HEENT Flashcards
(48 cards)
What is Herpes Keratitis? What are the S/S?
Acute onset of severe eye pain, photophobia, tearing and blurred vision in ONE eye. Infection will permanently damage the corneal eptihelium causing blindness.
What are the 2 types of HERPESVIRUS that infects the eyes?
- Herpes Simplex Virus: Due to self-inoculation “cold sore” 2. Herpes Zoster Ophthalmicus (Shingles of Trigemenial Nerve): Cranial Nerve V; acute eruption of crusty rashes that follow the opthalmic branch of trigeminal nerves: 1 side of the forehead, eyelids, tip of nose
* * Refer to ED**
What is Acute Angle-Closure Glaucoma?
Sudden blockage of aqueous humor that causes increased ICP, resulting in ischemia and permanent damage to the optic nerve (CN2)
S/S of Acute Angle-Closure Glaucoma
Objective findings: Fixed and mid dilated, cloudy pupils (4-6mm) that look more oval than round, pupil reacts slowly to light, conjunctival injection with increased lacrimation
Subjective finding: HA, N/V, halos around lights and decreased vision
**Refer to ED —> Ophthalmological Emergency!
S/S of Optic Neuritis
Occurs in young adults with new or intermittent loss of vision of 1 eye, accompanied by nystagmus or other abnormal eye movement.
Objective findings: NEUROLOGICAL (seen in multiple sclerosis): Aphasia, paresthesiam abnormal gait, spasticity.
Subjective findings: Daily fatigure upon awakening that worsens as the day goes on. Heat sensitivity (exacerbates symptoms)
Refer to Neurologist
What is Cholesteatoma?
“Cauliflower like” growth accompanied with foul-smelling ear discharge
Mass is NOT cancerous but can erode into the bones of the face and damage the facial nerve ( CN VII)
S/S of Cholesteatoma and Treatment
Exam: No tympanic membrane or ossicles are visible d/t destruction by the tumor
Subjective finding: hearing loss
TX: ATB and surgical debridement
Refer to Otolaryngologist
What is periorbital ecchymosis?
“Raccoon Eyes”- is bruising around eyes and behind the ears (mastoid area) that appears 2-3 days AFTER trauma.
assessment needs for periorbital ecchymosis
Physical exam (quickly after trauma) may not show clinical signs immediately
Assess for clear golden serous drainage from the nose/ear. Use urine dipstick- if CSF is present it will show + for glucose
Rule out basilar and/or temporal bone skull fracture.
Refer to ED
What is Presbyopia?
Age-related visual change d/t a decreased ability of the eye to accomadate stiffening of the lenses. Usually begins at age 40. Near vision is affected with decreased ability to read small print at close range.
What is cerum?
Ear wax- color ranges from yellow to dark brown
S/S of Peritonsillar Abscess
Subjective findings: severe sore throat, difficulty swallowing (Odynophagia), “hot potato voice”, Trismus (jaw mm spasm, making is difficult to open jaw), malaise, Chills
Objective findings: Unilateral swelling of peritonsillar area and soft palate. Swollen, bulging red mass with uvula displaced away from the mass. Fever
Refer to ED
Conditions that cause post nasal drip
Acute sinusitis
Allergic rhinitis
What is Papilledema?
Optic disc swollen with blurred edges d/t increase intracranial pressure secondary to bleeding, brain tumor, abscess and pseudotumor cerebri
Describe Cheilosis
Painful skin fissures and maceration at the corners of the mouth due to excessive moisture. Can be acute or chronic.
Commonly found in the elderly with dentures. Other etiologies: nutritional deficiencies, Lupus, Autoimmune disease, irritant dermitits, squamous cell carcinoma, pacifer use.
Secondary infections with Candida Albicans (yeast) or Baceria (Staphylococcus Aureus)
How do you treat Cheilosis
Check B12 level to rule out pernicious anemia, remove underlying cause (unfitted dentures), for yeast infection= topical azole ointment (Clotrimazole, miconazole) BID, for bacterial infection= C&S and treat with topical mupirocin ointment BID, once infection is clear use barrier cream with zinc or petroleum jelly at night.
High rate for recurrence
Hyperopia
“Farsightedness” Distance vision is intact- near vision is blurry
Myopia
“Nearsightedness”. Near vision is intact, distance is blurry
What is a Snellen test used for? How is it administered?
Snellen test is used for testing of central distance vision.
Have the person stand 20 feet away from chart
How do you test vision in an illiterate person?
Use Tumbling E Chart
What does the Snellen test results mean?
Top # = Distance in feet at which the patient stands from chart or picture eye chart (20ft)
Bottom # = number of feet that patient can see compared to a person with normal vision (20/20 or less)
At what age should children reach visual acuity of 20/20? When should you refer a child to an ophthalmologist?
Visual acuity should be reached by 6 years old
If the childs vision is not at least 20/30 in either eye by age 6, refer to ophthalmologist
Weber Test
Place a tuning fork on midline on forehead.
Normal findings: No lateralization
Abnormal findings: Lateralization (hearing sound in only 1 ear)
Rinne Test
Place tuning fork 1st on mastoid process and then in front of the ear. Time each area
Normal finding: Air conduction (AC) last longer than bone conduction (BC)
