HEENT

What is Arcus Senilis?

Gray circle around the eye due to aging

The nurse notes thrush on the palate of a patient. What should the nurse ask?

Have you been on antibiotics recently?

What is vital in maintaining vision and a healthy outlook for clients?

Health Education

What are the components of health promotion of the ear nose and throat?

Hearing Screening Ear protection Oral and dental screening Cancer Prevention

What does the Weber test test for?

Hearing lateralization

Past history of the ear would include what?

History of syphilis, rubella, meningitis Exposure to hazardous noise Swimmer's ear Removal of cerumen

What do palpitations and involuntary weight LOSS suggest?

HyPERthyroidism

What does intolerance to cold, preference for warm clothing, and decrease sweating suggest?

HyPOthyroidism

In adults, how do the tonsils usually look?

In adults, the tonsils are usually small or absent

How is tinnitus related to age?

Increases frequency with age

What do tender lymph nodes suggest?

Inflammation

How is the thyroid cartilage readily identified?

Its notch on the superior edge

What are signs of cancerous lymph nodes?

Large Irregular Nontender Cool Fixed

A patient complains of feeling like he is slowly losing his central vision. The nurse knows this symptom could represent what

Macular degeneration

What do hard or fixed nodes suggest?

Malignancy

What are the most frequent cause of headaches in practice?

Migraines

What are bleeding gums most often caused by?

Most often caused by gingivitis

During PE of the external ear, how might otitis externa present?

Movement of the pinna and tragus is painful

What kind of headaches raise concerns of tumor, abscess, or mass?

New and persisting, progressively severe headaches

What is Epistaxis?

Nose bleed

Discharge from the ear is termed what?

Otorrhea

What is the natural relate decrease in visual acuity called?

Presbyopia

What does the Consensual reaction to light test?

Pupil constricts when the other pupil has light

A patient tells the nurse that he is constantly congested in spite of using a decongestant at least twice daily. The nurse understands the patient might be experiencing what?

Rhinitis Medicamentosa

When using an ophtthalmoscope to examine a patients eyes, in what hand should it be held for each eye?

Right hand for right eye, left hand for left eye

Disorders of the inner ear cause what kind of hearing loss?

Sensorineural

What does the Sensorineural phase of hearing involve? People with sensorineural hearing loss experience what symptoms?

Sensorineural phase of hearing: involves cochlea and cochlear nerve People with sensorineural hearing loss have particular trouble understanding speech, have trouble in noisy environments

When assessing a patient with Graves disease, how would you expect the thyroid gland to be?

Soft

How do you assess the Corneal light reflex?

Standing 2 feet away from the patient, shine a light into the patient's eyes and ask patient to look at it, inspect the reflection in the corneas, they should be visible

What are crossed eyes called?

Strabismus

You can feel all lymph nodes with two hands except which?

Submental

What activities are known to aggravate a tension headache?

Sustained muscle tension (like driving or typing)

What does papilledema describe?

Swelling of the optic disc and anterior bulging of the physiologic cup

During the PE of the external ear, how might otitis media present?

Tenderness behind the ear

A headache that is pressing or tightening, non throbbing pain, and mild to moderate intensity is what kind of headache?

Tension Headache

What is the most common headache that most patients self treat?

Tension Headaches

When conducting the Rinne test, what are you testing? What is a normal finding?

Tests air conduction to bone conduction Normally, air conduction should be greater than bone conduction

What structure in the inner ear senses the position and movements of the head and helps to maintain balance?

The labyrinth

What are the most important attributes of a headache?

The most important attributes are severity and chronological patterns

What do the numbers mean when assessing a patients vision with a snellen chart?

The numerator, 20, is the distance away from the snellen chart. This should always be 20 unless the pt was moved. The denominator, bottom number, is the distance at which a normal eye can read the letters. The larger the second number, the worse the vision

Where in the mouth do most cancers of the mouth develop?

The sides and under surface of the tongue and floor of the mouth are where most cancer often develops

Vertigo points primarily to a problem in what part of the ear?

This points primarily to a problem in the inner ear

The nurse would expect to assess which symptoms in a patient complaining of migraine headaches?

Throbbinb Photophobia Recurrent

What is the primary purpose of the health history in relation to the eyes?

To identify changes

What is a prodrome?

Unusual feelings such as euphoria, craving for food, fatigue, dizziness

What are associated manifestations of a headache associated with TBI?

Vision changes Nausea or vomiting Attention span deficits drainage from the ears, nose, eyes, or mouth tremors seizures gait changes

If a patient has had a TBI, what should you ask next?

What happened to cause the TBI? Absence of protective equipment? Environmental? Symptoms prior to injury? Prevention of further injury?

What is Leukoplakia?

