the forehead and facial cavities, lighten the skull, produce mucous that empties into the nasal cavity

frontal & maxillary

Question 29

how many sinuses are there total?

Answer 29

8 - frontal, maxillary, ethmoid, and sphenoid

Question 30

where is the lingual frenulum?

Answer 30

the connective tissue attaching the tongue and floor of the mouth

Question 31

what is pruritus?

Answer 31

itching

Question 32

What is pallor? where are the best places to assess for pallor?

Answer 32

pale skin, best places to asses are mucous membranes of the mouth, palm of the hands, nail beds, soles of feet

Question 33

what is erythema?

Answer 33

intense redness of the skin

Question 34

what is cyanosis? where is it often most visible?

Answer 34

dark bluish or purple discolouration of the skin - nail beds or lips

Question 35

how do we assess temperature with our hands?

Answer 35

use the dorsal side of the hand

Question 36

how do we assess moisture with our hands?

Answer 36

use palmar side of the hand to test

Question 37

what is turgor?

Answer 37

elasticity of the skin - can tell us about hydration status

Question 38

what is edema? how do we test it?

Answer 38

caused by the accumulation of fluid in the intercellular spaces - test by using first three fingers and push into the skin to observe pitting

Question 39

what is an abnormal time for cap. refill?

Answer 39

anything over 3-5secs

Question 40

what is the edema scale?

Answer 40

• Grade 1
  0-2mm indentation; rebounds immediately
• Grade 2
  3-4mm indentation; rebounds in less than 15 seconds
• Grade 3
  5-6mm indentation; up to 30 seconds to rebound
• Grade 4
  8mm indentation; over 20 seconds to rebound

Question 41

review the locations of lymph nodes

Answer 41

o Preauricular – located in front of the ear/tragus
o Posterior auricular – superficial to the mastoid process
o Occipital – posterior base of the skull
o Submental – below the chin at midline and behind the tip of the mandible
o Submandibular – between the angle and tip of the mandible
o Jugulodigastric (tonsillar) – at the tonsils/angle of the mandible
o Superficial cervical – superficial and superior portion of the sternomastoid
o Deep cervical chain – throughout the sternomastoid muscle (3 total)
o Posterior Cervical – Base of the neck and anterior edge of the trapezius
o Supraclavicular – located within the groove superior to the clavicle between the sternomastoid and clavicle

Question 42

how should we assess the trachea during an EENT assessment?

Answer 42

I - check for any swelling of the thyroid gland, observe it moving up with swallowing

A - auscultate
use the bell of the stethoscope and listen for any abnormal whooshing or soft rushing sounds

Question 43

What is a bruit sound?

Answer 43

Can be a blowing, harsh, musical, or rumbling sound heard through ausculation of the bell

Question 44

in the thyroid, what is a bruit sound created by?

Answer 44

it is created by turbulent blood flow that can occur in an enlarged thyroid gland

Question 45

What is anisocoria?

Answer 45

Pupils are two different sizes normally

Question 46

What is otalgia?

Answer 46

Ear pain

Question 47

What is otorrhea?

Answer 47

Discharge from the ear (not cerumen)

Question 48

What is presbycusis?

Answer 48

Gradual hearing loss due to older age

Question 49

What is bruxism?

Answer 49

Teeth grinding

Question 50

What is rhinorrhea?

Answer 50

Nasal discharge

Question 51

What is odynophagia?

Answer 51

Pain upon swallowing

Question 52

What is xerostomia?

Answer 52

Dry mouth