Quick Review: Examination of the Head, Neck, and Eye

by Stephen Holt, MD, MS

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    00:01 Now let's move on to summarize what we've learned.

    00:05 So when you're engaging in the head and neck exam, there are particular things that you're going to pay close attention to.

    00:11 You're looking for generally, is there symmetry in the skull, you're going to take a look at the sinuses and potentially palpate or percuss them.

    00:18 Lymphatic exam is extremely important when you're thinking about upper respiratory tract infections, particularly in the anterior cervical chains, potentially the preauricular and posterior auricular chains as well.

    00:30 When you're thinking about patients with ear pain, you're going to first tug up on the auricle of the ear and potentially palpate the tragus looking for signs of otitis externa, and then you're going to perform otoscopy taking a look at the external acoustic meatus and looking for any of those classic findings on the eardrum that would indicate a middle ear infection.

    00:51 On the nasal exam, you'll be looking at those turbinates looking to see if there's any evidence of boggy inflammation of the turbinates.

    00:57 And then in the mouth, there's a host of different signs of systemic disease and potentially infectious causes of various manifestations in the mouth.

    01:08 Which of the following might suggest acute otitis media? Tenderness over the tragus? serosanguinous exudate in the acoustic meatus Parotid gland enlargement, or a poorly visualized malleus.

    01:25 So tenderness over the tragus typically goes with otitis externa.

    01:29 Serosanguinous exudate within the external acoustic meatus also would go with otitis externa.

    01:35 Parotid gland enlargement can be caused by a variety of different things including infectious causes, but not otitis media.

    01:43 So the answer is a poorly visualized malleus because of bulging out of the tympanic membrane, possibly erythema in the membrane which basically makes the membrane less transparent.

    01:54 And of course, just fluid potentially mucopurulent fluid behind the eardrum would obscure all of the ossicles in the middle ear.

    02:00 So the answer is D.

    02:03 So now let's review some of what we've covered during this lecture on the eye exam.

    02:08 Which of the following might you see with diabetic retinopathy? Cotton wool spots? AV nicking? Blurring of the optic disc or copper wiring.

    02:22 Now, among these four options, the most likely finding for diabetic retinopathy would be cotton wool spots.

    02:30 AV nicking and copper wiring are most commonly seen with hypertensive retinopathy.

    02:35 And blurring of the optic disc is a feature of papilledema.

    02:39 So the answer is letter A.

    About the Lecture

    The lecture Quick Review: Examination of the Head, Neck, and Eye by Stephen Holt, MD, MS is from the course Examination of the Head and Neck Region.

    Author of lecture Quick Review: Examination of the Head, Neck, and Eye

     Stephen Holt, MD, MS

    Stephen Holt, MD, MS

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