Ch. 13 - ENT

Question 1

In adults, the length of the external auditory canal is _____ cm.

Answer 1

2.5 cm

Question 2

The middle ear contains the

Answer 2

umbo and malleus.

• middle ear = malleus (w umbo), incus, stapes.

Question 3

The middle ear is normally filled with

Answer 3

air

Question 4

The hair cells of Corti and membrane of Corti stimulate what CN

Answer 4

CN8

(Vibrations from TM cause delicate hair cells of the organ of Corti to strike against the membrane of Corti, stimulating impulses in the sensory endings of the auditory division of the eighth cranial nerve.)

Question 5

The organ of Corti is a coiled structure located inside the

Answer 5

cochlea in inner ear

Question 6

A 5-year-old child presents with nasal congestion and a headache. To assess for sinus tenderness, you should palpate over the

Answer 6

maxillary sinuses only.

young child does not develop frontal sinuses until 7 to 8 years of age

Question 7

A 30-year-old woman presents with rapid swelling beneath her jaw that suddenly appears while
she is eating. The swelling is mildly painful but is not hot or red. You suspect Wharton salivary
duct stones and proceed to palpate

Answer 7

under the tongue, along each side of the frenulum.

Wharton = submandibular

Question 8

An infant’s auditory canal, when compared with an adult’s, is

Answer 8

short and curved upward.

Question 9

When examining an infant’s middle ear, the practitioner should use one hand to stabilize the otoscope against the head while using the other hand to

Answer 9

pull the auricle down and back.

(in an effort to straighten the
upward curvature of the canal.)

Question 10

The eruption of permanent teeth most commonly begins with the

Answer 10

lower central incisors

• 6-7 yrs = lower central incisors
• 7-8 yrs = upper central incisors
• 9-10 yrs = the lower canines
• 8-10 yrs = upper lateral incisors
• 11-12 yrs = upper canines

Question 11

The pregnant woman can expect to experience

Answer 11

more nasal stuffiness.

(nasal stuffiness, a decreased sense of smell, impaired hearing, epistaxis, fullness in the ears, Increased gingival vascularity)

Question 12

During what developmental stage are hoarseness, voice cracking, and a persistent cough a common finding?

Answer 12

pregnancy

Laryngeal changes = hoarseness, deepening or cracking of the voice, vocal changes, and persistent cough.

Question 13

Mr. S presents with the complaint of hearing loss. You specifically inquire about current
medications. Which medications, if listed, are likely to contribute to his hearing loss?

Answer 13

Salicylates.

(Ototoxic meds = aminoglycoside, salicylates, furosemide, streptomycin, quinine,
ethacrynic acid, and cisplatin)

Question 14

Mr. W, age 25 years, has recovered recently from an upper and lower respiratory infection. He
describes long-standing nasal dripping. He is seeking treatment for a mild hearing loss that has
not gone away. Information concerning his chronic postnasal drip should be documented in
which section of his history?

Answer 14

Past medical data

Question 15

A newborn whose serum bilirubin is greater than 20 mg/100 mL risks later

Answer 15

Hearing loss.

infant hearing loss RFs =
infection, irradiation, drug abuse, mom w RPR
birth wt <1500 g, excessively high bilirubin level, infections, cleft palate, craniofacial abnormalities, ototoxic antibiotic use, head trauma, and hypoxic episodes in infancy.

Question 16

To approximate vocal frequencies, which tuning fork should be used to assess hearing?

Answer 16

500 to 1000 Hz

Question 17

When conducting an adult otoscopic examination, you should

Answer 17

select the largest speculum that will fit in the canal.

Question 18

normal TM color is

Answer 18

pearly gray

Question 19

bulging of an amber TM without mobility is indicative of

Answer 19

middle ear effusion

Question 20

With OE, perf’d TM, or or myringotomy tube you should ___

Answer 20

avoid instilling fluids

Question 21

speech with monotonous tone and erratic volume may indicate

Answer 21

hearing loss

Question 22

placing tuning fork at midline vertex of pt’s head is a test for

Answer 22

lateralization of sound

Question 23

You are performing Weber and Rinne hearing tests. For the Weber test, the sound lateralized to
the unaffected ear; for the Rinne test, the air conduction to bone conduction-to-ratio was less
than 2:1. You interpret these findings as suggestive of

Answer 23

defect in the inner ear (sensorineural hearing loss)

Question 24

nasal Sx that imply an allergic response include

Answer 24

bluish gray nasal turbinates

Question 25

a smooth red tongue with a slick appearance may indicate

Answer 25

a niacin or Vitamin B12 deficiency

Question 26

White, rounded, or oval ulcerations surrounded by a red halo and found on the oral mucosa are

Answer 26

aphthous ulcers.

Question 27

A hairy tongue with yellowish brown to black elongated papillae on the dorsum is seen

Answer 27

after antibiotic use

Question 28

To inspect the lateral borders of the tongue, you should

Answer 28

pull the gauze-wrapped tongue to each side.

Question 29

A 6-month-old who can hear well can be expected to

Answer 29

turn their head toward the source of sound

Question 30

Which variation may be an expected finding in the ear examination of a newborn?

Answer 30

diffuse light reflex | newborn TM does not become conical until for several months

Question 31

an otoscopic and oral examination in a child should be

Answer 31

performed at the end of the examination. | gain trust first

Question 32

Which pediatric patient complaints would you refer immediately to the emergency department?

Answer 32

A drooling patient with muffled voice and stridor

Question 33

Expected physical changes associated with older adults include

Answer 33

bristly hairs in the vestibule.

Question 34

Evidence-based practice suggests that the strongest predictor of sinusitis is

Answer 34

maxillary toothache, purulent nasal secretions, dull or opaque sinus transillumination, poor response to decongestants, and colored nasal discharge.