PHYSICAL AND CLINICAL

ASSESSMENT OF SYMPTOMS

Ears, Nose, and Throat, Cough, Chest Pain, Heart Burn and
Abdominal Pain
Ears Nose Throat

Heart
Cough Chest
burn

Abdominal
pain
EARS
 EARS: ANATOMY

External Middle
Inner ear
ear ear
 EXTERNAL EAR

• Auricle/ pinna
• External auditory canal
• Tympanic membrane
• Function: protects the ear, and it blocks or facilitates passage of
sound into the external auditory canal.
• Tragus
• Cerumen: reduces chances of infection by slowing the growth
of microorganisms
 MIDDLE EAR

• Transmits sound via the auditory ossicles

• Eustachian tube: equalizes the pressure
• Auditory ossicles (malleus, incus, stapes)
• Conductive phase
 INNER EAR

• Sensorineural phase
• The sense of equilibrium
• Vestibule and semicircular canals
 EARS: SPECIAL CONSIDERATION

• Pediatric patients
• Difference in the size of eustachian tube → otitis media
• pull backward and downward
• Geriatric patients
• Hearing loss
• Presbycusis
PHYSICAL ABNORMALITIES OF THE EARS

Bony
landmarks
more
prominent
High- tone
Tympanic
frequency
membrane
hearing loss
Coarse wiry
hairs in
external
auditory canal
Pendulous
earlobes
 ASSESSMENT

Pain Discharge Itchiness

SUBJECTIVE ASSESSMENT
 ASSESSMENT

Hearing
Dizziness Tinnitus
loss
 ASSESSMENT

Flu/ fever Activities Recurrence

 ASSESSMENT

Otoscopic
Inspection Palpation
examination
 ASSESSMENT

Laboratory
Auditory Air and bone
and
acuity conduction
diagnostics
NOSE
 THE NOSE AND SINUSES

Watery Viral Hay

Sneezing
eyes infection fever

Throat Vasomotor
Itchiness rhinitis
discomfort
 ASSESSMENT

Drying and
Tumors
crusting

Foreign
Inflammation
bodies

Trauma Epistaxis Medications Anti-

coagulants
NSAIDs
 ASSESSMENT

Nasal
Inspect
mucosa

Palpate
Septum
sinuses
THROAT
 THROAT : PHARYNX

Nasopharynx Oropharynx Laryngopharynx

 THROAT : LYMPH NODES

• Lymphatic system
• Production, maintenance, and distribution of
lymphocytes
• Lymph nodes
• filter and purify lymph,
ABNORMALITIES OF THE PHARYNX

Koplik’s
spots

Pharyngitis Diphtheria

Exudative
pharyngitis

Diffused
pharyngitis
ABNORMALITIES OF THE THYROID

Diffuse
enlargeme
nt
Multinodul
ar goiter

Single
nodule
 ASSESSMENT

Sore throat/ Thyroid

Hoarseness
pharyngitis function
 ASSESSMENT

Sore Recent
Irritants
throat cold/ flu
 ASSESSMENT

Swelling Smoking Medications

Phenytoin

Hydralazine Allopurinol
 ASSESSMENT

Inspect the Thyroid

neck gland

Palpate
Trachea
lymph nodes
COUGH

Reading assignment
 COUGH

• protective reflex action

caused when the airway is
being irritated or
obstructed.
 COUGH

Age Duration Nature

Associated Previous Present

symptoms history medication
COUGH
CHEST
 CHEST PAIN

The myocardium Angina pectoris, myocardial

infarction
The pericardium Pericarditis
The aorta Dissecting aortic aneurysm
The trachea and large Bronchitis
bronchi
The parietal pleura Pericarditis, pneumonia
 CHEST PAIN

The chest wall, including the Costochondritis, herpes

musculoskeletal system and zoster
skin
The esophagus Reflux esophagitis, esophageal
spasm
Extrathoracic structures such Cervical arthritis, biliary colic,
as the neck, gallbladder, gastritis
stomach
 CHEST PAIN

For patients who are short of breath, focus on such

pulmonary complaints as:
Dyspnea and wheezing Cough and hemoptysis
HEART BURN
 HEART BURN

• is reflux of gastric
contents, particularly acid,
into the esophagus, which
irritate the sensitive
mucosal surface
(esophagitis).
 HEART BURN

Associated
Age Symptoms
factors

Precipitating Relieving
Medication
factors factors
HEART BURN
ABDOMINAL PAIN
 ABDOMINAL PAIN

• Abdominal discomfort is one of the most

common GI complaints because most abdominal
diseases manifest with some degree of pain.
 ABDOMINAL PAIN

Pain int the

Pain in the
substernal
epigastrium
area

Pain nearthe Pain in the

umbilicus hypogastrium
ABDOMINAL PAIN - ABNORMALITIES
ABDOMINAL PAIN - ABNORMALITIES
ABDOMINAL PAIN - ABNORMALITIES
ABDOMINAL PAIN - ABNORMALITIES
ABDOMINAL PAIN - ABNORMALITIES
END