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NUR350 > Nose, Mouth, Throat, Eye and Ear > Flashcards

Nose, Mouth, Throat, Eye and Ear Flashcards

1
Q

Nose (structures)

A

a. Superior, middle and inferior turbinate
- bone structure to increase space
b. Olfactory nerve (CN1)
c. Mucous membrane
- helps to warm and filter out the air via rich vascular supply
d. Sinuses
- frontal, ethmoid, sphenoid and maxillary

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2
Q

Mouth and Throat (structures)

A

a. Tongue
b. Soft and hard palate
c. Tonsils
d. Uvula
e. Salivary glands (parotid, submandibular, sublingual)

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3
Q

Dev Considerations (nose, mouth, throat) - Infants and Children

A
  • salivation doesn’t start until 3 months of age
  • deciduous teeth (6mos - 2yo)
  • permanent teeth (6yo-12yo)
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4
Q

Dev Considerations (nose, mouth, throat) - Pregnancy

A
  • nasal stuffiness and epistaxis (nose bleed), increase vascularity in URT
  • bleeding of gum
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5
Q

Dev Considerations (nose, mouth, throat) - Aging adult

A
  • decreased sense of smell
  • loss of taste sensation
  • receding gums and tooth loss
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6
Q

Subjective Assessment: Nose

A 
a. discharge
Rhinorrhea (nasal discharge)
b. cold
c. sinus pain
d. trauma
e. epistaxis (nose bleed)
f. allergies
g. altered sense of smell
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7
Q

Subjective Assessment: Mouth and Throat

A

a. sores and lesions
b. sore throat
c. bleeding gums
d. toothache
e. hoarseness
f. dysphagia
g. altered sense of taste
h. sleep apnea
i. smoking and alcohol
j. self-care behaviours

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8
Q

Objective Assessment: Nose

A

Inspect and Palpate

a. symmetry
b. inflammation
c. lesions
d. test for patency
e. inspect nasal cavity (nares)
- swelling, discharge, bleeding, foreign body
- turbinates
- polyps
- septum deviation
f. palpate sinuses
- frontal and maxillary

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9
Q

Objective Assessment: Mouth

A 
Inspect
- lips
- teeth
- alignment of jaw
- gums (pink, no swelling)
- tongue (pink, inspect sides)
- buccal mucosa (side of cheek)
Stensen's duct: dimple by second molar, opening of parotid ducts
Fordyce's granules: small yellow dots, benign sebaceous cysts

Palpate Torus palatinus (nodular bony ridge down middle of hard palate, normal variation)

Uvula and throat
Bifid uvula: uvula split in two
Tonsils (pitted)
- grade 1-2: health
- grade 3-4: swollen, might interfere with air flow
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10
Q

External Ear (structures)

A 
Pinna (external ear)
Tragus
Lobule
External Auditory canal
- cerumen (ear wax)
Tympanic membrane (ear drum)
- translucent, pearly grey, oval slightly concave
- cone of light
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11
Q

Middle Ear (structures)

A

Auditory ossicles (tiny ear bones)

  • malleus
  • incus
  • stapes

Functions:

  • conducts sound
  • protects inner ear
  • equalizes air pressure (eustachian tube, to the nasopharynx)
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12
Q

Inner Ear (structures)

A

Vestibule
Semicircular canals (equilibrium)
Cochlea (snail)

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13
Q

Hearing

A

Peripheral:
- sound waves > external auditory canal > vibrations on tympanic membrane
- middle ear ossicles > oval window
- semicircular canals, vestibule and cochlea > round window
- stimulated basilar membrane > receptor hair cells (organ of corti, sensory organ)
CN VIII - receive electrical impulse

Brainstem:
binaural interaction

Cerebral cortex:
interpret the meaning of the sound

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14
Q

Conductive Hearing Loss

A

Mechanical dysfunction of the external or middle ear

i.e. perforated ear drum

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15
Q

Sensorineural Hearing Loss

A

Dysfunction of the inner ear, cranial nerve VIII or auditory areas of the cerebral cortex
- unable to process auditory input

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16
Q

Equilibrium

A

Labyrinth in the inner ear provides information to the brain about the body’s position in space

  • cerebellum
17
Q

Vertigo

A

Inflamed labyrinth

- feeds wrong info to the brain causing staggering gait and a strong spinning, whirling sensation

18
Q

Dev Considerations (Ears) - Infant and Children

A

Rubella
- during 1st trimester, can damage organ or corti and impair hearing
Shorter eustachian tube
- greater risk of middle ear infections

