Head, Neck, Nose and Throat Assessment

Question 1

what components make up PAMFROSSSTI of the health history?

Answer 1

• P = previous medical history
• A = allergies
• M = medications
• F = family history
• R = review of systems
• O = occupation or education
• S = social
• S = sex life
• S = substances
• T = travel
• I = immunizations

Question 2

what are the 4 components of a physical exam?

Answer 2

• inspection
• palpation
• percussion
• auscultation

Question 3

in which area do we auscultate before palpating? why?

Answer 3

in the digestive system, so we don’t cause change to regular conditions/movement

Question 4

what is the Glasgow Coma scale?

Answer 4

a tool for assessing the patient’s response to stimuli based on eye opening response, best verbal response and best motor response

Question 5

what areas do we inspect for a head and nose assessment?

Answer 5

• scalp and hair
• face
• nose
• sinuses

Question 6

when does the posterior fontanelle typically close?

Answer 6

within first year from birth

Question 7

what technique do we use when palpating lymph nodes?

Answer 7

palpate bilaterally using 2nd, 3rd and 4th finger pads in circular motions

Question 8

which head/neck structures do we auscultate?

Answer 8

• thyroid
• carotids

Question 9

which cranial nerves are responsible for different eye movements?

Answer 9

CN III (oculomotor), CN IV (trochlear), CN VI (abducens)

Question 10

define ptosis

Answer 10

drooping of the eyelids

Question 11

what are the 3 divisions of the trigeminal nerve (CN V)?

Answer 11

• ophthalmic
• maxillary
• mandibular

Question 12

define hyperacusis

Answer 12

weakening of the stapedius muscle

Question 13

what is the expected finding upon palpation of lymph nodes?

Answer 13

• soft
• mobile
• nontender
• smaller than 1cm

Question 14

where is the coronal suture?

Answer 14

Between the frontal bone and the two parietal bones

Question 15

where is the sagittal suture?

Answer 15

Between the two parietal bones, running down the midline of the skull

Question 16

where is the lambdoid suture?

Answer 16

Between the parietal bones and the occipital bone at the back of the skull.

Question 17

where is the squamos suture?

Answer 17

Between the parietal bone and the temporal bone on each side of the skull.

Question 18

define cranial sutures

Answer 18

fibrous joints that connect the bones of the skull

Question 19

what are the expected findings upon inspecting mucus membranes?

Answer 19

• Pink
• moist
• smooth
• no swelling or discharge

Question 20

which areas of the nose can we inspect with a speculum?

Answer 20

• mucus membranes
• septum
• inferior and middle turbinates

Question 21

What are expected findings when inspecting the scalp and hair?

Answer 21

Scalp is smooth, intact, no lesions or infestations; hair is evenly distributed, appropriate thickness and texture.

Question 22

What are expected findings when inspecting the face?

Answer 22

Face is symmetrical, with normal expressions; no lesions, drooping, or swelling.

Question 23

What are expected findings when inspecting the frontal and maxillary sinuses?

Answer 23

No visible redness, swelling, or asymmetry over sinus areas.

Question 24

what do we assess when palpating the scalp?

Answer 24

• tenderness
• mobility

Question 25

should the scalp be mobile?

Answer 25

yes, scalp should move freely over the underlying bone when gently shifted with the fingers

Question 26

if there is pain which area should be palpated first?

Answer 26

the non painful area

Question 27

what are expected findings of palpating the temporal arteries

Answer 27

* Soft, elastic, and non-tender * Equal pulsation on both sides * No thickening, hardness, or nodularity * Non tender

Question 28

How do you assess the temporomandibular joint (TMJ)?

Answer 28

Palpate while the patient opens and closes their jaw; check for clicking or tenderness.

Question 29

What are expected findings when inspecting the carotid arteries?

Answer 29

Carotids are not visibly pulsating or enlarged; visible pulsations may be seen at midline but should not be bounding or abnormal.

Question 30

What are expected findings when inspecting the thyroid gland?

Answer 30

The thyroid is not visibly enlarged; normal to not see the thyroid at rest.

Question 31

How should carotid arteries be palpated, and what are expected findings?

Answer 31

Palpate one side at a time using thumb or index + middle finger; pulse should be strong, regular, and equal bilaterally without thrill.

Question 32

How is the thyroid palpated, and what are expected findings?

Answer 32

Palpate from behind; thyroid lobes should be smooth, non-tender, not enlarged, and may be slightly palpable in thin individuals.

Question 33

When would you auscultate the thyroid, and what is expected?

Answer 33

If thyroid is enlarged or vascular disease is suspected; no bruits should be heard over the thyroid.

Question 34

what hormones does the thyroid gland release?

Answer 34

* thyroxine (T4) * triiodothyronine (T3) * calcitonin

Question 35

where is the thyroid locateD?

Answer 35

anterior neck over the trachea

Question 36

do we percuss the neck and throat?

Answer 36

no

Question 37

what are