Advanced HEENT Flashcards
Weber test
Patient is asked to close their eyes. Tuning fork is placed on a midline structure. The patient is asked where they hear the sound. Note that up to 40% of normal hearing persons also alteralize the hearing test, so it is only effective if used on a patient with known hearing impairment.
If the hearing loss is neuropathic, the patient will report hearing the sound more in their good ear.
If the hearing loss is conductive, the patient will report hearing the sound more in their bad ear.
Performed in conjunction with Rinne test.
Sudden sensorineural hearing loss
Acute onset hearing loss (< 3 days). Most often affects only one ear. Etiology of the problem lies in the inner ear organs or the cochlear nerve.
Otologic eergency. Function may be restored with high dose prednisone if treated quickly. Otherwise could be permanent.
Rinne test
The patient is asked to close their eyes. The tuning fork is placed behind the ear on the mastoid bone and in front of the ear (held in the air).
A normal (positive) Rinne is when air conduction is louder than when the fork is on the mastoid bone
A negative (abnormal) Rinne is when bone conduction is louder than air conduction.
Hard palate
bony portion of the roof of the mouth, separating the nose from the mouth
Soft palate
Soft tissue that makes up the roof of the mouth. This is situated posterior to the hard palate and includes several muscles responsible for closing off the nose from the mouth during acts of swallowing and speaking.
The uvula is considered part of the soft palate.
Salivary glands
These are exocrine glands that produce saliva.
There are 3 paired major salivary glands (the parotid, submandibular, and sublingual glands) as well as hundreds of minor salivary glands. These glands can produce mucous or serous or mixed seromucous secretions.
Stenson’s duct:
Duct that drains the parotid gland. Seen on the buccal surface of the oral mucosa near the second molar.
Wharton’s duct
Duct that drains the submandibular gland. It is seen beneath the tongue.
Sialolithiasis
Calculi (or stones) that can block the duct and prevent drainage of saliva from the gland.
Sialoadenitis
Inflammation of the salivary glands that can lead to painful swelling or even more chronic recurrent swelling typically worse when eating
Nasal turbinates
These cylindrical shaped bones covered in a mucosal lining act as the humidifiers of the nose.
They have a lot of vascular tissue and are responsible for several properties of nasal physiology including, but not limited to, congestion and decongestion of the nose as well as helping to filter the air.
Salivary gland anatomy
Salivary duct anatomy
