Head, Neck, Eye, Ear, Nose, Mouth, and Throat Physical Assessment

A set of 90 vocabulary flashcards covering health history, assessment techniques, physical findings, developmental considerations, and clinical case studies for the head, neck, eyes, ears, nose, mouth, and throat.

Normocephalic

A term describing a head shape and features that are symmetric and within normal parameters.

Milia

A common skin condition in newborns causing small white bumps or cysts under the surface of the skin, often across the nose.

Obligate Nose Breathers

A developmental characteristic of newborn infants that makes immediate assessment of nasal patency essential in the newborn period.

Papillary Atrophy

An age-related anatomical change that causes the tongue of an aging adult to appear smoother.

Lymph Nodes

Small, soft, oval-shaped structures connected by vessels that work to filter foreign substances and carry immune cells throughout the body.

Lymph Node Density in the Neck

The region of the human body containing the largest number of lymph nodes.

Normal Palpable Lymph Node

A lymph node finding in a healthy individual that is typically less than $1\,m$, soft, non-tender, and slightly movable.

Nares

The nostril openings inspected for size differences, which can suggest partial or complete blockage of the nasal passage.

Nasal Patency Assessment

An evaluation technique where the client occludes one nare and breathes deeply once on each side.

Mucus Membranes (Oral)

The lining inside the mouth that should normally appear pink and moist upon inspection.

Buccal Mucosa

The membrane lining the inside of the cheeks, which should be pink, moist, and free of lesions.

Uvula

An anatomical structure located at the posterior oral cavity that should normally be intact and in midline position.

Posterior Pharynx

The area at the back of the throat that should normally inspect as pink and moist.

Palates (Hard and Soft)

The roof of the mouth, which should normally range in color from yellow to pink and be free of lesions.

Tonsils Inspection

An assessment evaluating whether tonsils are pink, moist, free of exudate/lesions, enlarged, or erythematous.

Social Determinants of Oral Health

Social, financial, and geographic obstacles that prevent individuals across the lifespan from receiving regular dental care.

Infant Head Turning Milestone

The developmental milestone where an infant can turn their head side to side by $2\,\text{weeks}$ of age.

Newborn Head Asymmetry

An asymmetrical head shape in a newborn often caused by birth trauma, during which sutures and fontanelles remain palpable.

Aging Adult Nasal Changes

An age-related structural change where the nose appears more prominent on the face due to loss of subcutaneous fat.

Aging Adult Neck Range of Motion

A physical limitation in neck turning, flexing, or extending commonly caused by arthritis in older adults.

Aging Adult Dental Changes

Physical findings where teeth appear slightly yellowed with uniform color and look longer as gum margins recede.

Head and Neck Abnormalities

Clinical abnormalities including headaches, head deformities, thyroid gland disorders, fetal alcohol syndrome, Down syndrome, and parotid gland enlargement.

Nose, Mouth, and Throat Abnormalities

Clinical abnormalities including nasal deformities, lip lesions or cracking, tooth decay, gingivitis, tooth loss, and infection of the pharynx.

Hypothyroidism

A metabolic condition caused by insufficient production of thyroid hormone by the thyroid gland.

Myxedema Coma

A life-threatening medical emergency caused by extremely low levels of thyroid hormone.

Myxedema Coma Symptoms

Clinical signs including behavior/mental status changes, nonpitting edema (hands/lower legs), hypothermia, hypotension, bradycardia, and bradypnea.

Hypothermia

A physiological state characterized by a lower-than-normal body temperature.

Hypotension

A condition characterized by a symptomatic blood pressure that is lower than normal.

Bradycardia

A clinical state defined as a heart rate that is less than $60\,\text{beats per minute (BPM)}$.

Bradypnea

A slowed respiratory rate of less than $12\,\text{respirations per minute (RR)}$ that can lead to respiratory failure.

Maria's Chief Complaints

A 52-year-old client presenting with a lump in her throat when swallowing, fatigue, weight gain, and constipation.

