Within Normal Limits
BC > AC
bone conduction greater than air conduction
weakness, drooping of one side of the face because of inflammation of the facial nerve
disorder of the thyroid gland characterized by the presence of hyperthyroidism, goiter, and exophthalmos
an abnormally small head and underdeveloped brain
inflammation of the gums
Increase in bulk of free & attached gingiva, especially involving the interdental papilla; Medications involved: phenytoin, calcium channel blockers, cyclosporine
an abnormal condition in which cerebrospinal fluid collects in the ventricles of the brain
inflammatory disease of the supporting tissues of the teeth
Mucous membrane lining the cheek.
inspection of a cavity or organ by passing light through its walls
membrane/ligament between the 2 pieces of cartilage, can place a tube if needed to help person breathe
cranial aponeurosis connecting frontal and occipital bellies
candidiasis of the oral cavity
also known as a canker sore, is a type of oral ulcer, which presents as a painful open sore inside the mouth or upper throat (including the uvula) caused by a break in the mucous membrane.
infection of the skin and tissue surrounding the cartilage of the outer ear
a tiny, red blood vessel lesion formed by the dilation of a group of blood vessels radiating from a central arteriole
if a person had a recent epistaxis where would you look for evidence?
Look in the back of the nose (posterior) if there is bleeding in the back of the nose it will go down the throat, which is a sign of hypertension and can be very serious.
Sometimes tendernees of maxillary sinuses produces pain in teeth of the maxilla, why is that?
The teeth are connected to the sinus cavity via the alveolar process. It also could be caused by fluid build up in the maxillary sinus which could be due to sinus infection.
why is the examination using a tongue depressor dangerous in a child with a bad sore throat or fever?
The gag reflex could cause the cricothyroid ligament to go into spasm and close down the larynx and cause airway distress.
what is the common cause of a 1 cm tender node in the post-auricular region?
Could be due to local infection of the scalp or ear which has drained into the lymph node.
What does an absence of the cone of light indicate?
There is an acute ear problem or disease, could be infection or fluid.
- sound waves move through the air in the external auditory canal, hit the tympanic membrane (TM) and cause the tympanic membrane to move.
- 3 bones in the middle ear (the malleus, the incus, and the stapes) are connected to the TM. When the TM moves, it is transmitted to the bones. These movements cause pressure waves in the fluid-filled inner ear.
- The cochlea in the inner ear is surrounded by fluid and contains multiple small hairs. Pressure waves in the fluid cause the hairs to move stimulating the auditory nerve. Different frequencies of noises stimulate different hairs on the cochlea, which translate to the sensation of sounds of different pitch.
-Can test by holding a tuning fork next to the ear. If they can't hear that, but can hear rapping on the skull, then the problem is in the ear.
air conduction should be better than bone conduction. If bone conduction is better than air conduction there is CONDUCTION problem which is normally an obstruction that causes problems with propagation though the air or bone. If someone has problems with TRANSMISSION that is problems with the sensory neuron signaling loss or propagation of the nerve.
How can the weber and Rinne trests be used to determine whether a hearing loss is due to a problem with conduction or with transmission?
Rinne test - if it is louder in the back there is conductive loss; bone conduction is greater than air conduction. With sensory neuron problems the normal pattern of air conduction is greater than bond conduction will prevail.
Weber test - the sound will lateralize to the impaired ear if conduction problems; sound will lateralize to the good ear if sensory neuron impaired (away from the affected side).
Extraocular Movements Intact
OD, OS, OU
right eye, left eye, both eyes
pupils equal, round, reactive to light and accommodation
a unit of measurement of the refractive power of a lens which is equal to the reciprocal of the focal length measured in meters
redness of the conjunctiva
protrusion of the eyeball from the socket
abnormal condition in which vision for distant objects is better than for near objects
An involuntary, rhythmic oscillation of the eyeballs; may be lateral, vertical, or rotary
swelling of the optic disc (where the optic nerve enters the eyeball)
a gray-white arc or circle around the limbu; it is due to the deposition of lipid material in the aging adult. as lipids accumulate, the cornea may look thickened and raised. but this has no effect on vision
thin tissue growing into the cornea from the conjunctiva, usually caused from sun exposure
outward turning of the rim of the eyelid
dilation of the pupil of the eye
farsightedness resulting from a reduced ability to focus caused by loss of elasticity of the crystalline lens with age
drooping of the upper eyelid caused by muscle paralysis and weakness
an isolated area of diminished vision within the visual field
abnormal condition of squint or crossed eyes caused by the visual axes not meeting at the same point
sty; an acute infection of a sebaceous gland of the eyelid
pain in the eye resulting from exposure to bright light (often associated with albinism)
respond to pressure changes in the walls of blood vessels and digestive, reproductive, and urinary tracts.
