HEALTH ASSESSMENT OF EAR,NOSE AND THROAT

SUBMITTED TO PROF.RENUKA GUGAN DEPT OF MSN,KGNC PUDUCHERRY

SUBMITTED BY MINTU JOSHUA 1ST YEAR MSC[N] PUDUCHERRY.

HISTORY COLLECTION 1]History of present illness Present complaints ; duration,onset,progression and Other accompanying complaints 2]History of past illness y History of similar complaints y Treatment y History of operation 3]Personal history y y y y y y Profession Nature of Job Personal habits Food habits Activities Exercise, or sedentary habits 4] Family history Genetic disease EXAMINATION OF EAR

1) Symptomatology y Hearing loss y Tinnitus y Dizziness or vertigo y Ear discharge y Earache y Itching of the ear y Deformity of the pinna y Swelling around the ear 2) PHYSICAL EXAMINATION OF a) Pinna and surrounding area Size ; [ microtia, macrotia] Redness ,swelling, scars Palpation; ; Fluctuations , Tenderness, thickness b) External auditory canal ; with speculum ; without speculum c) Tympanic membrane .color .position .surface of tympanic membrane,moility d) Middle ear e) Mastoid

.swelling .obliterations .fistula F]Examination of Eustachian tub G]Functional examination  Functional examination 1 Auditory function a) Voice test b) Tuning fork test y Rinne test y Weber s test y Schwabach test y Absolute bone condition test 2. Vestibular function a) Spontaneous function b) Fistula test c) Position test EXAMINATION OF NOSE AND PARANASAL SINUSES Symptomatology y Nasal obstruction y Nasal discharge

y Post nasal drip

y y y y y y

Sneezing Epitaxis Headache or facial pain Swelling or deformity Snoring Change in voice  Physical examination  External nose y Skin - ; Inflammation, sinus scars, swelling or neoplasm y Osteocartilagenous structure Palpation of nose ,- ; temperature, fixity of skin .Thickening, tenderness .Fluctuations or crepitation. y Vestibule; Furuncle, Fissure and tumor y Anterior rhinos copy Check for ;Nasal discharge ;Septum ;Floor of nose ;Roof

;Lateral wall

y Posterior rhinoscopy ; Check for .polyp or atresia .Hypertrophy .Discharge in middlematus y Functional examination of nose .Patency of nose .Sense of smell y Examination of paranasal sinuses 1. Maxillary sinuses 2. Frontal sinuses; .External examination .Examination of nose 3.Ethemoid sinuses External examination Nasal examination 4 .Sphenoid sinuses Anterior rhinoscopy Posterior rhinoscopy

EXAMINATION OF NASO PHARYNX Symptomatology

y y y y y y EXAMINATION; 1. Anterior rhinoscopy 2. Posterior rhinoscopy .Discharge .Crusting .Mass .Bleeding 3 Assessment of cranial nerve function 4Cervical lymph nodes Nasal obstruction Postnasal drainage Epistaxis Deafness Cranial nerve palsies Enlargement of lymphnode the neck

.mass

EXAMINATION OF OROPHARYNX

SYMPTOMATOLOGY y y y y y y y y y Sore throat Odynophagia Dysphagia Change in voice Earache Snoring Halitosis Hearing loss Abnormal appearance EXAMINATIONS 1. TONSILS AND PILLARS y Tonsils 1. Presence ,Size ,Symmetry 2. Crypts ,membrane ,ulcer .mass ,bulge. y Pillars ;Cogestion

2.SOFT PALATE .Redness ,swelling ,Movement 3. POSTERIOR PHARYNGEAL WALL Lymphoid nodules Purulent discharge rusting Hypertrophy of lateral pharyngeal bands

y y y y

4.BASE OF THE TONGUE AND CALLECULAE y Indirect laryngoscopy .colour .ulceration .Swelling Cystic swelling y Palpation of base of tongue

EXAMINATION OF LARYNX AND LARYNGOPHARYNX

SYMPTOMATOLOGY
y Disorders of voice y Respiratory obstruction

y y y y y

Cogh and expectoration Repeated clearing throat Pain in throat Dysphagia Mass in the neck

EXAMINATION 1External examination of larynx y y y y Redness ,swelling Widening of larynx ,Surgical trauma Contour ,Displacement of laryngeal structures Movement of larynx

2Indirect laryngoscopy 3Assessment of voice y Hoarse,rough,Bitonal ,Dysphoric y Widespread EXAMINATION OF LYMPHNODE y Palpation - ASSESS ; Colour, number ,consistency ,size,tenderness of  Upper horizontal chain  External jugular vein

 Internal jugular vein  Spinal acessory chain  Transeverse cervical chain  Anterior jugular chain  Juxta visceral chain

Bibliography
[ 1] D. L .DHINGARA;2004;DISEASES OF EAR ,NOSE, AND THROAT ;ELSEVIER PUBLICATIONS ;3rd EDITION;NOIDA;P.PNO;434-457. [2] WILSON AND GIDDENS[2001], HEALTH ASSESSMENT FOR NURSING PRACTICE 2nd EDITION; MOSBY PUBLICATIONS;P P NO;182-184. [3]LYNN S BICKLEY; 2004;GUIDE TO PHYSICAL EXAMINATION AND HISTORY TAKING;9th EDITION; LIPPINCOTT PUBLICATION; P P NO;172-173.