Maria's General Survey Findings

Physical survey findings including thinning scalp hair, brittle nails, dry skin, and cold intolerance.

Maria's Vital Signs

Temperature $98.9\,^\circ\text{F}$ ($37.1\,^\circ\text{C}$), HR $58\,\text{beats/min}$, RR $14/\text{min}$, pulse oximetry $98\%$ room air, and BP $132/90\,\text{mmHg}$.

Maria's Neck Examination Findings

Inspection showing mid-anterior neck enlargement and hoarse voice, with palpation revealing a diffuse firm protrusion in the anterior and inferior right neck.

Maria's TSH Result

$12.2\,\text{mIU/L}$, which is elevated above the normal reference range of $0.4\text{-}5\,\text{mIU/L}$.

Maria's T4 Result

$4.1\,\text{mcg/dL}$, which is below the normal reference range of $4.6\text{-}11.2\,\text{mcg/dL}$.

Maria's T3 Result

$75\,\text{ng/dL}$, which falls at the lower boundary of the normal range of $75\text{ to }195\,\text{ng/dL}$.

Maria's Active Nursing Diagnoses

Fatigue, Impaired Swallowing, and Imbalanced Nutrition: More Than Body Requirements.

Iodine Fortification in Table Salt

A public health fortification measure in the United States that significantly reduces the incidence of goiter.

Levothyroxine

A synthetic T4 hormone that serves as standard lifelong pharmacological treatment for hypothyroidism.

Levothyroxine Administration Instructions

Must be taken first thing in the morning on an empty stomach $30\,\text{minutes}$ before any food or other medication.

Levothyroxine Monitoring Schedule

TSH levels are monitored frequently when starting therapy, and checked annually once the correct dosage is established.

Substances Impairing Levothyroxine Absorption

Iron supplements, calcium supplements, biotin, antacids (aluminum, magnesium, calcium), certain ulcer medications, and cholesterol-lowering drugs.

Sclera

The white anatomical structure surrounding the iris of the eye, which should normally be white.

Conjunctiva

The mucus membranes lining the inner portion of the eyelid, which should normally be pink and moist.

Pale Conjunctiva

An abnormal physical finding during eye inspection that could indicate underlying anemia.

Erythematous Conjunctiva

An abnormal physical finding during eye inspection that could indicate infection.

PERRLA

An assessment acronym standing for Pupils Equal, Round, Reactive to Light and Accommodation.

Normal Pupil Diameter

Pupil measurement generally ranging between $3\,\text{mm}$, $4\,\text{mm}$, or $5\,\text{mm}$.

Miosis

Pupil constriction defined as pupils smaller than $2\,\text{mm}$ or pupils that do not dilate when light is removed.

Mydriasis

Pupil dilation defined as pupils $6\,\text{mm}$ or larger or pupils that do not constrict when light is applied.

Diagnostic Positions Test

An eye assessment technique using the H method or wagon wheel method to evaluate movement through the six fields of gaze.

Nystagmus

An involuntary shakiness or rapid movement of the eyes observed during fields of gaze assessment.

Snellen Eye Chart

A standard tool used to measure visual acuity at a distance of $20\,\text{feet}$.

Normal Visual Acuity ($20/20$)

A visual score indicating a person can read at $20\,\text{feet}$ what a person with normal vision sees at $20\,\text{feet}$.

$20/30$ Visual Acuity

A visual acuity measurement indicating a person sees clearly at $20\,\text{feet}$ what a person with normal vision sees at $30\,\text{feet}$.

Ear Auricle Malformations

Abnormal size and shape of the external ear structure that can indicate underlying renal problems.

Tophi

Nodules located on the external ear that may indicate underlying renal impairment or gout.

Ear Palpation Landmarks

Four specific anatomical structures palpated for tenderness: auricle, lobe, tragus, and mastoid process.

Otoscope

An instrument used to inspect the external auditory canal, cerumen, tympanic membrane, and ossicles.

Pinna Positioning for Adult Ear Exam

Pulling the pinna up and back to straighten the ear canal in adults and children older than 3 years.

