Head, Eyes, Ears, Nose, Throat

two, thin transparent mucous membranes, b/w eyelids and eyeball

covers scleral surface of eyeball

lines eyelids and contains blood vessels, nerves, hair follicles, and sebaceous glands

central opening of iris

sensory organ for hearing and maintaining equilibrium

humidifies, filters, and warms air before entering lungs

where are the 2 placements of sinuses?

lymphoid tissue between pillars

what are some structures within in the neck

Steps in head assessment

Steps in eye assessment

turing in of the eye

involuntary movement of the eye

white part of the eye

colored part of the eye

What do we use to inspect pupils?

steps in ears assessment

steps in nose assessment

plugging the nose and assessing if still able to breathe

steps in mouth assessment

steps in neck assessment

most common problems related to head and related structure (eyes, ears, nose, throat, neck)

headache assessment questions

headache that occurs more than once a day and for less than 1-2 hours. May follow pattern for a couple of months and disappear for months or years

headache that may occur at periodic intervals and may last from a few hours to 1-3 days

headache that causes tenderness over frontal/maxillary sinuses

headache that tends to be located in the front or back of head

headache that produces pain over the eye, temple, forehead, cheek

cause a burning or stabbing feeling behind eye

headache described as viselike

headache producing throbbing pain

feeling of faintness

sensation that the environment around you is whirling around

when a person experiences dizziness or vertigo, it is important to ask them if they treat it. Why?

When a person complains of a loss of hearing, what are 2 important questions to ask?

hearing loss associated with aging

ringing of the ears

sensation or sound heard only by affected individual and can manifest with a variety of sounds/sensations

when a patient complains of an earache, why is it important to ask if they have noticed any drainage?

a thick or purulent green-yellow, malodorous discharge from nose usually means what?

foul-smelling discharge, especially unilateral discharge from the nose, is associated with what?

profuse, watery discharge from the nose is associated (and normal) with what?

bloody discharge from the nose may be a result of what?

nose bleed

bleeding, lumps, thickened areas in mouth are symptoms of ____

enlarged lymph nodes may be associated with ___

recurrent headaches are a symptom of ___

clinical findings:

-starts with aura from vasospasm of intracranial arteries; throbbing unilateral distribution of pain

-may be accompanied by depression, restlessness, irritability, photophobia, nausea, or vomiting

-may last up to 72 hours

clinical findings:

-most painful of primary headaches

-intense episodes of excruciating unilateral pain

-lasts up to 30 min-1 hr and may repeat daily for weeks with some remissions or 6-12 weeks with remissions for 1+ years

-pain is burning, drilling, stabbing behind one eye

-may be accompanies with unilateral ptosis, ipsilateral lacrimation, nasal stuffiness and drainage

clinical findings:

-usually bilateral; may be diffuse or confined to frontal, temporal, parietal, occipital area

-onset may be gradual and last for several days

-may be accompanied by contraction of skeletal muscles of face, jaw, neck

-patients frequently describe as feeling of tight band around their heads

clinical findings:

-dull, generalized head pain

-accompanying symptoms may be lack of ability to concentrate, giddiness or dizziness

abnormal accumulation of CSF

clinical findings:

-Infant: gradual increase in intracranial pressure leads to an actual enlargement of head, fontanels may bulge and scalp veins dilate

-Adult: signs of increased intracranial pressure (decreased mental status, headache) are noted because skull is unable to expand

nodule of meibomian gland in eyelid, may be tender if infected

acute infection originating in sebaceous gland of eyelid (sty)

clinical findings:

-firm, nontender nodule observed in eyelid

inflammation of palpebral or bulbar conjunctiva caused by local infection of bacteria or virus, or by allergic rxn, systemic infection or chem irritation

clinical findings:

-eye appears red, with thick, sticky discharge on eyelids in monrings

disruption of corneal epithelium and stroma

clinical findings:

-intense pain, has foreign body sensation and reports photophobia; tearing & redness are observed

abnormal ocular alignment as visual axes do not meet at desired point

clinical findings:

1. Esotropia: inward-turning eye; most common type in infants

2. Exotropia: outward-turning of eye

opacity of crystalline lens from denaturation of lens protein caused by aging and may be congenital or caused by trauma

clinical findings:

-cloudy/blurred vision; glare from headlights, lamps, sunlight; diplopia

-may also report poor night vision and frequent changes in prescriptions for glasses

-cloudy lens can be observed on inspection

-red reflex is absent because light cannot penetrate opacity of lens

visual alteration with diabetes mellitus caused by changes in retinal capillaries; leading cause of blindness

clinical findings:

