What are the 3 layers that surround the eyeball?
Sclera, uvea, retina
What thin membranes lie between the eyeball and eyelid?
What are the 3 bones of the middle ear?
malleus, incus, stapes
What are the primary functions of the nose as they pertain to respiration?
Humidifies, filters. and warms air before it enters the lungs.
What are some risk factors for hearing loss?
incidence increases after 50
repeated exposure to loud noise
ototoxic medications (ie, aspirin)
history of congenital hearing loss.
what are some risk factors for cataracts?
between 65-74 yo 70%
75-84 yo 90%
Women at higher risk
Chronic disease (ie diabetes)
What are some risk factors for Glaucoma?
Asians and eskimos (closed angle)
What are some risk factors for macular degeneration?
Age: 56-74 yo 25%, 75+ 33%
Risk factors for Oropharyngeal Cancer?
Age: peak between 64-74 yo
2:1 men to women
Exposure to sunlight
History of cancer
Present Health Status Qs
Changes in overall health?
Chronic conditions that affect ears, nose, throat, eyes?
Last routine exams?
What corrective devices do you use?
Daily practices to maintain ears, nose, eyes, mouth.?
Past History Qs
Injuries to eyes, mouth, nose, throat, ears?
Surgery in area?
Chronic infections in area?
Family History Qs
What do you do?
Dizziness and Vertigo Qs
Interfere with day?
How do you treat?
What makes it worse?
Has is interfered with daily life?
Hearing Loss Qs
How much does it bother you?
When did it start?
Occur all the time or come and go?
Occur with certain activities?
How often and long?
Nasal Discharge/ Nose Bleed Qs
When did it begin? Describe.
One side or both?
Sore Throat Qs
Others in home ill?
Dust or fumes at work?
Fever or fatigue?
Mouth Lesions Qs
Sores anywhere else on body?
Routine Technique: Head
INSPECT: size, shape, skin characteristics. facial structures for size, symmetry, movement, intactness, skin characteristics, and facial expression.
Abnormal Findings: Head
Microcephaly: abnormally small head.
Macrocephaly: Abnormally large head
Abnormal skin color, uneven pigmentation, skin lesions, coarse facial hair in women, asymmetry, edema, abnormal facial movements.
Limited jaw movement and jaw clicking is associated with TMJ.
Tender, edematous, or hardened arteries with redness over temporal region suggest temporal arteritis. A bruit indicates vascular abnormality.
Routine Technique: Eyes
TEST: Snellens chart.
TEST: Visual acuity. Jaeger or Rosenbaum card at 14 in and read smallest line.
INSPECT: Ocular structures (external) eyebrows, eyelashes, eyelids for symmetry, hair distribution, skin characteristics, discharge. Blinking rate.
INSPECT: Ocular structures (Internal) Conjunctive for color, moisture, drainage, lesions. Corneal light reflex for symmetry. Sclera for color and surface characteristics. Cornea for transparancy and surface characteristics, Iris for shape and color. Pupils PERRLA
What is Hirschberg's Test?
Test for corneal light reflex for symmetry.
Ask the client to stare straight ahead with both eyes open. Shine a penlight towards the bridge of the nose at a distance of 12 to 15 inches. Light reflections should appear symmetrically in both corneas.
if lihght reflections appear in different places this may indicate weak extraocular muscles.
Abnormal Findings: Eyes
presbyopia is near sightendess and suggest a loss of elasticity of the lens.
Edema of lid may indicate trauma or infection.
Inward deformity of lid and lashes may indicate enophthalmos.
Red and congested conjunctiva may indicate conjunctivitis.
A sharply defined area of blood next to a normal area may indicate conjunctival hemorrhage.
Yellow sclera may indicate jaundice.
Corneal arcus white opaque rings circling the limbus.
Coloboma- congenital defect of iris.
Pupil dysfunction CN III
Routine Technique: Ears
ASSESS: Observe alignment and position
INSPECT: for shape, size and symmetry
TEST CN VII: Weber and Rinne tests, finger rubbing, whispered voice.
Abnormal Findings: Ears
Low set or misaligned ears
microtia- ears smaller than 4 cm in length.
Macrotia- ears larger than 10 cm in length
Cauliflower ear, tophi, hematoma, sebaceous cyst, edema
Routine Technique: Nose
INSPECT: General appearance, symmetry, discharge, tenderness,
Abnormal Findings: Nose
lesions and erythema and discolorations may indicate systemic illness.
Asymmetry may indicate current or past injury
Edema, nasal discharge, and crusting are possible signs of infection allergy or injury,
Watery unilateral nasal discharge following a history of head injury may indicate skull fracture.
Unilateral purulent, thick nasal drainage may indicate a foreign body
Rhinophyma- hypertrophy of sebaceous glands and soft tissue
Routine Techniques: Mouth
INSPECT: lips for color, symmetry, moisture, and texture.
Teeth and gums for condition, color, surface characteristics, stability, and alignment. Tongue for movement, color and surface characteristics. Buccal mucosa and anterior and posterior pillars for color and surface characteristics.Palate, uvula, pharynx, and tonsils for texture, color, surface characteristics and movement.
Abnormal Findings: Mouth
Pale lips may indicate anemia or shock. Cyanotic lips may indicate hypoxemia. Dry or cracked lips may indicate dehydration. Cracks in corners of maouth may indicate vitamin B deficiency.
Routine Technique: Neck
INSPECT: Position in relation to head and trachea. Skin characteristics and lumps or masses.
Abnormal Findings: Neck
Note tremors or rhythmic movements of head. ticks or spasms. lesions or masses. Enlarged thyroid.