ENT ASSESSMENT for Health Appraisal.pptx

This presentation provides a comprehensive guide to assessing the ears, nose, mouth, and throat, including key anatomical structures, patient history, physical examination techniques, and identification of common abnormalities to support effective clinical evaluations.

1. ENT ASSESSMENT PAUL EBENEZER P Asst. Professor

2. OBJECTIVES Identify key structures of the Ears, Nose, Mouth, and Throat. Discuss the specific patient history for evaluating the ears, nose, mouth, and throat. Describe normal findings during physical assessments of the ears, nose, mouth, and throat. Discuss common abnormalities found during physical assessments of the ears, nose, mouth, and throat.

3. ANATOMY AND PHYSIOLOGY OF EAR

4. HISTORY (EAR) P ast History. History of previous ear problems D rug History of ototoxicity (Antibiotic) F amily history sensorineural hearing loss S ocial history : Noise exposure

5. Physical Examination (EAR) Inspect the Pinna Observe shape, size, and deformity. Gently pull the pinna; ask if it is sore Push the tragus ask if it is painful Note the size of meatus any mastoid surgery. 2. Use an Otoscope Explain the procedure to the patient. Gently pull the pinna upward and backward. Insert the otoscope into the external auditory meatus. Check for infection, wax, and foreign bodies.

6. 3. Observe the Tympanic Membrane Look for the cone of light. Inspect the surface of the tympanic membrane. Ensure the light reflects forward.

7. Abnormal findings (EAR)

8. Screening Test Whispered voice test Tuning fork tests Weber’s test Rinne’s test . 3.Other Tests (balance)

9. WEBER’S TEST RINNE’S TEST

10. Unterberger’s Test Romberg Test Balance and Proprioception

11. Anatomy and Physiology of Nose

12. HISTORY (NOSE) Past Medical History Allergy, Bleeding, Trauma. Drug History Anticoagulants ,NSAID. Family history Atopy – Polyposis . ( allergic rhinitis, asthma  ) Social history Exposure to Dust.

13. Physical Examination (NOSE) Inspect the Nose Observe shape, size, and deformity,Swelling . Deviation (by looking upward) In children, observe the nasal vestibule; in adults, use a nasal speculum. 2. Palpation: Palpate the nasal bones for any deformity. Check for facial swelling or tenderness. Block each nostril and ask the patient to breathe through the other to check for obstruction

14. ABNORMAL FINDINGS TURBINATE HYPERTROPHY NASAL SEPTUM PERFORATION NASAL POLYPS.

15. Anatomy and Physiology of Mouth and Throat

16. HISTORY (THROAT) P ast Medical History Dental problems, Surgery, D rug History T ricyclic antidepressants and anticholinergics- cause a dry mouth. Antib iotics (Risk) F amily history H istory of head and neck cancer S ocial history A lcohol and smoking. Betel nut.

17. PHYSICAL EXAMINATION (THROAT) Inspect the Throat: Voice Inspect: hard palate, oropharynx- for any changes Ask the patient to say ‘ Aaah ’. and use a tongue depressor to improve visualisation. Tonsils : Size, symmetry, colour, and any presence of pus or membrane on the tonsils. Gently touch the back of the throat with a tongue depressor to stimulate the gag reflex. cranial nerves IX and X

18. 2. Palpation: If any lesion seen : palpate mouth and salivary gland, Check for stones Palpate the cervical lymph nodes Gently press along the sides and back of the neck to feel for swollen lymph nodes . Thyroid Gland

19. ABNORMAL FINDINGS Acute tonsillitis. 2. A left peritonsillar abscess.

20. Head and Neck Examination Overview Area Key Examination Points Ears Inspect: pinna (skin, shape, size, position) Palpate: pinna, tragus, mastoid Otoscopy: canal, tympanic Nose Inspect: external nose (swelling, deformity) Palpate: nasal bones, airway patency Mouth & Throat Inspect: oral cavity, tonsils, soft palate (cleft, lesions) Listen: voice (breathy, nasal escape) Neck Inspect: scars, midline swelling Palpate: neck triangles, parotid region, note lumps (size, shape, consistency)