-patients report decrease in vision

-in background, microaneurysms and hemorrhages are seen

-exudates may also be seen around macula

-patients with proliferative (this) report a sensation of "curtain over eye"

-on examination, a network of new blood vessels is seen along retinal surface

group of diseases that increases intraocular pressure and damages optic nerve, leading to blindness

what are 2 types of glaucoma?

clinical findings:

-no specific symptoms of open-angle

-most reliable indicator is intraocular pressure measurement

-patients with closed-angle complain of sharp eye pain and seeing halo around lights

clinical findings:

-patient feels sense of fullness in ear and experiences decreased hearing

-may hear movement of insect and often experience extreme pain/fever

-inspection of auditory canal reveals something

infection of middle ear

clinical findings:

-ear pain

-fever, vomiting in infants

-decreased hearing in older children/adults

-tympanic membrane appears inflamed, red and bulging/immobile in early stage

-discoloration (white or yellow drainage) and opacification to the TM in later stages

-purulent drainage from ear canal with sudden relief of pain suggests perforation

ear pain

inflammation of middle ear space, resulting in accumulation of serous fluid in middle ear

clinical findings:

-common symptoms= clogged sensation in ear, problems with hearing and balance

-some report clicking/popping in ear

-NO fever or ear pain

-TM often retracted, yellow/gray in color with limited mobility

caused by interference of air conduction to middle ear; may result from blockage of external auditory canal, problems with TM, or problems w/in middle ear

clinical findings:

-decreased ability to hear/report of muffled sounds

-obstructions w/in auditory canal or problems with TM may be visible with otoscopic examination

-problems w/in middle ear may not be visible

caused by structural changes, disorders of inner ear, or problems with auditory nerve

caused by atrophy and deterioration of cells in cochlea or atrophy, degeneration and stiffening of cochlear motion

clinical findings:

-usually manifests as gradual and progressive bilateral deafness with a loss of high-pitched tones

-patients have difficulty filtering background noise, making listening difficult

clinical findings:

-bleeding due to high vascularity; most occur anterior of septum

-bleeds from posterior septum may also occur and tend to be more severe

inflammation of nasal mucosa

clinical findings:

-exposure to allergen causes sneezing, nasal congestion and nasal drainage, and may include itchy eyes, cough and fatigue

-turbinates are often enlarged and may appear pale or darker red

infection as a result of pooling secretions within sinuses

clinical findings:

-most common symptom= throbbing pain in affect sinus

-fever, thick purulent discharge and edematous, erythematous nasal mucosa

-transillumination shows absence of red glow in affected sinus

a highly contagious, viral infection spread by direct contact

clinical findings:

-typically prodromal burning, tingling or pain sensation before outbreak of lesions

- lesions appear on lip and skin junction as groups with an erythematous base

-lesions progress from vesicles to pustules and finally to crusts

inflammation of gingivae (gums)

clinical findings:

-hyperplasia of gums, erythema and bleeding with manipulation are most common signs

-edema deepens crevice b/w gingivae and teeth, allowing for pockets where food particles collect, causing further inflammation

-periodontitis occurs when inflammatory process causes erosion of gum tissue and loosening teeth

infection of tonsils from common bacterial pathogens

clinical findings:

-classic presentation includes sore throat, pain with swallowing, fever, chills, tender cervical lymph nodes

-ear pain

-on inspection, tonsils appear enlarged and red and may be covered with white/yellow exudates

pain with swallowing

oral infection caused by Candida albicans in those chronically debilitated or immunosuppressed, or as a result of antibiotic therapy

clinical findings:

-appears as soft, white plaques on tongue, buccal mucosa, or posterior pharynx

-if membrane is peeled off, a raw, bleeding, erythematous, eroded, or ulcerated surface results

common oral lesion with unknown etiology

clinical findings:

-lesions are very painful and appear on buccal mucosa, lips, tongue, or palate as round or oval ulcerative lesions with a yellow-white center and an erythematous halo

-may last up to 2 weeks

condition associated w/ excessive production & secretion of thyroid hormone. Grave's disease is most common cause.

clinical findings:

-most body systems affected

-S&S reflect increased metabolism and may include enlargement of thyroid gland and exophthalmos

result of decreased production of thyroid hormone

clinical findings:

-overall decreased metabolism, patient is "slow in motion" with depressed affect

-goiter may be seen

group of disorders with malignant neoplasms of lymph tissue

clinical findings:

-malignancy causes lymph nodes to be large, discrete, nontender and firm to rubbery

-enlarged nodes usually unilateral and localized

-hodgkin's disease is painless, progressive enlargement of lymphoid tissues, usually first evident by cervical lymph nodes, splenomegaly, and atypical macrophages