EENT LCCW MT1

What are the tests for CN I?

- check patency of airways (PT blocks one nose at a time and breathes in and out)

- identify familiar aromas via scent viles (each nostril individually)

- examine internal nostril via otoscope (looking for: color of mucus, discharge, bleeding, growths/polyps/cancer, septal deviation, septal perforation, inflammation, middle and inferior turbinates and meatuses, erosions or ulcerations

CN I sensory information?

smell

CN II tests?

- Snellen chart: tests for central vision

- confrontation test for peripheral vision (fingers come in from the sides)

-Direct and consensual light reflex (with CN III)

- Fundoscopic exam

CN III tests?

- eye movement (cardinal field of gaze) looking for strabismus and nystagmus

- accommodations (lens - ciliary mm)

- direct and consensual light reflexes

- convergence

- look for anisocoria

look for ptosis of eyelid

what is anisocoria?

unequal size of the pupils

what is nystagmus?

repetitive uncontrolled movements of the eye

what is strabismus?

pupils do not look in same direction

mydriasis

overall dilated pupil

miosis

overly constricted pupil

most common eye deviation occurs in which direction? CN?

lateral rectus, CN VI

when performing CN III tests, what are you looking for?

aniscoria, ptosis

superior oblique muscle is innervated by which CN?

CN IV - trochlear

lateral rectus is innervated by which CN?

CN VI - abducens

which CN innervates taste to the anterior 2/3 of tongue?

CN VII

CNV innervates which portion of the tongue?

anterior 2/3: GENERAL SENSATION

CN VII innervates which portion of the tongue?

anterior 2/3: TASTE

which CN is responsible for GENERAL SENSATION and TASTE of the posterior 1/3 of the tongue?

CN IX (Glossopharyngeal)

which cranial nerve is responsible for the AFFERENT corneal reflex?

CN V (trigeminal)

which CN is responsible for the EFFERENT corneal reflex to lower heart rate?

CN X (Vagus)

unilateral lacrimal gland dysfunction are indicative of...

CN VII lesion

Bilateral lacrimal gland dysfunction are indicative of...

systemic issue

name tests used to determine CN VIII function

finger rub, weber, rinne (conduction vs. sensorineural)

which CN is responsible for the EFFERENTs for the gag reflex, carotid sinus reflex, and oculocardiac reflex?

CN X (VAGUS)

Parasympathetic innervation for CN IX?

parotid glands

CN IX sensory functions

posterior 1/3 tongue

oropharynx: gag reflex

carotid sinus reflex

CN IX motor functions

stylopharyngeus - swallowing

a CN X lesion would cause the uvula to deviate to the good/bad side?

good side (pulls towards good side)

CN X sensory function

bitter taste on epiglottis

CN XII motor functions

protrusion of tongue

intrinsic tongue mm strength

CN XII lesion would cause the tongue to deviate.....

and would cause weakness of the tongue to press into the cheek...

- towards lesion

- on the contralateral side

nystagmus is usually a defect in CN____?

CN VIII

medial and lateral pterygoids are innervated by CN_____

CN V

muscles of mastication are innervated by CN_____

CN V

the jaw jerk reflex is a test for CN?

CN V

the oculocardia reflex is a test for CN?

CN V

general sensation of the anterior 2/3 of the tongue is CN?

CN V

corneal reflex is a test for CN?

CN V

taste to the anterior 2/3 of the tongue is CN?

CN VII

accommodation of the lens is a test for CN?

CN III

CN II + III share which exams?

direct/consensual light reflexes

cardinal field of gaze is a test for CN?

CN III

convergence is an exam for CN?

CN III

the Snellen chart is used to test which CN?

CN II

Confrontation test for peripheral vision is a test for CN?

CN II

9 things to look for when inspecting the nails?

S3 CBPALP

size

shape

symmetry

color

nail bed

nail plate

angle of nail

lunula

paronychium (skin around nail)

reedy's nail is indicative of ________________ while beau's lines are indicative of ________________

- clinically insignificant

- systemic illness

blue lunula is indicative of....

Wilson's Dx

red lunula is indicative of

cardiac failure

aka for spoon nails?

koilonychia

nails that are concave and thin due to IRON DEF ANEMIA

spoon nails

which condition presents itself as a completely white nail (clinically insignificant)?

leukonychia

which condition is associated with increased nitrogenous wastes, seen in early renal failure?

- terry's nail

- lindsay nail

lindsay nail

which condition is associated with hepatic cirrhosis?

terry's nail

Terry's nail typically presents as _____% white, ______% pink at the tip while Lindsay nail presents as _____% white ______% pink at the tip

terry - 80white 20pink

lindsay - 40white 60 pink

yellow nails are often associated with..... while yellow nail syndrome is associated with....

yellow nail - fungal infections

yellow nail syndrome - decreased lymphatic circulation

nail pitting is associated with which condition?

psoriasis

clubbing of the nails requires a nail angle of _______ degrees or greater

180

congenital nail clubbing is often seen with ________ and _______ diseases

heart and lung

splitting of the nail from the nail bed is known as....

onychoLYSIS

onycholysis is most commonly caused by ________ but may also be caused by ________ or ________

1. trauma

2. fungus

3. psoriasis

what is it called when the paronychium is inflamed?

paronychia

the absence of a nail is known as...

anonychia

the thyroid cartilage is above/below the thyroid gland

above

what conditions can cause a deviated trachea?

large pneumothorax or pleural effusion, or atelectasis

if the trachea is "stuck", suspect....

cancer

a diffusely enlarged thyroid with NO nodules suggests...

inflammation, infection, hyper or hypothyroidism

multinodular thyroid suggests

systemic metabolic condition (grave's or hashimoto's)

uninodular thyroid suggests...

cancer

locations for lymphatic palpation of the head and neck...

preauricular

postauricular

occipital

tonsillar

submandibular

submental

superficial cervical

deep cervical

posterior cervical

supraclavicular

where are the superficial, deep, and posterior cervical lymph nodes found?

superficial - superficial to the SCM

deep - deep to the SCM (underside of the muscle)

posterior - anterior surface of the trap (close to the neck)

fatty yellow plaques due to increased cholesterol around the eyes

- entropian

- xanthelasmus

- chalazion

- dacrocystitis

xanthelasmus

an inflamed follicle of the eye is known as

hordeolum (stye)

when a meibomian gland is plugged, it is called

chalazion

lacrimal DUCT inflammation

dacrocystitis

dacrocystitis is found on the

medial

lacrimal GLAND inflammation

dacroadentitis

dacroadentitis is found where around the eye?

(supero)lateral

a liver shaped area of redness on the sclera of the eye is known as

subconjunctive hemorrhage

subconjunctive hemorrhage is usually caused by

increased intrathecal pressure

subconjunctive hemorrhages are/are not clinically significant?

are NOT

Keratoconjunctiva Sicca aka

Sjorgen Syndrome

pale grey-blue discoloration around the colored portion of the eye

arcus senilis

when is arcus senilis clinically significant? what might it signify?

<40yrs of age; hyperlipidemia

what are kayser-fleisher rings?

circular golden-brown bands found on the posterior surface of the cornea

kayser-fleisher rings are indicative of...

Wilson's Dx

an associated finding with kayser-fleisher rings would be...

blue lunula