Surgical removal of plaque from the inner layer of an artery
an unnatural condition in which the head leans to one side because the neck muscles on that side are contracted
mucous membrane lining the eyelids and covering the anterior portion of the sclera
the clear tissue that covers the front of the eye
dark area in center of iris where light continues its progress through the lens
muscular diaphragm that controls the size of the pupil
openings of the inner eye near the eyelid where tears are drained
blood leakage. homogenous, sharply demarcated red area.
inflammation of the iris
inflammation of the lacrimal sac causing obstruction of the tube draining tears into the nose
inflammation of the eyelids characterized by redness and swelling and dried crusts
display consisting of a printed card with letters and numbers in lines of decreasing size
red glow filling the pupil when ophthalmoscope reflects off retina
abnormally enlarged thyroid gland
the muscles on either side of the neck that allow movement of the head; Sternocleidomastoid muscles
chronic abnormal enlargement of the lymph nodes (usually associated with disease)
lymph nodes that are located just above and behind the clavicle at the sternomastoid muscle
abnormal blowing sound or murmur heard while listening to the blood flow through the arteries; indicates obstruction
Uveitis, nystagmus, strabismus
Name three common conditions that may be observed in the inspection aspect of the eye exam
CN 2 and CN 3
Which cranial nerve(s) are tested with the pupillary response?
Vestibular problem and Nystagmus
When testing EOM an eye "jump" is detected for the lateral gaze. What does this indicate and what is this called?
brain might ignore the input from one eye. Makes sure eyes are working together
why is it necessary to test vision in each eye individually and then both eyes together?
arteries pulsate, are smaller, and brighter than veins
How can you tell retinal arteries from the veins?
conductive hearing loss
distortion of sounds that impairs the understanding of words: relatively minor
ffects of a noisy environment:hearing may seem to improve
patient's own voice tends to be soft: the patient's own voice is conducted though bone to a normal inner ear and cochlear nerve.
Usual age of onset: most often in childhood and young adulthood, up to age 40.
Ear canal and drum: an abnormality is usually visible, except in otosclerosis.
Distortion of sounds that impairs the understanding of words: often present as the upper tones of words taht are disproportionately lost.
effects of noisy environment: hearing typically worsens.
patient's own voice: may be loud, the patient has trouble hearing his or her own voice.
usual age of onset: most often in the middle or late years
ear canal and drum: the problem is not visible
Weber test: conductive loss
the sound lateralizes to the impaired ear. since the ear is not distracted by room noise, it can detect the tuning fork's vibrations better though bone.
Weber test: sensorineural loss
The sound lateralizes to the good ear. The impaired inner ear or coclear nerve is less able to transmit impulses no matter how the sounds reaches the cochlea. The sound is therefore heard in the better ear.
Rinne Test: Conductive Loss
Bone conduction last longer than or is equal to air conduction. While air conduction through the external or middle ear is impaired, vibrations through bone bypass the problem to reach the cochlea.
Rinne Test: Sensorineural Loss
The normal air conduction lasts longer than bond conduction prevails. The inner ear or cochlear nerve is less able to transmit impulses regardless of how the vibrations reach the cochlea.
physically wasting away of body due to disease or illness (objective and symptom)
not having a fever or elevated body temp. (objective and symptom)
vomiting (objective and symptom)
no acute distress/ no apparent disease (objective)
flowing or running together without distinction (skin lesions) (objectives)
raised portions of skin (objective)
a small, flat skin lesion (objective)
dark, red-colored stool due to blood (objective and symptom)
tingling, numbness, burning of skin (symptom)
difficulty swallowing (symptom)
impairment of understanding or communicating speech (objective and symptom)
thickening of skin (objective)
ringing in the ears (symptom)
muscular pain (symptom)
swelling due to excessive interstitial fluid (objective and symptom)
enlargement of liver and spleen (objective)
reddening of skin caused by blood vessels (objective)
exaggeration of deep tendon reflexes (objective)
unusual sounds of the heart due to valve problems (objective)
crackling noises of the lungs (objective)
painful urination (symptom)
abnormal sound in patient's chest while breathing (objective)
rapid heartbeat (objective and symptom)
history of present illness
review of systems
past medical history
physical exam- using inspection, palpation, percussion, and auscilation
addition tests after physical exam
impression about what is going on with a patient, and development of a working diagnosis
development of a regimen.