HEENT Exam

Question 1

Introduce as PA Student _____

Answer 1

Good Afternoon I’m PA Student Hudson

Question 2

Inspect head and face for injury (while standing in front)

Answer 2

(Are you having any issues with this area?)

Head is normocephalic there are no lesions or areas of ecchymosis erythema, or swelling.

Question 3

Palpate cranium, mastoid, temporal artery, face. Say, “Are you having any tenderness in this area?”

Answer 3

There are no masses or tenderness elicited. The temporal artery is non tender.

Question 4

Inspect hair distribution. Palpate hair and scalp.

Answer 4

Symmetrical hair distribution with normal texture. hair and scalp are without scaling, lesions, infestation, or tenderness.

Question 5

Inspect and Palpate parotid glands.

Answer 5

Parotid glands are without nodules or irregularity.

Question 6

Inspect TMJ by applying pressure and asking pt to open and close mouth. Palpate for crepitus. Palpate temporal and master separately.

Answer 6

TMJ is non tender without swelling.

Symmetric motor function of cranial nerve 5.

Question 7

Tell pt to close eyes, you will touch their forehead cheek and jaw. Ask them where they feel the sensation.

Answer 7

No sensory deficit of cranial nerve 5.

Question 8

Ask pt to shut eyes tight, Open them, raise eyebrows, relax. Ask pt to puff out cheeks and not let you push down.

Answer 8

Symmetric motor function of cranial nerve 7.

Question 9

EYE

Give pt visual card and check visual acuity. both then right then left read in opposite ways.

Answer 9

Visual acuity is 20/20 OD/OS/OU.

Question 10

Inspect brown lashes and lids.

Answer 10

No exophthalmos, ptosis, periorbital discoloration, skin lesions, or edema.

Question 11

Inspect and Regurge Lacrimal ducts.

Answer 11

No swelling or regurgitation.

Question 12

Inspect conjunctiva sclera and cornea. Pull eye down and tell pt to look up and left and right. Pull eye lids up to see superior sclera.

Answer 12

No injection, icterus, lesions edema, or foreign bodies. Cornea is clear.

Question 13

Check anterior eye chamber shine light at lateral aspect bilaterally. While standing in front.

Answer 13

No crescent shadow noted.

Question 14

Shine light in left eye ( see constriction ) Shine light in right eye (looking at left) still see constriction.
Same in other eye.

Answer 14

Pupils are equal round and reactive to light.

Question 15

Shine light in one eye, see dilation. Shine light to other eye quick, keep light on second eye 3 seconds.
Repeat 2-3 times.

Answer 15

No RAPD.

Question 16

Stand in front of pt and shine pen light at nose tell them to look at your nose. Observe equal light reflection.

Have Pt. Perform cover uncover test.

Answer 16

No tropia.

Question 17

Have pt follow conjugate eye movements in H pattern.

Answer 17

Extraocular movements are full and equal.

Question 18

Shift finger in towards pats nose after the H.

Answer 18

“eyes converge equally and pupils constrict with near focus”

Question 19

Have pt look at your chin. Perform 3 movements with finger to elicit peripheral vision.

Answer 19

”visual fields are full and equal by confrontation”

Question 20

Get Otto scope. Brace finger on pt. Use same eye as pt to visualize fundus. Inspect for red reflex.

Answer 20

Red reflex is present.

Question 21

Inspect for clarity of cornea, move in to focus.

Answer 21

“cornea, ant. chamber, lens, and vitreous are clear”

Question 22

Inspect disc and cup.

Answer 22

Disc color is pink. Margins are sharp cup to disc ratio is 1/2.

Question 23

Check all 4 Retinal quads.

Answer 23

AV Ratio is 2/3 without nicking or spasms

Question 24

Inspect fundus.

Answer 24

“no hemorrhages or exudates”

Question 25

Ask pt to look directly into light. Inspect Macula.

Answer 25

Macula is without lesions.

Question 26

EAR Inspect Auricles

Answer 26

no lesions or tenderness of the auricles

Question 27

Palpate Tragus bilaterally, “Any tenderness here?”

