Nose and Throat Exam

Question 1

What should you note about nasal discharge?

Answer 1

color
consistency
odor
amount
timing
bilateral/unilateral?
CABCOT

Question 2

Normal nasal discharge is

Answer 2

clear/colorless
thin (not viscous)
no odor
some discharge (none is not normal)

Question 3

Bacterial infection may have what type of discharge?

Answer 3

green/yellow

Question 4

classic presentation of a nasal foreign body is

Answer 4

unilateral, malodorous, nasal discharge

Question 5

patency

Answer 5

how well you breathe through your nose

congestion, timing, uni/bilateral

Question 6

associated symptoms that are typical with nasal complaints

Answer 6

dental pain
burning
headache
fever

Question 7

things to observe when beginning nasal exam

Answer 7

swelling
deformity (bony abnormality)
erythema

Question 8

things to palpate during nasal exam

Answer 8

tenderness (at joint of nasal bone and cartilage)
crepitus (cracking sound or sensation-two bones rubbing together)
warmth
any skin lesions?

Question 9

things to observe when looking into the nasal canal

Answer 9

discharge
septum (midline? deviated? blood vessels visible?)
inferior turbinate (blob of pink tissue)

Question 10

viscous discharge is called

Answer 10

crusting

Question 11

kesovexplexus

Answer 11

most common spot of nose bleeds (area in the anterior nasal canal that is highly vasculated)

Question 12

turbinate

Answer 12

filtering units in the bone

covered with rich vasculated mucosa

Question 13

what does the maxillary sinusitis make the inferior turbinate look like?

Answer 13

coated in purulous fluid

Question 14

what are you noting when palpating the maxillary and frontal sinuses?

Answer 14

tenderness
bony abnormalities
hard when touched (could indicated cancer)

Question 15

transillumination can be used to diagnosis

Answer 15

fluid in the sinuses (should be able to see light on hard palate if sinuses are free of fluid-place the light on the cheek)

Question 16

nasal polyps

Answer 16

translucent, pearly mass in the nose
sign of chronic irritation (drugs, smoking, allergies)
may originate in the nose or in the sinuses
pt presents with persistent nasal congestion

Question 17

deviated septum

Answer 17

can be caused by trauma
>70% occlusion would indicate surgery
may cause hypertrophy of the turbinate on the “free” side
CC may be sleep apnea/snoring

Question 18

nasal vestibulitis

Answer 18

usually bacterial staph (MRSA) infection
red bulbous tip of their nose
red just inside the nose (vestibule)

Question 19

nasal foreign bodies may be combined with

Answer 19

impetigo (from scratching and breaking the skin)

-strep and staph infection

Question 20

best way to deal with nasal foreign bodies

Answer 20

try to blow it out

Question 21

new links are being made between oral health and

Answer 21

CV disease

Question 22

what to note w/lip inspection

Answer 22

color and moisture
lumps
ulcers
cracking
scaliness

Question 23

leukoplakia

Answer 23

precursor to cancer from ill-fitting dentures

Question 24

what to note w/oral mucosa inspection

Answer 24

color
ulcers
white patches/red patches
nodules

Question 25

what to note w/ gum inspection

Answer 25

color caries ulcers

Question 26

when patient phonates, the uvula should

Answer 26

elevate

Question 27

what does having the pt swallow test for?

Answer 27

nerve test

Question 28

floor of mouth holds

Answer 28

wartons duct | mandibular salivary gland

Question 29

asymmetry of tongue indicates

Answer 29

cranial nerve problem

Question 30

steps of the mouth exam

Answer 30

1. evert the lip (you can or have pt do it) 2. using pen light to visualize 3. use two tongue blades 4. palpate (careful with old people-dementia and little people)

Question 31

areas to palpate of the tongue

Answer 31

1. tongue 2. floor of mouth 3. buccal mucosa 4. roof of mouth (use two fingers)

Question 32

acute exudative tonsillitis

Answer 32

cryptic tonsils (surface has divites) infection of the tonsils erythema common in mononucleosis

Question 33

apthous stomatitis

Answer 33

cold sore on the inside of the mouth | organism is herpes virus

Question 34

dental abscess

Answer 34

infection of the teeth (cavities gone wild)

Question 35

herpes labialis

Answer 35

cold sores on the outside of mouth (around lips) | painful, pt may become dehydrated (painful to drink)

Question 36

peritonsillar abscess

Answer 36

tonsil itself is not abscessed, it is the peritonsillar space behind the tonsil that pushes the tonsil toward the midline CC: severe aphagia, dysphagia, look sick, high fever

Question 37

Rendu-Osler-Weber

Answer 37

familial telangectasias present all over lips, tongue, nose -most common on oral mucosa but can present anywhere on the body

Question 38

preauricular lymph node palpation

Answer 38

in front of the ear, usually reacts to infections of eye and scalp

Question 39

posterior auricular lymph node palpation

Answer 39

superficial to the mastoid process, usually reacts to infections of scalp and ear

Question 40

parotid nodes

Answer 40

palpable could indicate mumps, reacts to abnormality in parotid glands

Question 41

pharyngeal nodes

Answer 41

responds to whats going on in the throat (tonsillitis, pharyngitis)

Question 42

submandibular nodes and submental

Answer 42

along angle of the jaw/ at point of chin | respond to whats going in lower teeth of lower jaw

Question 43

occipital nodes

Answer 43

reacts to what goes on in the scalp

Question 44

anterior cervical node

Answer 44

in a smoking person is cancer until you prove that it's not | reacts to things in the neck or throat

Question 45

posterior cervical nodes

Answer 45

react to things in neck and throat | classic finding in mononucleosis

Question 46

supraclavicular node

Answer 46

classic presentation of lymphoma (one node) and also may be present in breast cancer

Question 47

goiter

Answer 47

enlarged thyroid gland

Question 48

what to include when describing masses

Answer 48

``` size shape consistency mobility position ```

Question 49

the throat is separated into

Answer 49

anterior and posterior triangle (separated by the sternoclaudomastoid muscle

Question 50

thyroglossal duct cyst

Answer 50

``` congenital cyst (usually asymptomatic) may get infected ```

Question 51

branchail cleft cyst

Answer 51

on left side of neck | usually on division line of anterior and posterior triangle