Introduction to Clinical Skills

HEENT and Neck

Universidad Iberoamericana UNIBE

Introduction to Clinical Skills

Teaching Staff Dra Elizabeth Peralta Dr Marcos Núñez Dra Cristina Páez C Dr Juan Carlos Mariñez Dra Wayna Greo Dra Yun Pey Lee

Introduction to Clinical Skills

Head Exam Skull Face Eyes Ears Nose Paranasal Oral cavity, Pharynx and Larynx

Introduction to Clinical Skills

Approach to the Physical Exam What we need to do it ?

Penlight Sthetoscope Sphygmomanometer HEENT set Goniometer Tune fork Hammer Pinwheel Measure tape Gloves Isopropilic Alcohol

Introduction to Clinical Skills

Head Exam. The Health History Headaches How is your vision ? Do yoy wear glasses ? How is your hearing ? Rhinorrea , Epsitaxis ? Sore Throat Hoarseness

Introduction to Clinical Skills

Head Exam. Health Promotion and Counseling Changes in vision:

Cataracts,glaucoma, macular degeneration Hearing loss Oral health

Introduction to Clinical Skills

Head Exam. Techniques of Examination The Hair

Quantity Distribution Texture Pattern of loss Flakes of dandruff

Introduction to Clinical Skills

Head Exam. Techniques of Examination The Scalp

Scaliness Lumps Nevi Other lesions

Introduction to Clinical Skills

Head Exam. Techniques of Examination The Skull

General size and contour Deformities, depressions, lumps, tenderness Irregularities in normal skull

Between parietal and occipital bones

Introduction to Clinical Skills

Head Exam. Techniques of Examination The Face

Facial expression and contours Asymmetry Involuntary movements Edema Masses TMJ

Introduction to Clinical Skills

Head Exam. Techniques of Examination

Introduction to Clinical Skills

Head Exam. Techniques of Examination The Face

Craneal nerves V and VII

Introduction to Clinical Skills

Head Exam. Techniques of Examination The Face palpation

Introduction to Clinical Skills

Head Exam. Techniques of Examination The Face

Temporomandibular joint

Introduction to Clinical Skills

Head Exam. Techniques of Examination The Skin

Color Pigmentation Texture Thickness Hair distribution Any lesion

Introduction to Clinical Skills

Head Exam. The Eyes Anatomy

Introduction to Clinical Skills

Head Exam. The Eyes Anatomy

Introduction to Clinical Skills

Head Exam. The Eyes Important areas of Examination

Visual acuity Visual fields Conjunctiva and sclera Cornea, lens and pupils Extraocular movements

Introduction to Clinical Skills

Head Exam. The Eyes Visual acuity

Snellen chart Position patient 20 feet from the chart

Introduction to Clinical Skills

Head Exam. The Eyes Visual fields

Temporal Nasal

Introduction to Clinical Skills

Head Exam. The Eyes Position and Alignment Eyebrows

Quantity, distribution Eyelids

Width palpebral fissure Color

Introduction to Clinical Skills

Head Exam. The Eyes Conjunctiva, Sclera and palpebral conjunctiva

Color Vascular pattern

Introduction to Clinical Skills

Head Exam. The Eyes Cornea and Lens Iris Pupils

Size Shape Symmetry Reaction to light

Introduction to Clinical Skills

Introduction to Clinical Skills

Head Exam. The Eyes Extraocular Muscles

Normal conjugate movements Nystagmus Lid Lag Test for Convergence

Introduction to Clinical Skills

Head Exam. The Eyes Ophthalmoscopic Exmination

Fundi Optic disc and cup Macula Retinal vessels

Introduction to Clinical Skills

Head Exam. The Ears The Auricle Ear canal and Drum Auditory Acuity Air and Bone Conduction

Weber Test Rinne Test

Introduction to Clinical Skills

Head Exam. The Ears The Auricle

Introduction to Clinical Skills

Head Exam. The Ears Ear canal and Drum

Introduction to Clinical Skills

Head Exam. The Ears Ear canal and Drum

Introduction to Clinical Skills

Head Exam. The Ears Auditory Acuity

Introduction to Clinical Skills

Head Exam. The Ears The Air and Bone Conduction

Weber Test

Introduction to Clinical Skills

Head Exam. The Ears The Air and Bone Conduction

Rinne Test

Introduction to Clinical Skills

Head Exam. The Nose Examination Techniques

Inspect anterior and inferior surfaces (symmetry) Nasal vestibule Test for nasal obstruction Rhinoscopic exam

Nasal mucosa Nasal septum

Introduction to Clinical Skills

Head Exam. The Nose Examination Techniques

Inspect anterior and inferior surfaces (symmetry)

Introduction to Clinical Skills

Head Exam. The Nose Examination Techniques

Nasal vestibule

Introduction to Clinical Skills

Head Exam. The Nose Examination Techniques

Test for nasal obstruction

Introduction to Clinical Skills

Head Exam. The Nose Examination Techniques

Rhinoscopic exam Nasal mucosa Nasal septum

Introduction to Clinical Skills

Head Exam. Paranasal Sinuses Examination Techniques

Palpation and percussion of the Sinuses Transillumination

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques The Lips The Oral mucosa The Gums and Teeth The Roof of the Mouth The Tongue and The Floor of the Mouth The Pharynx The Larynx

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques: The Lips

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques: The Oral Mucosa

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques: The Gums and Teeth

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques: The Roof of the Mouth

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques: The Tongue and Floor of the Mouth

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques: The Tongue and Floor of the Mouth

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques: The Tongue and Floor of the Mouth

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques: The Oropharynx

Introduction to Clinical Skills

Head Exam. The Oral Cavity, Pharynx and Larynx Examination Techniques: The Larynx

Introduction to Clinical Skills

The Neck Exam Landmarks

C6, C7 Triangles

Introduction to Clinical Skills

Neck Exam. Techniques of Examination General Inspection

Symmetry Masses Scars

Lymph nodes The Trachea and Thyroid gland The Carotid Arteries and Jugular Veins The Barchial Plexus ROM

Introduction to Clinical Skills

Neck Exam. Techniques of Examination General Inspection

Symmetry Masses Scars

Introduction to Clinical Skills

Neck Exam. Techniques of Examination Lymph nodes

Introduction to Clinical Skills

Neck Exam. Techniques of Examination The Trachea and Thyroid gland

Introduction to Clinical Skills

Neck Exam. Techniques of Examination The Trachea and Thyroid gland

Introduction to Clinical Skills

Neck Exam. Techniques of Examination The Carotid Arteries and Jugular Veins

Introduction to Clinical Skills

Neck Exam. Techniques of Examination The Brachial Plexus

Introduction to Clinical Skills

Neck Exam. Techniques of Examination ROM

Introduction to Clinical Skills