1 / 92

introduction to ENT History and Clinical Examination

ENT Undergraduate Lecture. introduction to ENT History and Clinical Examination. Dr. ZAID AL-DAHWI Consultant ENT Head of ENT department KING SAUD MEDICAL CITY. Evaluation of ENT Patient. Personal history. Name Age Sex Nationality Residence Occupation Habbits (smoking)

celine
Download Presentation

introduction to ENT History and Clinical Examination

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. ENT Undergraduate Lecture introduction to ENT History and Clinical Examination Dr. ZAID AL-DAHWI Consultant ENT Head of ENT department KING SAUD MEDICAL CITY

  2. Evaluation of ENT Patient Personal history • Name • Age • Sex • Nationality • Residence • Occupation • Habbits (smoking) • Marital state

  3. Evaluation of ENT Patient History of present illness • We asked about: • The present symptoms • The onset, • The duration, • Progression and severity • Any systemic disease • e.g. diabetes, hypertension, coronary artery disease, liver or kidney disease, or a bleeding disorder. • Treatment has taken.

  4. Evaluation of ENT Patient History of past illness • History of • Similar complaints in the past, • Previous operations • Allergy to any drug.

  5. Evaluation of ENT Patient Family history • Family history of same disorder • Some diseases have a genetic basis, • e.g. certain types of SNHL

  6. Evaluation of ENT Patient THE CLINICAL EXAMINATION

  7. EXAMINATIONofTHE EAR

  8. Symptoms OF EAR • A patient with ear disease presents with one or more of the following complaints: • 1. Hearing loss. • 2. Tinnitus. • 3. Dizziness or vertigo. • 5. Earache. • 4. Ear discharge. • 6. Itching in the ear. • 7. Deformity of ear pinna. • 8. Swelling around the ear.

  9. Examination of Ear Pinna • Inspection • Size • microtia, • macrotia

  10. Examination of Ear Pinna • Inspection • size (microtia, macrotia) • shape • cauliflower ear

  11. Examination of Ear Pinna • Inspection • size (microtia, macrotia); • shape (cauliflower ear); • position • bat ear.

  12. Examination of Ear Pinna • Inspection • size (microtia, macrotia); • shape (cauliflower ear); • position (bat ear). • Redness • Perichondritis

  13. Examination of Ear Pinna • Inspection • size (microtia, macrotia); • shape (cauliflower ear); • position (bat ear). • Redness (perichondritis); • Swelling • Auricular haematoma, or abcess

  14. Examination of Ear Pinna • Inspection • size (microtia, macrotia); • shape (cauliflower ear); • position (bat ear). • Redness (perichondritis); • Swelling • haematoma, or abcess • Sebacious cyst

  15. Examination of Ear Pinna • Inspection • size (microtia, macrotia); • shape (cauliflower ear); • position (bat ear). • Redness (perichondritis); • Swelling (haematoma, sebacious cyst); • Vesicles (herpes zoster)

  16. Examination of Ear Pinna • Inspection • size (microtia, macrotia); • shape (cauliflower ear); • position (bat ear). • redness (PERICHONDRITIS); • swelling (haematoma, SEBACIOUS CYST); • vesicles (herpes zoster); • sinus • preauricular sinus.

  17. Examination of Ear Pinna • Inspection • size (microtia, macrotia); • shape (cauliflower ear); • position (bat ear). • redness (PERICHONDRITIS); • swelling (haematoma, SEBACIOUS CYST); • vesicles (herpes zoster); • sinus (preauricular sinus.) • Ulceration or neoplasm. • Basal cell carcinoma

  18. Examination of Ear Pinna • Inspection • size (microtia, macrotia); • shape (cauliflower ear); • position (bat ear). • redness (PERICHONDRITIS); • swelling (haematoma, SEBACIOUS CYST); • vesicles in concha and retroauricular groove (herpes zoster); • ulceration or neoplasm. • sinus (preauricular sinus). • Palpation ; • Fluctuation • (hematoma or abscess) • Tenderness • (furunculosis)

  19. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • Size of meatus • (narrow or wide),

  20. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • Size of meatus (narrow or wide), • swelling • furuncle,

  21. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • Size of meatus (narrow or wide), • swelling • furuncle, • AuralPolyp

  22. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • Size of meatus (narrow or wide), • swelling • furuncle, • Aural Polyp • Exostosis. Exostosis(cold water swimmers)

  23. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • Size of meatus (narrow or wide), • swelling • furuncle, • AuralPolyp • Exostosis • Osteomas. Osteomas (beningneoplasia)

  24. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • Size of meatus (narrow or wide), • swelling • furuncle, • AuralPolyp • Exostosis • Osteomas. • neoplasm. Squamouspapilloma in EAC

  25. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • size of meatus (narrow or wide), • swelling • furuncle, • AuralPolyp • Tumour • contents of lumen • wax,

  26. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • size of meatus (narrow or wide), • swelling • furuncle, • AuralPolyp • Tumour • contents of lumen • wax, • OtitisExterna • Necrotizing

  27. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • size of meatus (narrow or wide), • swelling • furuncle, • AuralPolyp • Tumour • contents of lumen • wax, • OtitisExterna • Fungal • Otomycosis • Candida albicans

