Chapter 12 Ears, Nose, Mouth, and Throat

Chapter 12 Ears, Nose, Mouth, and Throat

Anatomy and Physiology • Ear • Sensory organ of hearing • Nose • Sensory organ of smell • Mouth and throat • Sensory organ of taste • First part of digestive system

Anatomy and PhysiologyThe Ear The Outer Structures The Internal Structures

Anatomy and PhysiologyThe Ear (cont’d) The Right Eardrum Conduction Pathways

The Health History The Ear • Common or concerning symptoms • Hearing loss • Earache • Discharge • Tinnitus • Vertigo

The Health History(cont’d) • Ear history • Hearing loss? • Conduction vs. sensorineural • Earaches? • Frequency, sharp, dull • Discharge or drainage? • Ear wax, pus, smell • Tinnitus? • Vertigo?

The Health History(cont’d) • Past history • Hearing loss • Removal of cerumen • Surgery • Trauma • Infection • Noise exposure • History of disease

The Health History(cont’d) • Family history • Hearing loss • Otitis media • Allergies • Smoking or exposure to cigarette smoke

Lumps On or Near the Ear Keloid Chondrodermatitis Helicis

Lumps On or Near the Ear(cont’d) Tophi Basal Cell Carcinoma

Lumps On or Near the Ear(cont’d) Cutaneous Cyst Rheumatoid Nodules

Eardrum Normal Right Eardrum Perforation

Eardrum(cont’d) Tympanosclerosis Serous Effusion

Eardrum(cont’d) Acute Otitis Media With Purulent Effusion Bullous Myringitis

The Health History(cont’d) • Lifestyle habits • Exposure to loud noises • Protective devices • Use of hearing aids • Use of medications or drugs that interfere with hearing or cause dizziness

Hearing Loss Conductive Loss Sensorineural Loss

Question • The ossicles consist of all of the following except: A. Incus B. Malleus C. Stapes D. Mastoid

Answer • The ossicles consist of all of the following except: • D. Mastoid • The mastoid bone is a part of the cranium. The three ossicles are the malleus, incus, and stapes.

Anatomy and PhysiologyThe Nose Outer Structures Internal Structures

Anatomy and PhysiologyThe Paranasal Cavities Lateral Wall: Nasal Cavity Cross Section of Nasal Cavity, Anterior View

Anatomy and PhysiologyThe Paranasal Cavities (cont’d)

The Health HistoryThe Nose and Sinuses • Rhinorrhea • Type of discharge • Congestion • Medications, infections • Epistaxis • May indicate bleeding disorder • Change in sense of smell • Pain

The Health HistoryThe Nose and Sinuses (cont’d) • Past history • Sinus infections • Upper respiratory infections • Allergies • Trauma or injury • Nasal or sinus surgery • Polyps • Dental history

The Health HistoryThe Nose and Sinuses (cont’d) • Family history • Allergies • Asthma • Cancer of nose or sinus • Lifestyle habits • Air quality • Pets • Alcohol, tobacco, recreational drugs

Anatomy and PhysiologyMouth and Throat

Anatomy and PhysiologyMouth and Pharynx (cont’d)

Anatomy and PhysiologyMouth and Throat (cont’d) A Tooth The Upper Teeth

Anatomy and PhysiologyMouth and Throat (cont’d)

Abnormalities of the Lips Angular Cheilitis Actinic Cheilitis

Abnormalities of the Lips(cont’d) Herpes Simplex Angioedema

Abnormalities of the Lips(cont’d) Hereditary Hemorrhagic Telangiectasia Peutz-Jeghers Syndrome

Abnormalities of the Lips(cont’d) Chancre of Syphilis Carcinoma of the Lip

The Health HistoryThe Mouth and Throat • Common or concerning symptoms • Sore throat • Upper respiratory infection • Hoarseness • Smoking, allergies, voice abuse, hypothyroidism, tuberculosis, tumors • Lesions • Aphthous ulcers, nutritional deficiency

The Health HistoryThe Mouth and Throat (cont’d) • Common or concerning symptoms (cont’d) • Sore tongue • Nutritional deficiency • Bleeding gums • Gingivitis • Toothache • Dysphagia • Any particular foods

The Health HistoryThe Mouth and Throat (cont’d) • Past history • Sore throat • Loss of voice • Dental, mouth, or throat surgery • Trauma or injury • History of infections • Oral cancer • Sexually transmitted disease

The Health HistoryThe Mouth and Throat (cont’d) • Family history • Allergies • Smoking or exposure to cigarette smoke • Stroke • Tuberculosis

The Health HistoryThe Mouth and Throat (cont’d) • Lifestyle habits • Brush teeth? • Use tobacco products? • Smoke recreational drugs? • Drink alcohol? • Past and present occupations? • Past and present active sports? • Use of dental dams?

Question • Patients should be encouraged to maintain good dental hygiene, that would include which of the following? (Choose all that apply.) A. Daily brushing B. Flossing C. Routine dental visits D. Good nutrition

Answer • Patients should be encouraged to maintain good dental hygiene, that would include which of the following? (Choose all that apply.) • A. Daily brushing • B. Flossing • C. Routine dental visits • D. Good nutrition • All of these steps will help maintain good dental hygiene and should be encouraged.

Physical ExaminationThe Ear • Equipment • Tuning fork • Otoscope • Speculum • Tongue blade • Gloves • Penlight

Physical ExaminationThe Ear (cont’d) • Auricle • Inspect tissues for deformities, lumps, or skin lesions. • Pain, discharge, inflammation • Movement painful in otitis externa • Tenderness behind ear may be present with otitis media.

Physical ExaminationThe Ear (cont’d) Ear Canal and Drum

Physical ExaminationThe Ear (cont’d) Ear Canal and Drum (cont’d)

Physical ExaminationThe Ear (cont’d) Right Eardrum Acute Otitis Externa

Physical ExaminationThe Ear (cont’d) • Auditory acuity • Test one ear at a time. • Occlude nontested ear. • Speak numbers or words with two equal syllables. • Do not let patient read your lips. • Ask them to repeat what they hear.

Physical ExaminationThe Ear (cont’d) Air and Bone Conduction

Physical ExaminationThe Nose • Equipment for examination • Penlight • Otoscope • Nasal speculum or largest speculum available • Gloves

Physical ExaminationThe Nose (cont’d)

Physical ExaminationThe Nose (cont’d) • Inspect anterior and inferior surfaces. • Test for nasal obstruction. • Inspect inside of nose. • Observe nasal mucosa, septum, and any abnormalities. • Palpate for sinus tenderness.

Chapter 12 Ears, Nose, Mouth, and Throat