HEENT
If a patient is smiling but one side goes down what could that mean?
stroke or bells palsy
When inspecting sclera what does yellow mean? what labs should you run?
1) jaundice 2) ALT, AST, billirubin
How do you assess extraoccular movement?
tell the patient to only follow your finger with their eyes. move fingers in shape of a cross and then diagonal.
What does PERRLA stand for? What do pupils do in the dark? in light?
1)pupils, equal, round, reactive to light, and accomodation. 2) dilate 3) constrict
How do you test hearing on the Whisper test?
stand behind them and whisper
what should you inspect on the eye?
eyelids, eyelashes, lacrimal ducts and glands, conjunctivae, and sclera
How do you test for pupil accommodation? What should the eyes do? What does it mean if eyes dont accommodate?
1) move your finger or a penlight from 12inches away to 1inch towards the eye. 2) eyes should accommodate to the change in distance by almost being crossed. 3) head injury
When assessing the head what should you observe?
size, symmetry, position, movement of head, neck and face, pain, redness, increased or decreased tremor movement, and facial expressions.
When palpating the skull what should you look for?
tenderness, massess, redness, pus and drainage
How do you know which ear is the affected ear on the Weber test?
Whichever ears hears it louder or longer
What do pink gums mean? red? pale?
1)normal 2) infection 3) anemia
When assessing the eyes what should you look for?
lumps, redness, swelling, pain
What do dry lips mean? what do blue lips mean? What are the white patches on the tongue that dont brush off?
1) dehydration 2) cyanosis or lack of O2 3) thrush
What should you inspect the external nose and sinuses for? Internal nose? How do you check for patency?
1) redness, lumps, asymmetry. 2) deviation, redness, pallor. 3) close one nostril and have them blow. if there is no pressure that means it isn't patent or open.
What does a cloudy lens mean? What eye disease usually has no symptoms?
1) cataracs 2) glaucoma
When inspecting the conjunctivae what does red mean? Pus? Pale?
1) allergy or infection 2) infection 3) anemia
sinus infection
Why should you palpate the temporomandibular joint?
too see if there is pain when opening and shutting the mouth
How do you do the Weber test?
Place vibrating tunning fork midline on the skull, ask if tone is equally bilatteraly or better in one ear.
What are the three tests that test hearing?
Whisper, weber and rhine
What should you inspect on the tongue? How can you test a gag reflex?
1) dryness and grooves 2) tongue blade/sip of water
What could it mean if your uvula isn't midline? What is the most common place for oral cancer?
1)stroke or abscess. 2)under tongue
On the neck what should you palpate? Should the thyroid be felt?
1) thyroid and cervical lymph nodes. 2) no
What does the snellen eye chart test? What does 20/200 mean?
1) whatever line you can read from a distance is ur vision. 2) you can only read at 20ft what everyone else can read at 200ft.
How do you do the Rhine test?
Strike the tunning fork and place it in the air in front of the ear. Then place the fork behind ear on mastoid bone. Tell them to say when they can no longer hear it. Air conduction should be heard twice as long as bone conduction.