Академический Документы
Профессиональный Документы
Культура Документы
Week 3 Health Assessment
External Ear
Perforated drum
Cauliflower Ear: from chronic trauma to the ear (boxer, football player)
Otoscopic Exam
Inspect external canal
Inspect eardrum
Identify
o >cone of light
o >handle & short process of the malleus
Remember to brace the otoscope for safety!
Position the Otoscope Safely
THE NORMAL EARDRUM
Eardrum
Otitis media: inflammatory disease of the middle ear
Otitis media with effusion
Foreign Bodies:
Not for the squeamish
Examining Nose & Sinuses
Inspection
HEENOT
Week 3 Health Assessment
Test for nasal obstruction
Inspects internal nose with otoscope (largest speculum)
o Nasal mucosa
o Nasal septum & turbinates
Palpates frontal/maxillary sinuses
Examination of the Nose
Foreign body
Internal nares
Nasal turbinates
Nasal polyps: pale saclike growth of inflamed tissue that can obstruct the air passage or sinus. Seen in
allergic rhinitis, aspirin sensitivity, asthma , chronic sinus infection and cystic fibrosis.
Goals of the Oral Exam
1) Determine the health status of teeth and oral cavity
2) Identify abnormal oral lesions & signs of precancer/cancer
3) Offer patient anticipatory guidance
Quick Review!
How many teeth should an adult have? 32
Where are the most common sites of oral cancer? the side of the tongue and the floor of the mouth, back
of the throat (tonsil)
Components of the Oral Exam
1. Face, lips
2. Gums
3. Teeth
4. Soft/Hard Palate
5. Tongue (lateral & under)
6. Pharynx
Common Lip Abnormalities
Vesicles (Herpes): known as cold sore
Angular Chelosis: vitamin B deficiency, xerostomia, cardia infection
Oral Exam
Gums & mucosa
Apthous ulcer
Buccal Mucosa, Gums & Teeth
HEENOT
Week 3 Health Assessment
Examination
Periodontal Disease
Assess hygiene, condition of teeth, and presence of xerostomia
Periodontitis linked to serious underlying disease: DM, CV disease, even links with dementia
Tongue findings
Geographic tongue: benign
Cancer of the tongue
Examining the pharynx
Tonsils: Size, symmetry
Erythema
Exudate
Ulcerations
Lesions
Petechiae
Strep Pharyngitis
Tonsillar edema, erythema and exudate
Fungus Among Us
Candida
Candida too!
The Changing Landscape of Head and Neck Cancer
HPVRelated Oral Cancer
Oral cancer claims increased
61% from 20112015.
Tongue/throat most common sites (lymph Assessment essential)
Examining the Neck
Inspection
HEENOT
Week 3 Health Assessment
o Symmetry, masses, scars, enlarged glands or lymph
nodes
o Trachea – position, alignment
o Thyroid gland symmetry
Examining The Thyroid
Flex neck slightly back.
Place fingers of both hands below cricoid cartilage.
Ask pt to swallow and feel thyroid isthmus rise up under your
fingers.
Displace trachea to R to palpate R lobe of thyroid. Repeat for
L lobe
If enlarged, listen for bruit.