ENT Examination

Ear Examination
Examination without speculum
- Pinna
- Both pinna are normal in shape and size
-Normal in position
-Swelling and scar marks
- Post aural region
-Visible swellings
-Sinus/fistula
-Scars
-Mastoid tenderness
- Tragus
-Tenderness
- Pre-auricular region
-Scars
-Sinus/fistula
- External Auditory Canal
-Visible swelling, redness or impacted wax.
Examination with speculum
- External Auditory Canal
-Impacted wax
-Visible swelling
-Redness and pain
- Tympanic Membrane (TM)
-Cone of light - Present /Absent
-Colour of Tympanic Membrane eg: normal (pink)/congested
-Vesicles in TM
- Position
-Normal position retracted or bulging and state location of abnormality
- Perforation
-Present or intact and location of perforation

Nose Examination -Oral Cavity Examination -Neck Examination -Systemic Examination ENT Examination Nose Examination .Hearing Test: (Tuning Fork Test) -Tuning fork or reported audiometrey ..Mobility of TM -Specialised test .

position of septum. and may contain adenoids or nasopharyngeal cancer) Finally examine the palate. Visualise Insert thudicum gently. it should be insensitive to touch). - Use either a head mirror or illuminated spectacles with a thudicum speculum to open up the nose. Look at nose from front and side for any signs of the following: - Size and shape Obvious bend or deformity: a deviated nose is often best looked at from above Swelling Scars or abnormal creases Redness (evidence of skin disease) Discharge or crusting Offensive smell Inspection - The nose can be inspected from the front to examine the anterior nares by lifting the tip of the nose up and looking inside without a speculum. Identify nasal septum medially.First look at the external nose. the middle turbinate is often difficult to see as it is small. Ask patient to remove glasses. - Check patency of each side and ask the patient to sniff. A foreign body. inferior turbinate (nearly always possible to see). which contains the Eustachian tube orifices and pharyngeal recess (of Rosenmuller). Check for inflammation (rhinitis). ENT Examination . child. usually accompanied by an offensive unilateral discharge. - To assess the nasal airway hold a cold metal tongue compressor under the nose while the patient exhales and note the condensation under both nostrils. turbines laterally. presence of polyps (touch to check sensitivity. Look for large nasal polyps and tumours arising from the soft palate. A mirror and headlight or an endoscope instrument is used to view the nasopharynx (postnasal space. which allows examination of the nasal cavity.

gingivolabial/gingivobuccal sulci. until the whole hard palate is visible) Examine buccal area and the gingivolabial (gingivobuccal) sulcus. check for submandibular duct stones or masses (ask patient to stick their tongue out) Palpate the base of the tongue for early tumours which may not be easily visible Examine the nasopharynx and larynx with a mirror or flexible fibre-optic nasendoscope .Throat Examination - - Inspection o Obvious asymmetry & scars o Obvious lumps/swellings o Areas of erythema or inflammation o Any rashes (EBV) o Cachexia o Cranial nerve palsies o Does it move when patient swallows/protrudes tongue Palpation o Lymphadenopathy (painful?) o Palpate mass for asymmetry o Plapate mass when patient swallows o Splenomegaly (EBV) Requires thorough examination of the oral cavity Ask patient to remove dentures and examine mouth systemically (use a bright torch): tongue. floor of mouth/undersurface of tongue as follows: - - Examine mouth and note condition of tongue Examine back of tongue and tonsils (press down on tongue with a tongue depressor) Palate the base of tongue (look for tumours that may not be easily visible) Inspect uvula and soft palate Inspect hard palate (ask patient to tip their head backwards. (space between cheek and gums) Examine the floor of mouth. which may require bimanual palpation. hard and soft palate. tonsillar fossa.