Head and Neck

Question 1

What are you inspecting for in face?

Answer 1

• Scars
• Deformity/assymetry/head size
• Muscle wasting/weakness
• Swellings
• Skin lesions
• Hair distribution

Question 2

What are you inspecting for in eyes?

Answer 2

Lid lag, proptosis, eye movements

Sclera for jaundice or anaemia

Thyroid eye disease

Question 3

What are you inspecting for in nose?

Answer 3

Symettry, discharge

Question 4

What are you inspecting for in ear?

Answer 4

• Skin lesions
• Bruising
• Discharge
• Scars

Question 5

How far should whisper test be from?

Answer 5

60cm, 15cm after if not heard

Question 6

What does Webers test?

Answer 6

• In normality hearing equal each side
• If conducted deafness on one side sound be heard loudest in that ear
• If sensori-neural hearing loss sound will be reffered to the good ear

Question 7

What does Rinne’s test?

Answer 7

• Compared air conduction and bone conduction
  
  • Air conduction should be loudest
• Postive if AC>BC
• If negative (BC

Question 8

Descibe normal tympanic membrane?

Answer 8

• Pale, grey, ovoid, semi-transparent located at end of external auditory canal

Question 9

In Weber’s, what is seen in:

• sensorineural hearing loss
• conductive hearing loss

Answer 9

• Sensorineural
  
  • Sound is heard louder on side of intact ear
• Conductive
  
  • Sound heard louder on side of affected ear

Question 10

In Rinne’s, what is seen in:

• sensorineural hearing loss
• conductive hearing loss

Answer 10

• Sensorineural
  
  • AC>BC (due to both air and bone conduction being reduced equality)
• Conductive deafness
  
  • Bone conduction > air conduction (rinnes negative)

Question 11

What do you comment on in otoscopy?

Answer 11

• External auditory canal
  
  • Wax, erythema, oedema, discharge, foreign bodies
• Tympanic membrane (inspect the 4 quadrants)
  
  • Colour - should be pearly grey
  • Shape - should be flat
  • Light reflex - should be cone shaped in anterior inferior quadrant
  • Perforation
  • Scarring

Question 12

What does erythema of tympanic membrane suggest?

Answer 12

Ottitis media

Question 13

What does the following of tympanic membrane suggest:

• bulging
• retraction

Answer 13

• Bulging
  
  • Otitis media with effusion
• Retraction
  
  • Dysfunction secondary to URTI and allergies

Question 14

What is absent or distorted light reflex suggest?

Answer 14

Otitis media

Question 15

What are causes of perforation?

Answer 15

• Infection
• Truama
• Cholesteatoma and insertion of tympanostomy tubes