HEENOT Flashcards by Will S

Present/past medical Hx to look out for

Eye disorders
Ear infections
Sinus infections
Throat infections
Allergies
Thyroid disease
Cancer

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Past surgical Hx to look out for

Head and neck procedures/medication

Cataract correction

Lasik eye correction

Ear tubes

Tonsillectomy

Wisdom teeth removal

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Family hx to look out for

Thyroid, atopic triad

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General signs to look out for

Fever

Chills

weight changes

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Integumentary signs to look out for

Rashes

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Face signs to look out for

Tenderness/swelling

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Eyes signs to look out for

pain
redness
drainage
itching

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Ear signs to look out for

tinnitus
ear pain
drainage

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Nose signs to look out for

congestion
rhinorrhea
sneezing
epistaxis

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Throat signs to look out for

Pain
dysphagia
hoarseness

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Neck signs to look out for

lymphadenopathy

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Gordon health patterns to reference

Sleep

Sexuality (infections)

Nutrition/metabolic

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Head exam:

Aligned?

Normocephalic

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Face exam

Scars
Lesions
Symmetry
Muscle weakness

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Tell-tale signs on initial exam

Allergic shiners

Nasal crease in allergies

Noisy nasal breathing

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Patient voice points to listen to

Breathy voice
Nasaly
Stridor?

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External eye points of interest

Eyebrow thinning/symmetry

Eyelashes (even distribution and direction of curl, infestations)

Able to close eyelids fully/lesions

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Eye abnormalities

Ptosis

Entropion

Hordeolum (sty)

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PERRLA for eye assessment

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Pupils

Equal

Round (should be perfectly round)

Reactive (should react to:

Light: dilation/contraction

Accommodation
(Looking far away pupils dilate, looking close pupils constrict)

Red light reflex

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Detect cataract and retinoblastoma

Reddish-orange reflection of light from fundus

How to hold opthalamascope

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Hold right hand, use your right eye and examine the patient’s right eye

Vice versa for left

Cataracts

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Clouding of lens

Leading cause of blindness worldwide

Risk factors: 
Age
UV B light
Diabetes
Cigarettes
HTN
Steroid use
Obesity
Beta blockers
Female

Further eye testing

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Peripheral vision

6 cardinal fields (slowly) (three descending vertical on left side, three descending vertical on right side)

Ear external exam

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Alignment
Deformities
Nodules
Ulcers
Lesions

Otoscopy use

External auditory canal for erythema, stenosis, debris/discharge

Examine tympanic membrane for

Normal: shiny, translucent, visible light reflex (R 5o clock vs. L 7 o clock) White= scarring Redness, bulging, dull, retraction= infection Perforations and tubes

Whisper test

6 words on each side, should hear at least 3/6

What size otoscope?

Biggest that will fit

Rinne test for ears

determine conductive or sensorineural hearing loss Place tuning fork on mastoid behind ear Patient will tell you when sound disappears Then put tuning fork to ear If air conduction>bone conduction they should hear it

Weber test for hearing

Tuning fork on top/center of head Normal=equal on both sides Check if sound is lateralized

ear abnormalities

Otitis externa (swimmers ear)=crusty, inflammed, nasty af Otitis media (ear infection)=red and opaque Tympanostomy tubes Scarring= opaque white

Which ear has cone of light at 7 O clock

Left ear

Which ear has cone of light at 5 o clock

Right ear

Nose external exam

Deformities, symmetry, size/nare patency Press on maxillary and frontal sinus

Nasal speculum to find

Septum (deviation) Rhinorrhea Masses Polyps (peeled grapes) Prominent vessels (snorting drugs) Allergies (pale/blue, puffy)

Abnormal nose findings

Sinusitis Epistaxis Deviated septums Polyps

Grading tonsils

1 and 2 normal 1+: fills <25% oropharynx between tonsil pillars 2+: 25-50% 3+: 50-75% 4+: >75% (almost or fully touching each other)

Posterior pharyngeal wall look for

Erythema Drainage Purulence Exudates Cobblestone appearance (allergies)

Black harry tonge

Smokers, pepto bismol, antibiotics

Leukoplakia in mouth

Permanent white marks in mouth Can turn to oral cancer

Head lymph nodes should be

Less than 1cm or invisible Soft Doesnt move

Meniere's disease

Inner ear disease that causes dizzy spells (verigo) and hearing loss. Can affect one or both ears.

atopic triad

Eczema, allergies, asthma

Delayed gagging is common in

Elderly

ectropion vs entropion

Ectropion: eyelid turns outwards Entropion: eyelid inwards

Allergic shiners

Allergy symptom Looks like you got punched in the eye

HEENOT Flashcards

(46 cards)