OSCE 2: ENT Lab Flashcards
What are some external ear structures to visualize for?
Auricle Helix Antihelix Concha Antitragus Tragus Triangular fossa Lobule External auditory canal
What are some internal ear structures to visualize for?
Cone of light
Umbo
Malleus
Manubrium
Pars tensa: portion of drum inferior to pars flaccida
Pars flaccida: superior to malleus
Chorda Tympani Nerve: superior part near pars flaccida
When inspecting the ear canal in adults, what direction do you pull the ear?
Pull UP, out, and posterior
When inspecting the ear canal in children, what direction do you pull the ear?
Pull DOWN, out, and posterior
What should the normal tympanic membrane look like?
Translucent and pearly
What does conductive hearing loss mean?
Problem in external or middle ear
- sound will localize to affected ear
- louder in impacted ear
- Abnormal Weber and Rinne Test
What does sensorineural hearing loss mean?
Problem in internal ear, cochlear nerve, or central brain connections
- sound localized to opposite ear
- louder in unaffected ear
- Abnormal Weber Test and normal Rinne Test
Describe the Whisper test.
- Have patient occlude an ear with doctor behind patient
- Doctor whispers combination of letters/numbers
- Have patient repeat sequence: needs to minimum identify 3/6
- Repeat with other ear
What does the Weber Test test for?
Lateralization
Describe the Weber Test.
Vibrating tuning fork placed on top of patient’s head or on middle of forehead
● Normal: sound lateralizes to both ears equally
● Abnormal: Sound lateralizes to one ear - either conduction loss in that ear or sensorineural loss in the opposite ear.
What does the Rinne Test test for?
Compares air and bone conduction
Describe the Rinne Test.
Vibrating tuning fork placed on mastoid bone behind ear, level with canal. When patient no longer hears sound, place fork close to ear canal and inquire if they can hear the sound and for how long.
● Normal: AC>BC
● Abnormal: If AC=BC or BC>AC
If Weber test was abnormal and Rinne test was normal, what should you suspect?
Sensorineural loss in the opposite ear
What does it mean if Rinne test is abnormal?
Conductive loss to that ear.
What are some external nose structures to visualize for?
Ala nasi
Columella
Vestibule
Bridge
What are some internal nose structures to visualize for?
Septum
Vestibule: most anterior part of the nasal cavity
Turbinates
If nose mucosa is red or edematous, what should you suspect?
Viral rhinitis
If nose mucosa is pale, bluish or red, what should you suspect?
Allergic
If nose mucosa has a septal perforation, what should you suspect?
Cocaine
Meth
Trauma
Surgery
What is the function of turbinates?
Cleansing
Humidification
Temperature control of inspired air
What lymph nodes should be palpated?
Preauricular Posterior Auricular Occipital Tonsillar Submandibular Submental Superficial Cervical Posterior Cervical Deep Cervical Chain Supraclavicular
When palpating lymph nodes, what should you feel for?
Size Shape Consistency Tenderness Mobility Overlying Skin
What are the four sinuses?
Frontal
Maxillary
Ethmoid
Sphenoid
How do you palpate for the frontal sinus?
Press up under bony brows
How do you palpate for the maxillary sinus?
Press up on location of maxillary sinuses
What are some external mouth and throat structures to visualize for?
Lips
Philtrum
Vermillion border
What are some internal mouth and throat structures to visualize for?
Labial and Lingual Frenulum Gingiva Sublingual caruncle Lesser sublingual ducts Tongue Hard and soft palate Uvula Palatine tonsil Posterior pharynx
What is the soft palate controlled by?
CN IX and X
If CN IX and X is paralyzed on side of the body, in what direction does the uvula deviate?
Opposite side
-soft palate does not rise with saying “ah”
What are aphthous ulcer?
Cancker sores
What is cheilitis?
B12 or iron deficiency
-red cracks at corners of mouth
What is gingivitis?
Swelling or ulcerations of gums
What is torus palatinus?
Benign lump on hard palate