Answer 27

Tragus are non tender

Question 28

Inspect and then palpate Mastoid. “Any tenderness here?”

Answer 28

No mastoid discoloration swelling, or tenderness

Question 29

Inspect ear canal condition with otoscope.

Answer 29

No swelling redness or obstruction. Check both ears.

Question 30

Inspect TM for landmarks and appearance.

Answer 30

"TM is pearly gray and translucent; light reflex is in ant. inf. quadrant; landmarks are undistorted"

Question 31

Inspect for fluid in ear. ASK pt to perform Valsava.

Answer 31

"there is no visible evidence of fluid in the middle ear" “TM’s are mobile.”

Question 32

Ask pt to close eyes. Whisk fingers together. On left right and both.

Answer 32

No unilateral defects.

Question 33

Weber Test. Ask which ear they hear the noise in, BOTH.

Answer 33

Weber test is midline.

Question 34

Rinne Test. Mastoid then ear then your OWN ear.

Answer 34

Ac>BC Bilaterally

Question 35

NOSE Inspect external general nose appearance.

Answer 35

Nose is midline without lesions.

Question 36

Test for patency, ask pt to close one nostril and blow and the other.

Answer 36

“Nasal passageways are patent.”

Question 37

Have PT close eyes. Test each nostril with two different scents.

Answer 37

Do defect of olfactory nerve.

Question 38

Hand braced ask pt to tilt head back. Inspect septum, turbinates,, septal floor. Inspect for discharge.

Answer 38

“mucosa is pink and moist without lesions” or other appropriate description

Question 39

Palpate maxillary and frontal sinuses.

Answer 39

No maxillary or frontal sinus tenderness.

Question 40

ORAL CAVITY Inspect lips.

Answer 40

Lips are pink and moist without ulcers or cracking.

Question 41

USE LIGHT SOURCE< and inspect oropharyngeal mucosa for color ulcers, white patches or nodules.

Answer 41

"oral mucosa is pink and without ulcers or other lesions”

Question 42

Inspect gingiva w/ LIGHT SOURCE

Answer 42

No lesions, swelling, or discoloration on gingiva.

Question 43

Grab tongue scraper, percuss teeth.

Answer 43

“teeth are in good repair, non-tender with good oral hygiene”

Question 44

Acknowledge breathe odor.

Answer 44

Would evaluate and note no abnormal breathe odor.

Question 45

inspect tonsils ad uvula with light source, have pt say ahhhhhhhhhhhh

Answer 45

Tonsils are size 1 and equal with midline uvula; no exudate or lesions. “uvula and soft palate rise symmetrically”

Question 46

GAG Reflex.

Answer 46

Gag reflex active.

Question 47

(Grab gauze) Have pt protrude tongue and inspect using GAUZE.

Answer 47

Tongue is midline with protrusion. No apparent discoloration or lesions noted.

Question 48

Bimanual mass exam around entire mouth and check both ducts.

Answer 48

“there are no stones, masses or areas of induration.”

Question 49

NECK Inspect anterior and posterior neck.

Answer 49

No lesions swelling or discoloration.

Question 50

Inspect and palpate trachea for mobility.

Answer 50

Trachea is midline and mobile.

Question 51

Palpate all 10 lymph nodes. “Please let me know if you feel any tenderness in these areas.”

Answer 51

``` occipital, post auricular, preauricular, submental, submandibular, tonsillar, anterior cervical, deep cervical, posterior cervical, and supraclavicular nodes. No lymphadenopathy noted. ```

Question 52

Inspect thyroid. Then palpate on posterior approach. Have patient swallow after palpating and note symmetry of movement.

Answer 52

“thyroid is normal size, shape, and consistency without nodules or tenderness”

Question 53

Test active range of motion.

Answer 53

flexion, extension, rotation and lateral bend. “Neck is supple.”

Question 54

Test shoulder shrug and head rotation.

Answer 54

“strength is [5/5] and symmetric”

Question 55

“my examination is complete.” !!!!!!!!

Answer 55

YASSSSS BIHHHHHHH.