HENT PHYSICAL EXAMINATION

PETER LOUIE T. BELLO

09/03/2020
 INTRODUCTION
o Greet the patient
o Introduce yourself
o Ask for consent

 EAR EXAMINATION
o EXTERNAL EARS
 Pull auricle and press tragus for both ears; note for any tenderness or lesions
o INTERNAL EARS
 Use an otoscope to inspect external auditory canal and assess the tympanic membrane
 Perform Valsalva maneuver and Toynbee maneuver

 NOSE EXAMINATION
o Hyperextend the neck and lift the tip of the nose with your thumb; note any septal deviation or perforation
o PALPATION OF THE SINUSES
 Palpate the frontal, ethmoid, and maxillary sinuses and note for any tenderness
o TRANSILLUMINATION OF THE SINUSES
 Darken the room
 Transilluminate frontal and maxillary sinus
 Observe the glow above the eye and in the hard palate

 ORAL CAVITY EXAMINATION

o Check stensen’s duct and wharton’s duct
o Depress tongue to examine the tonsils, uvula, soft and hard palates
o SALIVARY GLANDS EXAMINATION
 Palpate parotid, submandibular, and submental glands
 Note any tenderness, enlargement or asymmetry

 NECK AND THRYOID EXAMINATION

o Lift the chin to expose the neck and ask patient to swallow
o Palpate for the thyroid gland and lymphatics
 Pre-auricular
 Occipital
 Mastoid
 Submental
 Superficial
 Deep cervical
 Supraclavicular

 TUNING FORK TESTS

o WEBER TEST
 Strike tuning fork and place it against the middle of the forehead
o RINNE TEST
 Strike tuning fork and place it against the mastoid process.
 Ask when the vibration stops