Upper Respiratory Exam Flashcards
What is the umbo?
where eardrum meets tip of the manubrium of malleus
What is the manubrium?
handle of malleus (part that you can see)
What are the two portions of the eardrum?
pars flaccida = superior
pars tensa = inferior
What is the nerve in the eardrum and where would you see it?
chorda typani nerve - runs in superior part near pars flaccida
How do you perform a whisper test?
dr stands behind pt and has them occlude one ear
dr exhales fully and then whispers a combo of numbers and letters
normal: pt repeats sequence or after 2 sequences can ID 3/6
abnormal: pt incorrectly iDs 4 of 6
How do you perform a weber test?
tests for lateralization
vibrating fork placed in top of pt’s head or on middle of forehead
if they hear it better on one side –> should do Rinne test to see if the side lacking has issues
How do you perform a Rinne test?
put vibrating for on mastoid bone behind ear
when pt can no longer hear sound –> put fork close to ear canal and ask if they can hear sound and for how long
normal: AC>BC
* if Weber was abnormal and Rinne was normal, suspect sensorineural loss in opposite ear
If AC = BC or BC>AC –> conductive loss to that ear
What nerves control the soft palate?
CN 9 and 10
What would you see in paralyses of the soft palate?
uvula deviates to opposite side and soft palate doesn’t rise with saying “ah”
What are the 4 sets of lymph nodes you should know how to palpate?
anterior cervical
posterior cervical
submandibular
supraclavicular
When are frontal sinuses developed?
8 to 10 years of age
in forehead
If you expect an ear infection, what PE do you perform?
check eyes check sinuses for tenderness check nose and nasal turbinates check throat, tonsils check external and internal ear
What does otitis media look like?
Will see bulging tympanic membrane with varying degrees of erythema
will distort cone of light/ it won’t be seen
What is pharyngitis?
inflammation of pharynx with resulting sore throat
Can be viral or bacterial
Can see coryza, conjuctivitis, malaise or fatigue, hoarseness, and low grade = suggest viral
What is coryza?
inflamed mucus membrane
Why can patients report nausea with sore throat?
the pharynx is right next to intra-abdominal organs on the somatosensory map
What is GABHS?
group A beta-hemolytic streptococcus
What things let you know a sore through has the highest likelihood of being GABHS?
children 5-15 winter and early spring absence of cough tender anterior cervical lymphadenopathy tonsillar exudate fever
What is the centor score?
Each risk factor for GABHS gets one point
if 0 or 1 –> no further antibiotic testing necessary
if 1-3 –> do culture –> can tell if antibiotics or not
if 4 or greater –> can consider empiric tx with antibiotics
What does a rapid antigen detection test look for?
detects presence of group A strep
What is a monospot test?
rapid slide agglutination test for mononucleosis
What are the 4 types of middle ear infections?
acute otitis media
acute suppurative OM: acute OM w/ purulent material in middle ear
OM with effusion: inflammation and fluid buildup in the middle ear without bacterial or viral infection; may occur bc fluid buildup persists after an ear infection has resolved
Chronic OM w effusion: persistent infection that often results in tearing of the eardrum
What is an inner ear infection called?
labyrinithitis
What is considered chronic?
lasting more than 6 weeks
