Test 2 Lecture Material Flashcards
Pt. sticking out tongue in a asymmetric protrusion suggests
A lesion in CNXII- the deviation of the tongue going toward the same side as the lesion in the CN
Saying “AHHHH” and seeing the uvula rise is done by what CN?
CN X…Uvula should rise midline, a deviation to one side suggests a lesion in Vagus.
For tracheal deviation…If have volume loss..collapsed lung, atelectasis
Tracheal will be pulled toward affected lung
Trachea will be pulled away from affected side when?
In thyroid enlargement, pleural effusion, tension pneumothorax
What do firm nodules confirm in thyroid gland? What does tenderness?
A. Malignancy or Hashimoto’s Thyroiditis
B. Tenderness=Thyroidititis
How can tell for hyperthyroidism?
During palpation find that gland is enlarged and listen for a bruit (unusual sound blood makes when rush past an obstruction.
What are some HPI and Pros associated with oral cavity?
Sore Throat or pharyngitis? Sore tongue? bleeding from gums? hoarseness? Any Swollen glands or lumps in neck? temperature intolerance? Sweating? skin changes? tobacco
When examining the mouth and throat it helps?
To have patient in a comfortable seat, best if you are positioned higher than the patient.
Stenson’s Duct?
Duct near the second molar…Parotid.
Wharton’s Duct?
Submandibular duct. Floor of the mouth.
Infant Ear Exam
Position of ear should be in a way that the upper portion of the auricle joins the scalp at or above the level of a line drawn from the inner and outer canthus.
Infant Ear exam externally
Looking for skin tags, and pits. Skin Tags have small association with renal problems in children.
Ear canal from 3 to 6 months
Gently pull ear down and outward to see the TM in infants. As child grows angle will develope in child to adult.
Why use Pneumatic Otoscopy
Should be part of every exam of the ear. Diminished movement is found in effusions and acute otitis media. Can be seen with ruptured TM.
Infant Nose Exam
Children are obligate nose breathers. Check patency of one nare…if concerned utilize catheter placement.
For children with allergies, what physical signs should you see?
Assess for crease of nose and allergic shiners.
When do sinuses develop?
They do not all develop at once. One Year Maxillary. BY 6 years old should have sphenoid and ethmoid sinus. At 10 years old Frontal sinus. All Sinus dont fully develop till 21 years old.
Child Tonsil Examination
Tonsils–If Tonsils 2+ for age 2-6 years of age…thats ok just look for other signs of infection- erythema, cobblestoning, exudate, assymetry of tonsil location.
Teeth development of child.
Childrens teeth should be developed by 2-3 years. Start around 6 to 7 months. Four teeth added around every four months. Losing of primary teeth usually occurs by age 5. Secondary teeth usually begin around 6 or 7 years of age.
Exophthalmos
Eyes bulging out. Rare to see..seen with thyroid disease.
HPI or PROS for eye questions
Persistent or transitory, any recent trauma, time spent on computer screens, new medications, past medical and surgical history, recent URI, Last eye exam.
Tendency for early thyroid problem
thinning out of the eyebrow toward the end.
For Snellen Eye Chart.. What is Numerator and what is Denominator.
Numerator–is the distance from the chart (20ft)…and Denominator–is the distance the avg eye can read the chart.
Eye movement is controlled by what three cranial nerves
CN III, IV, VI