Pinna Positioning for Infant Ear Exam

Pulling the pinna straight down to inspect the auditory canal in children under 3 years of age.

Normal Tympanic Membrane

An eardrum finding described as pearly gray, translucent, and intact.

Whispered Voice Test

A hearing assessment used to detect high-tone loss, performed standing $1\text{-}2\,\text{feet}$ behind the client while one ear is occluded.

Whispered Voice Test Passing Score

The correct repetition of at least $4\text{ of }6$ whispered numbers/letters.

Rinne Test

A tuning fork test evaluating air conduction compared to bone conduction ($\text{AC}:\text{BC}$).

Normal Rinne Test Result

Air conduction is twice as long as bone conduction, documented as $\text{AC} > \text{BC}$ at a $2:1$ ratio.

Weber Test

A tuning fork test placed on the center top of the head where sound should normally be heard equally in both ears.

Weber Test in Conductive Hearing Loss

An abnormal finding where sound lateralizes and is heard louder in the poorer ear.

Weber Test in Sensorineural Hearing Loss

An abnormal finding where sound lateralizes and is heard louder in the unaffected ear.

Infant Binocularity Milestone

The developmental ability established by $3\text{-}4\,\text{months}$ of age to fixate on a single image with both eyes simultaneously.

Aging Adult Tear Changes

Involution of the lacrimal glands causing decreased tear production, dryness, and burning sensations.

Common Causes of Decreased Vision in Older Adults

Cataract formation, glaucoma, age-related macular degeneration, and diabetic retinopathy.

Aging Adult Ear Canal Changes

Coarse, stiff cilia in the ear canal causing cerumen to accumulate and oxidize, leading to reduced hearing.

Tinnitus

A subjective perception of ringing, buzzing, or sound in the ears.

Vertigo

A rotational spinning sensation or dizziness caused by inner ear or vestibular dysfunction.

Noise-Induced Hearing Loss

A permanent form of hearing impairment that progresses incrementally with each repeated noise exposure.

Consequences of Untreated Hearing Loss

Psychosocial and cognitive impacts including depression, social isolation, loss of independence, and cognitive decline.

Kelly's Presenting Diagnosis

A 14-year-old client presenting to the clinic with seasonal allergic rhinitis starting in May.

Kelly's Vital Signs

Temperature $99.2\,^\circ\text{F}$ ($37.3\,^\circ\text{C}$), HR $78\,\text{beats/min}$, RR $12/\text{min}$, pulse oximetry $97\%$ room air, and BP $118/80\,\text{mmHg}$.

Allergic Rhinitis Symptoms

Tiredness, headache, painful temples/forehead, ear congestion, itchy/red/watery eyes, loss of smell, runny/blocked nose, sneezing, coughing, and itchy throat/mouth/ears.

Healthcare Provider Indicators for Allergic Rhinitis

Clinical indications requiring healthcare provider evaluation including respiratory distress, sleep interference, or worsening/additional symptoms.

Kelly's Charted Nursing Diagnoses

Impaired airway clearance, Impaired sleep pattern, and Deficient Knowledge: Allergic Rhinitis.

HEPA Filter

A high-efficiency particulate air filtration unit recommended to minimize environmental allergy triggers indoors.

Nasal Rinse

A non-pharmacological practice used to flush sinuses and minimize seasonal allergy symptoms.

Tongue Blades and Cotton Gauze

Tools used to move the tongue out of the way when visualizing the throat during a physical examination.

Penlight or Flashlight

An essential light source necessary to visualize the mouth and throat during a physical assessment.

Risk Factors for Eye Disease and Vision Loss

Family history, advancing age, untreated strabismus, UV exposure, increased intraocular pressure, smoking/alcohol, hypertension, diabetes mellitus, and renal dysfunction.

Risk Factors for Hearing Impairment

Genetic predisposition, loud environments (music, factory, guns), chronic ear infections, cerumen buildup, and advancing age.

Tools Needed for Eye Assessment

Snellen eye chart, ophthalmoscope, opaque card or occluder, and penlight.