Test 2 Lecture Material

Question 1

Pt. sticking out tongue in a asymmetric protrusion suggests

Answer 1

A lesion in CNXII- the deviation of the tongue going toward the same side as the lesion in the CN

Question 2

Saying “AHHHH” and seeing the uvula rise is done by what CN?

Answer 2

CN X…Uvula should rise midline, a deviation to one side suggests a lesion in Vagus.

Question 3

For tracheal deviation…If have volume loss..collapsed lung, atelectasis

Answer 3

Tracheal will be pulled toward affected lung

Question 4

Trachea will be pulled away from affected side when?

Answer 4

In thyroid enlargement, pleural effusion, tension pneumothorax

Question 5

What do firm nodules confirm in thyroid gland? What does tenderness?

Answer 5

A. Malignancy or Hashimoto’s Thyroiditis

B. Tenderness=Thyroidititis

Question 6

How can tell for hyperthyroidism?

Answer 6

During palpation find that gland is enlarged and listen for a bruit (unusual sound blood makes when rush past an obstruction.

Question 7

What are some HPI and Pros associated with oral cavity?

Answer 7

Sore Throat or pharyngitis? Sore tongue? bleeding from gums? hoarseness? Any Swollen glands or lumps in neck? temperature intolerance? Sweating? skin changes? tobacco

Question 8

When examining the mouth and throat it helps?

Answer 8

To have patient in a comfortable seat, best if you are positioned higher than the patient.

Question 9

Stenson’s Duct?

Answer 9

Duct near the second molar…Parotid.

Question 10

Wharton’s Duct?

Answer 10

Submandibular duct. Floor of the mouth.

Question 11

Infant Ear Exam

Answer 11

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.

Question 12

Infant Ear exam externally

Answer 12

Looking for skin tags, and pits. Skin Tags have small association with renal problems in children.

Question 13

Ear canal from 3 to 6 months

Answer 13

Gently pull ear down and outward to see the TM in infants. As child grows angle will develope in child to adult.

Question 14

Why use Pneumatic Otoscopy

Answer 14

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.

Question 15

Infant Nose Exam

Answer 15

Children are obligate nose breathers. Check patency of one nare…if concerned utilize catheter placement.

Question 16

For children with allergies, what physical signs should you see?

Answer 16

Assess for crease of nose and allergic shiners.

Question 17

When do sinuses develop?

Answer 17

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.

Question 18

Child Tonsil Examination

Answer 18

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.

Question 19

Teeth development of child.

Answer 19

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.

Question 20

Exophthalmos

Answer 20

Eyes bulging out. Rare to see..seen with thyroid disease.

Question 21

HPI or PROS for eye questions

Answer 21

Persistent or transitory, any recent trauma, time spent on computer screens, new medications, past medical and surgical history, recent URI, Last eye exam.

Question 22

Tendency for early thyroid problem

Answer 22

thinning out of the eyebrow toward the end.

Question 23

For Snellen Eye Chart.. What is Numerator and what is Denominator.

Answer 23

Numerator–is the distance from the chart (20ft)…and Denominator–is the distance the avg eye can read the chart.

Question 24

Eye movement is controlled by what three cranial nerves

Answer 24

CN III, IV, VI

Question 25

What is a consensual response

Answer 25

When light is shinned into left eye can watch for a constriction in the right eye.

Question 26

Swinging Light Test

Answer 26

A clinical test for functional impairment in the optic nerves….Light in one eye…swing to other eye….dilates second eye prior to light then…constrict to match first pupil.

Question 27

Lateral Penlight Test

Answer 27

Shine light from the temporal side of head. Measures depth of the anterior chamber of the eye. This exam mydriatic drops to the eye. A shallow anterior chamber indicates a risk of acute-angle glaucoma.

Question 28

Corneal light reflex

Answer 28

testing for ocular alignment by reflecting light off the patient’s pupils. Normally light reflects from center of both pupils. Eye turned in (esotropic)light reflected lateral to the pupil. Eye turned out exptropia light reflected medial to pupil.

Question 29

Cover test

Answer 29

a test to to detect tropia…full time eye misdirection. Normal test no movement.

Question 30

Cover-to uncover testing

Answer 30

USed to destect presence of a phoria.