Exam 1 Review: HEENT Basics

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Questions and Answers

What indicates increased intracranial pressure (ICP) in patients with eye issues?

  • Failure of both eyes to close (correct)
  • Inability to focus on light sources
  • Swelling of the eyelids
  • Excessive tearing

What is the first step in the fluorescein stain technique?

  • Inspect the cornea and sclera (correct)
  • Inspect the upper lid using UV light
  • Moisten the stain strip with saline
  • Administer ocular anesthetic

During eyelid eversion, which item is used to evert the upper lid?

  • Cotton swab (correct)
  • Ocular anesthetic
  • Tissue paper
  • Sterile gauze

In the corneal light reflex test, what should happen to the light reflections in both pupils?

<p>They should appear equally bright (D)</p> Signup and view all the answers

Which of the following procedures requires the patient to be unconscious?

<p>Eyelid eversion (A)</p> Signup and view all the answers

What is the correct direction to pull the ear for examining a child under three years old?

<p>Outward and downward (C)</p> Signup and view all the answers

In the cover-uncover test, what does it indicate if the covered eye moves to focus after its cover is removed?

<p>The covered eye is the weaker eye (A)</p> Signup and view all the answers

What structure in the inner ear is primarily responsible for hearing?

<p>Cochlear organs (B)</p> Signup and view all the answers

What does the acronym SOAP stand for in health documentation?

<p>Subjective, Objective, Assessment, Plan (A)</p> Signup and view all the answers

What is the primary cause of xerosis in the elderly?

<p>Impaired keratinocyte formation and abnormal epidermal cell turnover (C)</p> Signup and view all the answers

Which of the following describes stasis dermatitis?

<p>An eruption of the lower leg related to underlying vascular issues (B)</p> Signup and view all the answers

Which component is NOT part of the OLD CARTS acronym?

<p>Laceration (B)</p> Signup and view all the answers

What are the chronic changes associated with stasis dermatitis?

<p>Hyperpigmentation, lichenification, and scars of healed ulcers (D)</p> Signup and view all the answers

In the context of the HPI, what aspect does the 'P' in PQRST represent?

<p>Precipitation (D)</p> Signup and view all the answers

How is subjective data primarily obtained in a health assessment?

<p>From patient self-reports (A)</p> Signup and view all the answers

What condition is often misdiagnosed in the elderly population?

<p>Rosacea (D)</p> Signup and view all the answers

What is the hallmark sign of rosacea in the geriatric population?

<p>Bulky tissue and dilated telangiectatic vessels (D)</p> Signup and view all the answers

Which condition is commonly overlooked during an ocular examination in the elderly?

<p>Ocular rosacea (D)</p> Signup and view all the answers

What does a visual acuity test result of 20/30-1 imply?

<p>The patient can read at 20 feet what a normal eye can read at 30 feet, with one error. (C)</p> Signup and view all the answers

Which cranial nerve is primarily responsible for transmitting visual images to the brain?

<p>Cranial nerve III (B)</p> Signup and view all the answers

What is the clinical term for the inward turning of the eyelid margin towards the eye surface?

<p>Endotropion (D)</p> Signup and view all the answers

Which type of diplopia is primarily associated with issues in Cranial nerve VI?

<p>Horizontal diplopia (D)</p> Signup and view all the answers

What causes the white or gray ring seen in arcus senilis in older adults?

<p>Fat deposits in the cornea (C)</p> Signup and view all the answers

The recommended mnemonic for eye history assessment includes which of the following questions?

<p>Redness, Sensitivity to light, Vision loss, Pain (B)</p> Signup and view all the answers

What does an opaque tympanic membrane most likely indicate?

<p>Chronic otitis without perforation (D)</p> Signup and view all the answers

During the Weber test, if the sound is heard louder in one ear, what does this suggest?

<p>Conductive hearing loss in the opposite ear (A)</p> Signup and view all the answers

What could air bubbles behind the tympanic membrane indicate?

<p>Serous otitis or acute otitis media (C)</p> Signup and view all the answers

Which cranial nerves are associated with otalgia?

<p>V, VII, IX, and X (A)</p> Signup and view all the answers

What is a positive result in the Rinne test indicative of?

<p>Normal air conduction (A)</p> Signup and view all the answers

What condition is suggested by a yellow tinged tympanic membrane?

<p>Infection with pus (D)</p> Signup and view all the answers

What does a lack of tympanic membrane flexibility typically lead to?

<p>Conductive hearing loss (C)</p> Signup and view all the answers

How is the Whisper test conducted?

<p>Cover your mouth and whisper from two feet away (D)</p> Signup and view all the answers

Flashcards

SOAP

A method for organizing patient information: Subjective, Objective, Assessment, Plan.

Old Carts

A mnemonic for pain assessment: Onset, Location, Duration, Characteristics, Alleviating factors, Relieving factors, Timing, Severity.

HPI

History of Present Illness; a detailed account of the patient's current health issues.

