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Physical Diagnosis Scalp, Ears, Nose and Sinuses. Describe the patient’s scalp. Diagnosis?. Psoriasis. Describe findings. Normal TM. Malleus (short process & handle) Cone of light Incus Pars tensa The unbelievable UMBO. Describe findings. Otitis Media. Red and bulging Hyperemia
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Normal TM • Malleus(short process & handle) • Cone of light • Incus • Pars tensa • The unbelievable UMBO
Otitis Media • Red and bulging • Hyperemia • Dullness of light reflex • Opaque
Serous OM • Bulging, amber drum • Decreased mobility
Cerumen in Canal • Parents may be advised to soften first • May remove yourself in physician’s office • VA patients: May remove a lot of ear wax in the ER
Bullous Myringitis • Large vesicles/bullae visible on the drum • Landmarks obscured • Drum is reddened • Viral infection characterized by painful hemorrhage
Traumatic Perforation • Usually result from purulent infection of the middle ear • Central perforation or marginal
Tympanostomy Tube • May be placed in children with a series of ear infections • The major goal is to prevent conductive hearing loss to prevent delayed language development • “Mom, the TV is so loud!”
Sinus Anatomy: Front View • Frontal sinus = black check • Maxillary sinus=red • Anterior ethmoid sinuses = green • Posterior ethmoid sinuses = purple • Sphenoid sinus = yellow
Sinus Anatomy: Side View • Frontal sinus = black check • Maxillary sinus = red • Anterior ethmoid sinuses = green • Posterior ethmoid sinuses = purple • Sphenoid sinus = yellow