Upper Resp Exam - Clinical Considerations Flashcards
osteopathic considerations in URE
lymphatics and cranial
- open the thoracic inlet
- sinus milking
- galbreath technique
- temporal rocking
s/s of acute bacterial rhinosinusitis
- localized pain over frontal and maxillary sinus
- upper teeth hurting from maxillary sinuses
- thick nasal discharge
from both sides that may be worse on one side
rare: severe headaches, redness, tenderness or swelling in or around the eyebrow/ eye - peristent and not improving (>10 days)
- severe (> 3-4 dyas)
- worsening/ double sickening ( > 3-4 days)
dizziness differentials
ENT issues: BPPV, labyrinthitis, meniere’s disease
CV: dysrhythmia, hypotension
resp: hyperventilation
neuro: parkinsonism
diagnosing, treatment for BPPV
diagnosis: Dix-Hallpike - patient sitting on end of table, tilt head to 45 degrees in one position then quickly tilt head back 20 degrees back, + test is nystagmus, indicates lithiasis
treatment: Epley maneuver (canalith repositioning) and vestibular rehabilitation, and Meclizine (Antivert)
strep throat s/s
- beefy red soft palate and uvula
- enlarged red tonsils
- white or yellow patches on tonsils (tonsillar exudate)
- tiny red hemorrhages on soft palate
- no cough
- fever (subjective or measured)
- cervical adenopathy
- age 1 point for age 15
antibiotic if > or = 4 points
streaks of lymphoid tissue running down posterior oropharynx
cobblestoning
3 main causes of earaches
AOM
- otitis media with effusion/ serous otitis
- otitis externa
bulging TM along with symptoms of tugging on ear, fever, pain, decreased hairing maybe irritation then likely..
AOM
no bulging TM, but opacificaiton or air-fluid level, pooling of fluid halfway through TM then likely…
OME (otitis media with effusion)
pneumatic otoscope what might indicate a bulging vs. retracted TM?
- puff of air and TM went away, its a BULGING TM
- when you let air out and TM comes back towards otoscope - then its a RETRACTED TM
Tx for bacterial rhinosinusitis
amoxicillin/ clavulanate (augmentin)
if penicillin allergies then doxycycline or a respiratory fluoroquinolone or moxifloxacin ( avelox)
vestibular neuritis Tx
steroids
Meniere disease Tx
intratympanic dexamethasone
gentamicin
orthostatic hypotension causing presyncope Tx
alpha agonists
mineralocorticoids
lifestyle changes
4 categories of dizziness
vertigo, disequilibrium, presyncope, or lightheadedness