19
Q

Dev Considerations (Ears) - adults

A

Otosclerosis

  • conductive hearing loss caused by gradual hardening that cause stapes to become fixed in oval window
  • onset ages 20-40
20
Q

Dev Considerations (Ears) - Aging adults

A
  • cilia in external canal become coarse and stiff
  • impacted cerumen
  • presbycusis: gradual sensorineural loss caused by nerve degeneration in the inner ear and auditory nerve
21
Q

Subjective Assessment of Ears

A

a. earache (otalgia)
b. infections
c. discharge (otorrhea)
d. hearing loss
e. environmental noise exposure
f. tinnitus (ringing or buzzing)
g. vertigo
h. self-care behaviours

22
Q

Objective Assessment of Ears

A 
Inspect and palpate the external ear
a. size and shape
b. skin condition
Darwin's tubercle: small painless nodule at the helix
c. tenderness
d. external auditory canal
- swelling, redness, discharge

Inspect with otoscope
a. tympanic membrane (no perforations)

23
Q

Objective Assessment of Ears (hearing acuity and vestibular apparatus)

A

a. Whispered voice test
b. Romberg Test
- maintain balance with eyes closed

24
Q

External Eye (structures)

A
  • palpebral fissures
  • canthus (corner of the eye)
  • caruncle (small fleshy mass containing sebaceous glands)
  • conjunctiva (transparent protect covering)
  • sclera (whites of eye)
  • cornea (translucent layer)
  • limbus (border between cornea and sclera)
  • iris
  • lacrimal gland (upper eye lids, moisture and tears)
  • puncta (opening where tears drain)
  • lacrimal sac (drainage)
25
Q

Extraocular muscles

A

Six muscles for movement

- stimulated by cranial nerves III, IV and VI

26
Q

Internal Eye

A

Outer layer
- sclera

Middle layer

  • choroid (deliver blood and prevent light from refracting)
  • lens (biconvex disc just behind pupil)
  • Anterior and posterior chambers (contains watery aqueous humour, delivers nutrients and removes waste)

Inner layer

  • vitreous body
  • retina (visual receptive layer, lightwave to nerve impulse)
27
Q

Retina

A
  • optic disc
  • optice nerve
  • retinal vessels
  • macula
  • fovea centralis
28
Q

Visual Reflexes

A

a. pupillary light reflex
- direct light reflect
- consensual light reflect (simultaneous constriction of other pupil)
b. fixation (ability to fix an imagine in centre of visual field - impaired by drugs, alcohol, fatigue and inattention)
c. accommodation

29
Q

Dev Considerations (Eyes) - Infants

A

Macula not fully formed until 4 month and not mature until 8 months

Eyes mature at age 8

30
Q

Dev Considerations (Eyes) - Older adults

A
  • decreased tear production
  • arcus senilis (infiltration of degenerative lipid material around limbus)
  • presbyopia (lens loses elasticity)
  • floaters
  • macular degeneration (breakdown of cells in retina)
  • cataract (clumping of proteins)
  • glaucoma (increased intraocular pressure, decreased peripheral vision)
  • diabetic retinopathy (damage to tiny blood vessels in the retina, leakage, cloudy vision)
31
Q

Subjective Assessment of Eyes

A

a. vision difficulty
b. pain
c. strabismus (crossed eye)
d. diplopia (double vision)
e. redness/swelling
f. watering/discharge
g. hx of ocular problems
h. glaucoma
i. use of corrective lenses
j. self-care behaviours
k. medications

32
Q

Objective Assessment of Eyes

A

a. Visual acuity
- snellen chart
- jaeger card

b. Visual fields
- confrontation
- corneal light reflexes
- cover-uncover test (muscle weakness)
- diagnostic positions test (six cardinal positions of gaze)

c. external ocular structures
- general
- eyebrows
- eyelids and lashes

d. anterior eyeball structures
- cornea and lens (abrasions)
- iris and pupil
PERRLA

e. ocular fundus
- red reflex
- optic disc
- retinal vessels
- genearl background
- macula

33
Q

ptosis

A

drooping of upper eyelid

34
Q

periorbital edema

A

swelling, fluid back up

35
Q

styes

A

caused by staph infection

  • painful, pustule, swelling
  • antibiotic or warm compress
36
Q

exophthalmos

endophthalmos

A

protruding eyes

sunken eyes

NUR350 (27 decks)

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