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NUR103ModD.ppt
- 1. NUR 103 HealthAssessment Module D: Physical Assessment of the Head, Eyes, Ears, Nose, and Throat (HEENT)
- 2. Physical Assessment ofthe Head and Neck Interview Data (Subjective ) • History of: – Headaches – Head injury – Dizziness – Neck pain – Lumps or swelling – Head or neck surgery
- 3. Physical Assessment ofthe Head and Neck Physical Data (Objective ) • HEAD – Size and Shape – Temporal Area – Facial Structures • NECK – Symmetry – Range of motion – Lymph nodes (posterior auricular, prearticular, occipital, jugulodigastric, superficial cervical, posterior cervical, deep cervical, supraclavicular, submandibular, submental) – Trachea – Thyroid gland
- 4. ABNORMAL FINDINGS • Abnormalitiesin head size and contour • Swellings on the head or neck • Pediatric facial abnormalities • Abnormal facial appearances with chronic illnesses
- 5. Structure and function: Eyes • External Anatomy Eyebrow Eyelids (upper and lower) Canthus Caruncle Conjunctiva Lacrimal apparatus Extraocular muscles Internal Anatomy sclera cornea choroid pupil lens anterior chamber retina optic disc retinal vessels
- 6. Structure and function: Eyes • Visual pathways and visual fields – Refraction of light rays – Crossing of fibers at optic chiasm Visual reflexes – pupillary light reflex (direct and consensual ) – Fixation – Accommodation
- 7. Physical Assessment ofthe Eyes Interview Data (Subjective ) • HISTORY of: – Vision difficulty – Pain – Strabismus or diplopia – Redness or swelling – Watering or discharge – Past history of ocular problems, surgery – Glaucoma – Use of glasses or contact lenses – Examinations – Medications
- 8. Physical Assessment ofthe Eyes Physical Data (Objective ) • Equipment: – Snellen eye chart – Handheld visual screener – Opaque card or occluder – Penlight – Applicator stick – Ophthalmoscope
- 9. Physical Assessment ofthe Eyes Physical Data (Objective ) • Test central visual acuity Snellen eye chart Near vision Test visual fields Confrontation test Inspect extraocular muscle function Corneal light reflex (Hirschberg test) Cover test Diagnostic positions test
- 10. Physical Assessment ofthe Eyes Physical Data (Objective ) • Inspect external ocular structures – General – Eyebrows – Eyelids and lashes – Conjunctiva and sclera – Eversion of the upper lid – Lacrimal apparatus
- 11. Physical Assessment ofthe Eyes Physical Data (Objective ) • Inspect anterior eyeball structures – Cornea and lens – Iris and pupil size and shape pupillary light reflex accommodation
- 12. Physical Assessment ofthe Eyes Physical Data (Objective ) • Inspect the ocular fundus – Use of the ophthalmoscope – Red reflex – Optic disc Color Shape – Retinal vessels Number Color – General background of the fundus – Macula
- 13. ABNORMAL FINDINGS • Abnormalitiesof the: extraocular motor function eyelids cornea and iris pupil optic disc retinal vessels and background • Vascular disorders of the external eye • Opacities in the lens
- 14. Structure and function: Ears • External Ear Auricle External Auditory canal Tympanic membrane Internal Ear Malleus, Incus, and Staples Eustachian tubes Functions Inner Ear Vestibute, and semicircular canals Cochlea
- 15. Structure and function: Ears • Auditory system: Three levels of hearing – Peripheral – Brain stem – Cerebral cortex Pathways of hearing – Air conduction – Bone conduction
- 16. Physical Assessment ofthe Ears Interview Data (Subjective ) • HISTORY of: _Ear aches – Infections – Discharge – Hearing loss – Environmental noise – Tinnitus – Vertigo – Self care
- 17. Physical Assessment ofthe Ears Physical Data (Objective ) • Equipment: – Otoscope – Pneumatic bulb – Tuning fork in 512 and 1024 Hz
- 18. Physical Assessment ofthe Ears Physical Data (Objective ) • External Ear – Size and shape – Skin condition – Tenderness – External auditory meatus
- 19. Physical Assessment ofthe Ears Physical Data (Objective ) • Otoscopic Exam External canal color lesions swelling discharge Tympanic Membrane color, characteristics, integrity Test hearing acuity conversational speech, voice test tuning fork tests (Weber, Rinne) Vestibular apparatus Romberg test
- 20. ABNORMAL FINDINGS • Abnormalities: – External ear – Ear canal – Tympanic Membrane – Tuning fork tests
- 21. Structure and function: Nose, Mouth, and Throat • Nose – Function in the respiratory system – External nose – Nasal cavity – Septum – Turbinate – Paranasal sinuses • Frontal • Maxillary • Ethmoid • Sphenoid
- 22. Structure and function: Nose, Mouth, and Throat • Mouth – Function in the digestive and respiratory system – Hard and soft palates – Uvula – Tongue – Salivary glands • Parotid • Submandibular • Sublingual Teeth
- 23. Structure and function: Nose, Mouth, and Throat • Throat – Oropharynx – Tonsils – Nasopharynx
- 24. Physical Assessment ofthe Nose Interview Data (Subjective ) • Nose – Discharge – Frequent colds – Sinus pain – Trauma – Epistaxis – Allergies – Altered smell
- 25. Physical Assessment ofthe Mouth and Throat Interview Data (Subjective ) • Mouth and Throat – Sores or lesions – Bleeding gums – Toothache – Hoarseness – Dysphagia – Altered taste – Smoking and/or alcohol consumption – Self-care behaviors • Dental care • Dentures or appliances
- 26. Physical Assessment ofthe Nose, Mouth and Throat: Physical Data (Objective ) • Equipment: – Otoscope with short, wide-tipped nasal speculum – Pen light – Two tongue blades – Cotton gauze pad – Gloves
- 27. Physical Assessment ofthe Nose, Mouth and Throat: Physical Data (Objective ) • Nose Inspect and Palpate – External nose – Test patency of nostril – Nasal cavity Nasal septum Turbinates – Sinus Areas- Palpate Frontal and maxillary sinuses Transillumination
- 28. Physical Assessment ofthe Nose, Mouth and Throat: Physical Data (Objective ) • Mouth- Inspect – Lips – Teeth and gums – Tongue – U-shaped areas under the tongue – Buccal mucosa – Uvula – Hard and soft palate
- 29. Physical Assessment ofthe Nose, Mouth and Throat: Physical Data (Objective ) • Throat- Inspect – Tonsils – Posterior pharyngeal wall
- 30. Abnormal Findings • Abnormalitiesof the: – Nose – Lips – Teeth and gums – Buccal mucosa – Tongue – Oropharynx