HEENT Exam

Question 1

General components of HEENT Exam

Answer 1

1. Head/scalp: Inspect
2. Face: Inspect, palpate
3. Nose: Inspect, Otoscope
4. Ears: Insepct, Palpate, Evaluate, Otoscope
5. Mouth/throat: Inspect, palpate
6. Neck: Inspect, palpate
7. Lymph nodes

Question 2

Head/scalp exam

Answer 2

Inspect:
 Skull shape, symmetry
 Hair distribution, texture
 Scalp for lesions

Question 3

Facial exam

Answer 3

Inspect:
  Symmetry, deformity
  Skin
  Hair distribution
  Areas of swelling
Palpate:
  Tenderness (including sinuses)
  Temporomandibular joint tenderness, crepitus
  Temporal arteries for pulses, tenderness, thickening

Question 4

Nose exam

Answer 4

Inspect:
  Symmetry
  Deviations
  Discharge
  Skin lesions
Inspect using Otoscope:
  Mucosa for color, masses, lesions, exudates, bleeding
  Septum for color, masses, lesions, perforations, deviation

Question 5

Ear exam

Answer 5

Inspect:
 External ear alignment, surface characteristics, symmetry
 Mastoid area and area behind auricle
Palpate:
 Auricle
 Mastoid process
Evaluate:
 Gross hearing with whisper test or ticking watch test
 Conductive vs. neural hearing with Weber and Rinne tests
Inspect Using Otoscope:
 Auditory canal for redness, swelling, discharge/cerumen, color
 Tympanic membrane for color, landmarks, light reflex, mobility

Question 6

Mouth/throat exam

Answer 6

Inspect:
 Lips for swelling, color, lesions
 Teeth for caries, missing teeth, appliances
 Gums for color, swelling, inflammation
 Mucous membranes for color lesions, and salivary duct openings
 Tongue for lesions, contour, movement (including under the tongue and lateral edges
 Palate, uvula
 Tonsils for size and exudates
 Pharynx for color, lesions
Palpate:
 Teeth and gums for tenderness
 Buccal mucosa for masses

Question 7

Neck exam

Answer 7

Inspect:
  Trachea position, symmetry
  Thyroid size, symmetry
Palpate:
  Musculature masses, tenderness
  Thyroid nodules, enlargement, tenderness

Question 8

Lymph node exam

Answer 8

Inspect and palpate: size, consistency, mobility, shape, tenderness, symmetry
  Occipital
  Postauricular
  Preauricular
  Submandibular
  Anterior cervical

Question 9

Weber test procedure

Answer 9

•Place vibrating tuning fork on the top of the head
•Ask the patient if the sounds can be heard the same in both ears of better in one
•Testing lateralization
a.Conductive loss – sound goes to deaf ear
b.Sensorineural – sound goes to better ear

Question 10

Rinne test procedure

Answer 10

•Place vibrating tuning fork on the mastoid bone of each ear
•The examiner asks the patient to tell them when they can no longer hear the sound
•Then move the tuning fork in front of the ear and ask the patient to tell them when he can no longer hear it
•Air conduction should be longer than bone conduction 2:1
a.Conductive loss – BC>AC
b.Sensorineural – AC>BC but not 2:1