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Pt Assess Final > Head/Neck/ENT Lecture > Flashcards

Head/Neck/ENT Lecture Flashcards

(68 cards)

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1
Q

Tangential lighting

A
  • Indirect or cross lighting

- Works to enhance inspection

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2
Q

Palpation can be used to assess:

A
  • Size
  • Presence of mass/abnormality
  • Presence of tenderness
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3
Q

Tenderness is in the ____ portion of SOAP note, pain is in the _____ portion

A

Objective

Subjective

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4
Q

Percussion is used to assess:

A
  • Presence of fluid
  • Enlargement of organs
  • Solidification of normally hollow body parts (e.g. lungs)
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5
Q

Percussion is used mainly with which body parts?

A

Lungs
Abdomen
Sinuses
Peripheral nerves

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6
Q

Auscultation is used mainly with which body parts?

A

Heart
Lungs
Abdomen
*Also for bruits elsewhere

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7
Q

Special tests

A

NOT a part of inspection, palpation, percussion, auscultation

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8
Q

Inspection of head:

A

Symmetry
Distribution of hair
Areas of baldness
Flakes, rash, nits

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9
Q

What would make a head asymmetric?

A
  • Untreated craniosynostosis (as an infant)

- Prior head trauma

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10
Q

What would make a head increased in size?

A
  • Hydrocephalus (infants)
  • Acromegaly
  • Paget’s disease
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11
Q

What would make a head decreased in size?

A

Microcephaly

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12
Q

Palpation of the head includes:

A
  • Skull for masses, defects, tenderness

- Texture of hair

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13
Q

Possible abnormalities found with palpation of head:

A

-Defects d/t trauma or surgeries

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14
Q

Thin hair could indicate:

A
  • Iron deficiency anemia

- Thyrotoxicosis (hyper)

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15
Q

Coarse hair could indicate:

A

Hypothyroidism

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16
Q

Inspection of the neck includes looking for:

A
  • Masses, scars, deformities
  • Swelling
  • Deviation of trachea
  • Goiter
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17
Q

Why do we have patient swallow during neck exam?

A

Evaluate thyroid - it moves up and down with swallowing

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18
Q

How to palpate thyroid:

A
  • Stand behind pt
  • Neck relaxed, slightly flexed
  • Find cricoid cartilage
  • Have pt swallow
  • Displace trachea to each side and palpate opposite side
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19
Q

T/F: Goiter is a sign of abnormal thyroid function.

A

FALSE, it is not necessarily an indication of abnormal function

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20
Q

When do we auscultate the thyroid?

A

IF it is enlarged, to listen for a bruit

*Bruit may be present in hyperthyroidism, but not always

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21
Q

Name the lymph nodes we palpate:

A

Preauricular, postauricular, occipital, tonsillar, submandibular, submental, superficial cervical, posterior cervical, deep cervical, supraclavicular

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22
Q

What is Virchow’s node?

A
  • Enlarged and/or firm supraclavicular node on the LEFT

- Can indicate gastric cancer

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23
Q

Inspection of the carotid artery:

A
  • Medial to SCM
  • Look for any visible pulsations
  • AUSCULTATE prior to palpation
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24
Q

What is a thrill?

A
  • Palpable counterpart of a bruit

- Vibration due to turbulence in a vessel

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25
Auscultation of the carotid
- To identify a bruit | - Pt must hold breath to eliminate tracheal noise
26
Carotid bruits
- May indicate stenosis | - Sometimes they are aortic murmurs that radiate to neck
27
T/F: Always palpate carotids one at a time
True - palpating both simultaneously can cause total occlusion of blood flow to the brain
28
Inspection of the ears:
- Each auricle for lumps, skin lesions - Note piercings - Grossly inspect ear canal for redness, cerumen, discharge
29
Palpation of the ears:
- Ask about pain first! - Then palpate auricle and tragus for tenderness - Tug test - Mastoid
30
Tug test positive:
Otitis externa
31
T/F: pts with otitis media will have pain with tug test
FALSE, they will not have pain on tug test
32
Tenderness of mastoid may indicate:
- Mastoiditis | - Otitis media
33
Special tests of the ear:
- Auditory acuity - Lateralization (Weber) - Air/Bone conduction (Rinne)
34
Auditory acuity test
"Finger rub" | Crude test of hearing
35
Lateralization hearing test
- Weber - Place 512 tuning fork on top midline of head - Normal: equal both ears
36
Conductive hearing loss Weber test results
-Hears the tone in AFFECTED ear | Need Rinne to figure this out
37
Sensorineural hearing loss Weber test results
-Hears the tone in UNAFFECTED ear | Need Rinne to figure this out
38
Normal response of Rinne test:
Air > bone conduction | Next to ear is louder
39
Conductive hearing loss Weber & Rinne results:
- Weber lateralizes to 1 ear | - Rinne B > A in same ear
40
Sensorineural hearing loss Weber & Rinne results:
- Weber lateralizes to 1 ear | - Rinne A > B in same ear
41
Sensorineural hearing loss Weber & Rinne results:
- Weber lateralizes to 1 ear | - Rinne A > B in same ear
42
Conductive hearing loss
Outer or middle ear
43
Sensorineural hearing loss
Inner ear or CN 8
44
What to look for on otoscopic exam?
- Cone light reflex (below malleus) - Handle and short process of malleus in upper portion of TM - Note color and position of TM
45
Normal color and position of TM
Red/pale or pink/yellow | Neutral position
46
TM red and bulging associated with?
Otitis media
47
TM retracted a/w?
Tympanosclerosis
48
TM air-fluid level a/w?
Otitis media
49
TM has vesicles a/w?
Bullous myringitis
50
Inspection of the nose:
- Nares for flaring - Nasal bone for symmetry - Mucus membranes - Septum - Turbinates - Discharge
51
Nasal speculum should open in which direction inside the patient's nose?
North to South | Septum is sensitive
52
Normal findings of septum, turbinates, mucosa, discharge?
- Septum midline - Turbinates project into nasal passage leaving room for air passage - Mucosa is red but not "angry" - Discharge, if any, is scant and thin
53
Normal findings of septum, turbinates, mucosa, discharge?
- Septum midline - Turbinates project into nasal passage leaving room for air passage - Mucosa is red but not "angry" - Discharge, if any, is scant and thin
54
Septum perforation a/w?
Cocaine inhalation (or other drugs)
55
Edematous and erythematous nasal mucosa a/w?
Acute rhinitis
56
Pale, boggy, swollen nasal mucosa a/w?
Allergic rhinitis
57
Hypertrophied turbinates?
Chronic rhinitis
58
Nasal polyps
Soft, gray occluding lesions in nasal passages
59
Pus in nasal passages?
Sinusitis
60
Nasal patency test
Pt occludes one nostril, breathes out the other
61
Which sinuses can be percussed?
Frontal | Maxillary
62
Normal inspection of exterior mouth:
No sores, well hydrated, no cracking, no cyanosis
63
Inspect teeth for:
Wear, decay, missing
64
Inspect dorsal tongue for:
Geographic tongue, hydration, atrophy, fasciculations
65
Stenson's duct location
Buccal mucosa at 2nd upper molar
66
Deviation of uvula indicates:
CN 10 problem
67
Deviation of tongue indicates:
CN 12 problem
68
Torus palatinus
Hard lump on hard palate | Common finding, benign

Pt Assess Final (7 decks)

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