Please enable JavaScript.
Coggle requires JavaScript to display documents.
Head, Ear, Nose & Throat
Examination (2. EARS (Inspect/palpate…
Head, Ear, Nose & Throat
Examination
1. HEAD
Head
- Normocephalic
- Atraumatic
- Tenderness
Hair distribution
- Pattern hair loss
- Texture
-
Face
- Symmetry (palsy)
- Rashes
- Masses
- Oedema
- Involuntary movement
Palpate lymph nodes
- Sub-mental
- Submandibular
- Tonsillar
- Pre-auricular
- Anterior cervical
- Post- auricular
- Posterior cervical
- Supraclavicular
2. EARS
- Inspect/palpate auricles & post-auricular regions bilaterally
- Palpate mastoid process- tenderness/deformity
Use otoscope to examine both ears
Canal
Tympanic Membrane
- light reflex
- bulging
- dull
- visible fluid behind TM
- erythema
-
Weber Test
- Use 512 Hz tuning fork
- Place fork on middle of forehead
- Ask pt where sound is loudest
- Normal = heard centrally
- Abnormal
- Conductive - sound lateralises to bad ear
- Sensorineural - sound lateralises to better ear
Rinne Test
- Place vibrating fork on mastoid
- Ask pt to tell you when sound can't be hear anymore
- Hold fork perpendicular to ear canal
- Ask pt again
Interpretation
If sound is still heard or for longer in front of ear
- Air conduction > bone conduction
- Normal/Sensorineural hearing loss
- +ve Rinne test
If sound is NOT heard or shorter in front of ear
- Bone conduction > air conduction
- Bone conduction = air conduction
- Conductive hearing loss
- -ve Rinne test
3. NOSE/SINUSES
Palpate sinuses
- Frontal
- Ethmoid
- Maxillary
- Periorbital
- Ask pt to lean forward, observe any discomfort
Examine external surface of nose
- Colour
- Size
- Shape
- Symmetry
Inspect inside nose
- Tilt pt head back
- Using otoscope gently place onto edge of nostril
- Hold pt's chin for stability
- Observe:
- mucosa
- nasal septum
- obstruction
- tenderness
4. ORAL CAVITY
Inspect
- Lips/angles of mouth
- colour
- moisture
- ulcers
- angular stomatitis
- cyanosis
- Buccal mucosa
- Hard/soft palate
- Floor of mouth
- Gums/teeth
Examine oropharynx
- Use tongue depressor
- Make pt say 'aahh'
- Observe uvula & tonsils for
- colour
- symmetry
- exudate
- swelling
- ulceration