Unit 6 Part 1 PDF

PA of the Head, Eyes, Ears, Nose and Throat Unit 6 : Pharm 316 Objectives 1. Determine the skills and techniques for conducting a physical assessment of the HEENT. 2. Conduct general physical assessment of the HEENT. C...

PA of the Head, Eyes, Ears, Nose and Throat Unit 6 : Pharm 316 Objectives 1. Determine the skills and techniques for conducting a physical assessment of the HEENT. 2. Conduct general physical assessment of the HEENT. ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Overview I. Review of AnaPhy II. Assessment Techniques III. Recording of Findings IV.Abnormal Findings and Their Clinical Significance ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Review of AnaPhy Medical Terminologies Otitis media Auricle Presbycusis Blepharitis Presbyopia Canthus PERRLA Cataract Ptosis Cerumen ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Medical Terminologies Sclera Conjunctivitis Strabismus Nares Tinnitus Diplopia Exophthalmos Glaucoma Miosis Mydriasis ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Medical Terminologies Oropharynx Epistaxia Periodontitis Frenulum Stoma Gingiva Xerostomia Gingivitis Glossitis Buccal ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Assessment Techniques  Routinary Steps 1. Perform hand hygiene. 2. Check room for contact precautions. 3. Introduce yourself to patient. 4. Confirm patient ID using name and date of birth. 5. Explain process to patient. 6. Be organized and systematic in your assessment. 7. Use appropriate listening and questioning skills. 8. Listen and attend to patient cues. 9. Ensure patient’s privacy and dignity. 10. Apply principles of asepsis and safety. 11. Check vital signs. ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 1 : History taking a. Obtain health history: Ask if the patient presents with complaints regarding skin, hair and nails, perform a symptom analysis. b. Review related medical, surgical and family history. c. Review risk factors related to problems with skin, hair and nails. ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 1 : History taking Concerning Symptoms Headache Change in vision: blurred vision, loss of vision, floaters, flashing lights Eye pain, redness, or tearing Double vision (diplopia) Hearing loss, earache, ringing in the ears (tinnitus) Dizziness and vertigo Nosebleed (epistaxis) Sore throat, hoarseness Swollen glands Goiter ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 2 : Inspection/Palpation HEAD a. Inspect the head and face for symmetry. b. Inspect the hair for color, distribution, and texture. c. Palpate the scalp and skull for tenderness and inspect for flaking, lesions, deformities, or tenderness ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 2 : Inspection/Palpation EYES a. Note position and alignment of the eyes and presence of discharge, irritation, and redness. b. Observe the eyelids. c. Inspect sclera and conjunctiva of each eye; sclerae should be white and clear. d. Inspect each cornea, iris, and lens, checking for transparency. e. Compare the pupils and test each reaction to light. (PERRLA) ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 2 : Inspection/Palpation EYES f. Assess extraocular movements for abnormalities. g. Screen visual fields in both eyes: medially/laterally, superiorly/inferiorly (cranial nerve II). h. Perform a visual acuity test with the Snellen Chart (cranial nerve II) i. For fundoscopic examination, use an ophthalmoscope to inspect the ocular fundi. ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 2 : Inspection/Palpation EARS a. Examine each ear using an otoscope. Gently pull the pinna of the ear up and back to straighten the external canal. b. Test auditory acuity in each ear with the whisper test (cranial nerve VIII). ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 2 : Inspection/Palpation NOSE a. Inspect the external nose for color, size, shape, symmetry, and presence of drainage, tenderness, and masses. b. Using a light and nasal speculum or otoscope, inspect the nasal passages for patency, nasal mucosa for color, nasal septum for deviation, and turbinates for color and swelling. c. Check the patency of each nare by asking the patient to occlude one nare and breathe through the other. d. Assess the patient’s sense of smell (cranial nerve I) with an orange or lemon peel, coffee, vinegar, or essence bottles of vanilla or peppermint. e. Palpate the frontal and maxillary sinuses for tenderness and assess for signs of infection. ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 2 : Inspection/Palpation THROAT o Check the patient’s ability to swallow and their gag reflex (cranial nerves IX and X). ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 2 : Inspection/Palpation NECK a. Check neck muscles for symmetry, masses, swelling, and range of motion. b. Palpate cervical lymph nodes for signs of swelling or tenderness; cervical lymph nodes should not be fixed (unmovable) or palpable (unless the patient is very thin). Lymph nodes should be small and freely moving. c. Assess head and neck range of motion. d. Check trapezius muscle strength. Ask the patient to shrug their shoulders against your hands as you apply resistance (cranial nerve XI). e. Check cervical muscle strength. Ask the patient to turn their chin/jaw against your hand. ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy Step 2 : Inspection/Palpation NECK f. Assess trachea for deviation; it should be midline. g. Evaluate thyroid gland noting enlargement or presence of nodules and masses; it should be smooth. h. Examine the carotid arteries as part of the cardiac assessment, taking care to palpate the carotid arteries one at a time, noting symmetry, strength, amplitude, and presence of an abnormal thrill. Listen for bruits using the diaphragm of your stethoscope. i. Assess for cervical point tenderness along the posterior aspect of the neck ClinPharm 1| A.Albay © 2024 Saint Louis University | Department of Pharmacy