White spots on tongue

What is the difference between thyroid glands of men and women?

Women have more palpable thyroid glands than men

When assessing peripheral visual acuity and the patient has glasses or contacts, should they be worn during the exam?

YES

What is Xanthelasma?

Yellow spots on the eyelids due to high cholesterol

When inspecting the mouth of a patient with dentures, what should you ask?

ask them to remove them to inspect the mouth mucosa

As aging occurs, what eye diseases become more prevalent?

cataracts, macular degeneration, and glaucoma

When inspecting the size of the pupils, what is considered large? What is considered small?

large is bigger than 5mm, small is less than 3 mm

If the thyroid gland is enlarged, what should you do?

listen over the lateral lobes with the bell of the stethoscope to detect a bruit

What is Exostoses?

nontender nodular swellings covered by normal skin deep in the ear canal, nonmalignant, may obscure the ear drum

What does PERRLA stand for?

pupils equal round, and reactive to light and accommodation

What are the RED FLAGS of headaches?

recent onset (less than 6 months), onset after 50 years of age, acute onset "like a thunderclap", "worst headache of my life", elevated blood pressure, presence of rash or signs of infections , cancer, HIV, pregnancy, vomiting, recent head trauma, persistent neurological deficits

What peripheral field are most defects found in?

temporal fields

Excessive use of decongestants can have what affect on congestion?

worsen symptoms, causing rhinitis medicamentosa

What is Amblyopia?

"lazy eye", loss of vision in one eye

What is a Scotomas?

(area of lost or depressed vision within the visual field surrounded by an area of normal vision)

What is Hyperopia?

(farsightedness, difficulty seeing close)

What is Myopia ?

(nearsightedness, difficulty seeing far)

What is the grading scale for tonsils?

+1 Tonsils are visible +2 Tonsils are between the tonsillar pillars and the uvula +3 Tonsils are touching the uvula +4 Tonsils are touching each other

What drugs can cause stuffiness?

- Oral contraceptives - Reserpine - Guanethidine Alcohol

What are the 10 lymph nodes in the head and neck?

- Preauricular - Posterior auricular - Tonsilar - Occipital - Submandibular - Submental - Deep cervical Chain - Superficial Cervical - Posterior Cervical - Supraclavicular

Why does hoarseness usually arise? If a patient sounds hoarse, what should you ask about?

-Usually arises from inflammation or infection of the larynx buy may also develop as laryngeal lesions which press on the laryngeal nerves -Ask about smoking, inhaling irritants, acid reflux, allergies

When performing the Rinne Test, what steps are performed?

1. Place the base of a vibrating tuning fork on the mastoid bone until the patient says she cannot hear the sound 2. Place the tuning fork in front of the ear and ask the patient if she can hear the sound

What is legally blind?

20/200

The nurse examines the pharynx of a patient and records that the tonsils are touching the uvula. What would the nurse grade the tonsils as?

3+

Functionally, the mos important range for hearing is the range of human speech. What is the range for human speech?

500 Hz to 3000 Hz

When asking the patient to look at a far object and then a near objecting, observing for pupillary constriction, what are you testing for?

Accommodation

What is Halitosis? What might it be indicative of?

Bad breath, may be indicative of diabetic ketoacidosis, renal failure, or mouth, nose, or pharynx infection

What is Anisocoria?

Benign difference in pupil size less than 0.5mm or up to 1mm, make sure pupillary reactions are normal

If a patient complains of loss of hearing out of one ear. What ear should you test first during the whisper test?

Better Hearing ear

An alternate pathway that bypasses the external and middle ear is called what

Bone conduction

How is a near visual acuity test different from a peripheral visual acuity test?

Both eyes are tested at the SAME TIME WITHOUT corrective lenses

What is Exophthalmos?

Bulging of the eyes anteriorly out of the orbit

The patient complains of Clouding in lenses of eyes, blurred vision, inability to see in dim light, what is this suspicious of?

Cataracts

What kind of headache is less common, more common in men, unilateral, usually behind or around the eye or temple, sharper continuous, intense, severe in intensity?

Cluster headaches

Hearing disorders of the external and middle ear cause what kind of hearing loss?

Conductive

In what kind of hearing loss may noisy environments help?

Conductive phase of hearing: external ear to middle ear

What are you testing when you ask the patient to follow your finger as you move it in toward the bridge of the nose?

Convergence

What is Ptosis?

Drooping of an upper eye lid

What is otalgia?

Earache

What does the nurse assess the face for?

Edema Asymmetry Involuntary Movements

What is Miosis?

Excessive constriction of the pupil of the eye

What is a characteristic symptom of Graves hyperthyroidism?

Exopthalmos

When testing for the 6 cardinal fields of gaze, what are you testing?

Extra Ocular Movements