The Head and Neck Exam

Question 1

Inspection points on the head

Answer 1

1. Hair Distribution and quantity
2. Scalp: scaling, nevi
3. Skull: size and contour
4. Face: expression, contour
5. Skin: color, pigmentation, hair distribution, lesions

Question 2

Palpation Points on the head

Answer 2

1. Hair texture
2. Skull: lumps
3. Face: sinuses
4. Skin: texture, temperature

Question 3

External ear exam inspection points

Answer 3

1. Check pinna for size, position, deformity, inflammation, symmetry, nodules, scars or lesions
2. Check external auditory canal
3. Look for presence of ear discharge: color, consistency, clarity, presence or absence of odor

Question 4

External ear exam Palpation points

Answer 4

1. Check pinna, periauricular area, and mastoid process for tenderness & nodules
2. Check pain over the mastoid process

Question 5

Normal Weber test Results

Answer 5

No sound lateralization, pt hears/feels vibration in the middle

Question 6

Abnormal Weber Test Results

Answer 6

1. Conductive hearing loss = sound lateralization to AFFECTED ear
2. Sensorineural hearing loss = sound lateralization to NON-AFFECTED ear

Question 7

Otoscopic exam: external auditory meatus

Answer 7

1. External Auditory meatus: foreign body , cerumen, inflammation, discharge

Question 8

Otoscopic Exam: TM

Answer 8

1. Color: Translucent and pearly grey
2. Light reflex: cone of light directed anteriorly and inferiorly
3. Landmarks: Pars flaccida, malleus (near center), incus (posterior to malleus)
4. Abnormal margins: Clear and tense margins
5. Mobility: Brisk, equal movement with positive and negative pressure using pneumatic otoscope
6. Shape: Drawn inward slightly at center by handle of malleus

Question 9

Nasal External Exam Inspection

Answer 9

1. Swelling, trauma, deviation, congenital abnormalities

2. Symmetry of nares

Question 10

Nasal External exam Palpation & percussion

Answer 10

1. Frontal and Maxillary sinuses

Question 11

Nasal Internal Exam

Answer 11

1. Mucosa: Color, swelling, bleeding, exudate, ulcers, polyps
2. Septum: Deviation, inflammation, perforation (snorting cocaine)
3. Turbinates: middle and lower

Question 12

Inspection of Lips

Answer 12

Note color, moisture, lumps, ulcers, cracking,or scaliness

Question 13

Inspection of Oral mucosa

Answer 13

Note color, ulcers, and nodules

Question 14

Inspection of gums and teeth

Answer 14

Note color, presence, and position of teeth

Question 15

Inspection of roof of mouth

Answer 15

Note color

Question 16

Inspection of tongue and floor of mouth

Answer 16

Note color and texture, ulcers, nodules

Question 17

Inspection of Pharynx, soft palate, anterior and posterior pillars, uvula, tonsils, and pharynx

Answer 17

Note color, symmetry, presence of exudate, swelling, ulceration, or tonsillar enlargement

Question 18

Palpation of lymph nodes

Answer 18

1. size, shape, delimitation, mobility, consistency, tenderness
2. Preauricular, posterior auricular, occipital, tonsillar, submandibular, submental, superficial cervical, posterior cervical, deep cervical chain, supraclavicular

Question 19

Enlargement of the posterior cervical lymph nodes indicates what?

Answer 19

Mono