PQRST

A mnemonic to evaluate pain: Precipitation, Quality, Radiation, Severity, Timing.

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Xerosis

Dry skin resulting from impaired keratinocyte formation, common in the elderly.

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Stasis Dermatitis

Dry, itchy skin on lower extremities caused by vascular changes and fluid buildup.

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Rosacea

A chronic inflammatory skin condition, often undiagnosed, characterized by redness and visible blood vessels.

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SOAP Notes

Notes containing Subjective and Objective data, assessments, and treatment plans for patient interactions.

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Otalgia

Pain in the ear, can be caused by infection, inflammation, or other conditions.

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Tympanic membrane reflex

Light reflex seen in the tympanic membrane indicating health; located at different positions based on ear side.

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Opaque tympanic membrane

An opaque appearance indicates chronic otitis, repetitive perforation, or tympanosclerosis.

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Air bubbles behind tympanic membrane

Indicates acute otitis media or serous otitis due to fluid accumulation.

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Weber test

A hearing test to assess bone conduction by placing a tuning fork on the forehead.

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Rinne test

A test comparing air conduction to bone conduction using a tuning fork on mastoid and near the ear.

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Conductive hearing loss

Hearing loss caused by problems in the outer or middle ear, indicated by Rinne and Weber tests.

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Sensorineural hearing loss

Hearing loss resulting from damage to the inner ear or neural pathways; tested with Rinne test results.

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Increased ICP

Increased intracranial pressure can prevent eyelids from closing.

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Eyelid Eversion

Technique used to examine upper eyelid for foreign bodies or injury.

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Fluorescein Stain Technique

Method to identify corneal abrasions using a fluorescent dye.

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Corneal Light Reflex Test

Test to assess symmetry of light reflection in pupils.

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Cover-Uncover Test

Test to identify the weaker eye based on movement.

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Outer Ear Anatomy

Includes the pinna (auricle) and ear canal, key for hearing.

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Middle Ear Components

Contains bones transmitting sound waves from the tympanic membrane to the cochlea.

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Inner Ear Function

Contains structures for hearing and balance; key for auditory processing.

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Rosacea hallmark

Bulky tissue and dilated vessels seen in geriatric patients.

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Ocular rosacea

A variant of rosacea affecting the eyes, often overlooked.

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RSVP eye assessment

Mnemonic for crucial eye history questions: Redness, Sensitivity to light, Vision Loss, Pain.

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Arcus senilis

Gray or white ring at corneal margin due to fat deposits in older adults.

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Pterygium

Wedge-shaped conjunctival growth usually related to irritation.

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Endotropion

Inward turning of eyelid margin and lashes, increasing with age.

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Vertical diplopia

Double vision caused by issues with Cranial nerve IV (trochlear).

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Visual Acuity test

Measures eyesight as a ratio, e.g., 20/30-1 indicates distance and errors.

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Study Notes

Exam 1 Review: HEENT

  • Components of health history and SOAP note documentation are crucial
  • Skin examination includes assessment of lesions, common geriatric skin problems and skin cancer
  • Eye examination includes assessment techniques and findings, focusing on cranial nerves and potential emergencies like vision loss
  • Ear examination considers infections, hearing loss, and testing techniques like Weber and Rinne tests
  • Nose, Mouth, and Throat (NMT) assessment involves techniques for examining the structures and thyroid/lymph nodes.
  • Health history includes SOAP- (subjective, objective, assessment, plan) components. Important considerations include old carts (onset, location, duration, characteristics, alleviating/aggravating factors, radiation or relieving pain, timing, severity).
  • Common geriatric skin lesions, like xerosis (dry skin) and stasis dermatitis (often found in lower extremities due to vascular issues), are crucial to understand and differentiate from other conditions.
  • Eye exams include testing for pupils, arcus senilis (white rings in cornea due to fat deposits), and pterygium (a wedge-shaped growth in conjunctiva).
  • Eyelid conditions, like entropion (inward-turning of eyelid) and ectropion (outward turning of eyelid), are important to identify. Common causes include eyelid malignancy, hordeolum (sty), and chalazion.
  • Cranial nerves III, IV, and VI are responsible for eye movements, while horizontal and vertical diplopia are symptoms often resulting from cranial nerve issues.
  • Visual acuity and corneal reflex tests are essential for comprehensive eye evaluation.
  • Ear exams involve testing the outer/middle/inner ear, tympanic membranes, and whisper tests to assess hearing acuity.
  • Otalgia, or ear pain, can have different causes.
  • Hearing loss can arise from various factors like cerumen impaction.
  • Cranial nerve function encompasses smell, vision, eye movements, facial sensations and expressions, hearing, taste, swallowing, neck muscle and shoulder movement, tongue movement.
  • Mnemonic (acronym) "Oh Oh Oh To Touch And Feel Very Good Velvet. Such Heaven!" can help remember the cranial nerves.
  • Fluorescein and corneal light reflex tests aid in assessing corneal health.

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