  28. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • size of meatus (narrow or wide), • swelling • furuncle, • AuralPolyp • Tumour • contents of lumen • wax, • OtitisExterna • fungal • discharge

  29. Examination of external auditory canal • The pinna is pulled upwards and back­wards • Inspection • size of meatus (narrow or wide), • swelling • furuncle, • AuralPolyp • Tumour • contents of lumen • wax, • OtitisExterna • fungal • discharge • FB

  30. Examination of Mastoid • Acute Mastoiditis

  31. Examination of tympanic membrane • Normaltympanicmembrane is pearly white in color and semi­transparent

  32. Examination of tympanic membrane • Normal tympanic membrane is pearly white in colour and semi­transparent • A tympanic membrane is examined for: • (a) Colour. • Red and congested in acute otitis media, bluish in secretoryotitismedi or haemotympanum. A chalky plaque is seen in tympanosclerosis.

  33. Examination of tympanic membrane • Normal tympanic membrane is pearly white in colour and semi­transparent • A tympanic membrane is examined for: • (a) Colour. • Red and congested in acute otitis media, bluish in secretoryotitismedici or haemotympanum. A chalky plaque is seen in tympanosclerosis.

  34. Examination of tympanic membrane • Normal tympanic membrane is pearly white in colour and semi­transparent • A tympanic membrane is examined for: • (a) Colour. • Red and congested in acute otitis media, bluish in secretoryotitismedici or haemotympanum. A chalky plaque is seen in tympanosclerosis.

  35. Examination of tympanic membrane • Normal tympanic membrane is pearly white in colour and semi­transparent • . A tympanic membrane is examined for: • (a) Colour. Red and congested in acute otitis media, bluish in secretoryotitismedici or haemotympanum. A chalky plaque is seen in tympanosclerosis. • (b) Position. • retracting or • bulging.

  36. Examination of tympanic membrane • Normal tympanic membrane is pearly white in colour and semi­transparent • . A tympanic membrane is examined for: • (a) Colour. Red and congested in acute otitis media, bluish in secretoryotitismedici or haemotympanum. A chalky plaque is seen in tympanosclerosis. • (b) Position. • Retracting or • Bulging.

  37. Examination of tympanic membrane • Normal tympanic membrane is pearly white in colour and semi­transparent • . A tympanic membrane is examined for: • (a) Colour. Red and congested in acute otitis media, bluish in secretoryotitismedici or haemotympanum. A chalky plaque is seen in tympanosclerosis. • (b) Position. Tympanic membrane may be retracting or bulging. • (c) Surface of tympanic membrane. • show bullae , or • perforation

  38. Examination of tympanic membrane • Normal tympanic membrane is pearly white in colour and semi­transparent • . A tympanic membrane is examined for: • (a) Colour. Red and congested in acute otitis media, bluish in secretoryotitismedici or haemotympanum. A chalky plaque is seen in tympanosclerosis. • (b) Position. Tympanic membrane may be retracting or bulging. • (c) Surface of tympanic membrane. • show bullae , or • perforation

  39. Examination of tympanic membrane • Normal tympanic membrane is pearly white in colour and semi­transparent • . A tympanic membrane is examined for: • (a) Colour. Red and congested in acute otitis media, bluish in secretoryotitismedici or haemotympanum. A chalky plaque is seen in tympanosclerosis. • (b) Position. Tympanic membrane may be retracting or bulging. • (c) Surface of tympanic membrane. • show bullae , or • Perforation • Cholesteatoma

  40. Examination of facial nerve. • Paralysis of facial nerve may co-exist with disease of the ear,

  41. Auditory and Vestibular function • Tuning fork tests • Rinne test

  42. Auditory and Vestibular function • Tuning fork tests • Rinne test • Weber test

  43. Auditory and Vestibular function • Tuning fork tests • Rinne test • Weber test • Pure tone audiogram (PTA)

  44. Auditory and Vestibular function • Tuning fork tests • Rinne test • Weber test • Pure tone audiogram (PTA) • Tympanogram

  45. Auditory and Vestibular function • Tuning fork tests • Rinne test • Weber test • Pure tone audiogram (PTA) • Tympanogram • Nystagmus

  46. Auditory and Vestibular function • Tuning fork tests • Rinne test • Weber test • Pure tone audiogram (PTA) • Tympanogram • Spontaneous nystagmus • Fistula test

  47. EXAMINATIONof THE NOSE

  48. Symptoms of NOSE AND PARANASAL SINUSES • A patient with nose disease presents with one or more of the following complaints: • 1. Nasal obstruction. • 2. Nasal discharge. • 3. Post-nasal drip. • 4. Epistaxis. • 5. Sneezing. • 6. Headache or facial pain. • 7. Swelling or deformity. • 8. Disturbances of smell. • 9. Snoring. • 10. Change in voice (hyper- or hyponasality).

  49. EXAMINATION External Nose • signs of inflammation (furuncle, abscess)

  50. EXAMINATION External Nose • signs of inflammation (furuncle, abscess) • swelling • Glioma non-neoplastic lesion consisting of neuroglial tissue without the communication to the central nervous sytem

More Related