Nose, Throat

sandyle909's version from 2016-09-05 22:59

Section 1

Question Answer
Nasal Speculum Exam / Otoscope Speculumdo not touch septum and turbinates
inspect nasal septum, mucosa, and turbinates
look forseptal deviation, septal perforation, inflammation, polyps or drainage
Wharton's duct of submandibular glandfloor of mouth
Stenson's duct from parotid glandupper 2nd molar
Inspect soft palate and uvula ask patient to say "AH' / gag reflex with tongue blade
CN IX and CN X
CN XII - hypoglossal Stick tongue out and move tongue side to side
Palpate oropharynx - bimanual exampalpate wall of mouth between internal and external fingers
feel floor of mouth, tongue for masses, induration
Torus palatinus benign midline mass in hard palate

Section 2

Question Answer
CN XI - Accessory n. - evaluate motor functionlateral rotate of neck against resistance
should shrugging against resistance
Examination of lymph nodesNeck relaxed
use pads of index and middle fingers in examination
exam both sides at once
size, shape, consistency, mobility or tenderness of nodes
Carotid Artery Examgentle pressure
one side at a time
palate the lower half of the carotid to avoid sinus stimulation causing bradycardia
auscultate each carotid - listen for bruits (signs of arterial obstruction)
Tracheal deviationsuggests: mediastinal mass, atelectasis (partial collapse of lung tissue), pneumothorax
Thyroid - have pt swallow stand behind patient
place fingers below cricoid cartilage on each side of neck
palpate for isthmus (connects the R and L lobes)
Enlarged thyroid Goiter
Head Exam ProcessInspect facial features
Inspect/ palpate hair, scalp and skull
Test facial m. (CN VII) function
Test facial sensation (CN V) - light touch
Palpate facial bones, sinuses
Palpate masseter muscles
Eye Exam ProcessInspect external eyes
Test visual acuity
Assess depth of anterior chamber
Check corneal light "reflection"
Direct and consensual pupillary reflexes
EOM with accommodation
Ophthalmoscopic (fundoscopic) exam
Ears & Nose Exam ProcessAssess gross hearing
Inspect and palpate external ear
Inspect ear canal & TM
Inspect and palpate external nose
Assess nasal patency
Inspect nasal septum, mucosa, and turbinates
Throat & Neck Exam ProcessInspect lips, teeth, gingiva, & oropharynx
"AH" / Tongue protrusion (CN IX , X ) CN XII
Bimanual palpation of oral cavity
Inspect neck (thyroid, trachea, JVD, masses)
Evaluate ROM of neck
Neck rotation
Shoulder shrug
Palpate lymph nodes
Palpate and auscultate carotid a.
Palpate tracheal position
Palpate thyroid