No automatic alt text available. 26.Normal assessment findings of an adolescent’s nose and throat Assessment findings of adolescent’s nose and throat are pretty much the same as an adult. What makes them interesting and likely a test question is that the frontal sinus is not fully developed until adulthood and the sphenoid sinus develops during adolescence. It is not present for younger children. Here are some normal assessment findings in the nose and throat of adults. Throat • Tonsils, graded 1-4 depending on size, color and presence of exudate should be noted, tonsils should be symmetric • The mouth is separated from the oropharynx by tonsillar pillars • Soft palate should move symmetrically otherwise this indicates lesions on cranial nerves IX or X
Normal assessment would read like this, clear without erythema, tonsils 1+ without exudate, Uvula rises evenly and gag reflex is intact, no hoarseness Nose • Nasal septum divides nose into two anterior cavities • Turbinates form the lateral wall of the nose there are three pairs, inferior, superior, and middle • Assessment should look for redness, swelling, or bleeding, nostrils should be patent Normal assessment – No discharge or polyps, mucosa pink and moist, septum midline, patent bilaterally. No edema over frontal or maxillary sinuses, no sinus tenderness to palpation 27.Normal examination findings of an infant’s fontanelles • Anterior fontanel (soft spot)- the junction where the frontal and parietal bones meet, described as a 5cm diamond shape. They remain soft up to 12 months to 15 months • Posterior fontanel- the junction of the parietal and the occipital bones. Closes before the anterior fontanelle during the first several months of life (around 6ths) • The third fontanel (mastoid)-located between anterior and posterior fontanelles common in infants with down syndrome • Depressed fontanell es are due to dehydration; bulging fontanelles are due to increased intracranial pressure, hemorrhage, infection or tumor • Large flat and soft fontanels are caused by hydrocephaly, hypothyroidism, or malnutrition • Palpable ridges indicate skull fractures 28.Examination findings of a patient with hypothyroid and hyperthyroid Hypothyroid • Weight gain • Constipation • Fatigue • Cold intolerance • Normal size thyroid, goiter or nodules Hyperthyroid • Weight loss • Tachycardia • Diarrhea • Heat sensitivity • Fine hair, bridle nails, proptosis. • Normal size thyroid, goiter or nodules 29.Techniques for examining the HEENT systems • Before the exam, gather all the necessary equipment: Tape measure (primarily for infants), stethoscope, cup of water, an otoscope with a pneumatic attachment, nasal sepeculum, tongue blades, tuning fork, Snellen chart or Lea Cards, Rosenbaum or Jaeger near vision card, gauze, gloves, penlight or similar, cotton wisps, and vials with different odors.
• Review with patient: chief complaint, history of present illness, past medical history, family history, and personal/social history.
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