Unit 5A.7: NOSE & SINUSES Assessment | Eyes, Ears, Nose & Sinuses, Mouth & Pharynx, Neck

1. Inspect and palpate external nose

2. Check patency of air flow through nostrils

3. Inspect internal nose

4. Palpate frontal and maxillary sinuses

5. Percuss sinuses

6. Transilluminate frontal and maxillary sinuses

6 Steps for Nose & Sinuses Assessment

• Color is the same as the rest of the face

• Nasal structure is smooth and symmetric

• No tenderness

Normal findings for inspecting and palpating the external nose

Local Infection

Abnormal finding for inspecting and palpating the external nose

What does nasal tenderness on palpation accompany?

Client able to sniff through each nostril while other is occluded

Normal finding for checking patency of air flow through the nostrils

• Swelling

• Rhinitis

• Foreign object obstructing the nostrils

Abnormal finding for checking patency of air flow through the nostrils

If the client cannot sniff through a nostril that is not occluded nor sniff or blow air through the nostrils, what does this indicate?

Line across the tip of the nose

Abnormal finding for checking patency of air flow through the nostrils

What is usually seen above the fleshy tip of the nose in clients with chronic allergies?

• Dark pink

• Moist

• Free of exudate

Normal finding for inspecting the internal nose

What is the normal finding for the nasal mucosa?

• Intact

• Free of ulcers or perforations

Normal finding for inspecting the internal nose

What is the normal finding for the nasal septum?

• Dark pink

• Moist

• Free of lesions

Normal finding for inspecting the internal nose

What is the normal finding for the turbinates?

Allergies

Abnormal finding for inspecting the internal nose

What does the following indicate: Nasal mucosa swollen and pale pink or bluish gray?

Upper Respiratory Infection

Abnormal finding for inspecting the internal nose

What does a nasal mucosa is red and swollen indicate?

Exudate

Abnormal finding for inspecting the internal nose

What is common with infection and may range from large amounts of watery discharge to thick yellow-green, purulent discharge?

Acute Bacterial Rhinosinusitis

Abnormal finding for inspecting the internal nose

What is purulent nasal discharge seen with?

Epistaxis

Abnormal finding for inspecting the internal nose

What is another name for nosebleed?

• Use of cocaine

• Trauma

• Chronic Infection

• Chronic Nose Picking

Abnormal finding for inspecting the internal nose

When are ulcers of the nasal mucosa or a perforated septum usually seen?

Polyps

Abnormal finding for inspecting the internal nose

What are small, pale, round, firm overgrowths or masses on mucosa seen in clients with chronic allergies called?

• Nontender to palpation

• No crepitus

Normal finding for palpating the frontal and maxillary sinuses

• Allergies

• Acute bacterial rhinosinusitis

Abnormal finding for palpating the frontal and maxillary sinuses

What do tender frontal and maxillary sinuses indicate?

Crepitus

Abnormal finding for palpating the frontal and maxillary sinuses

What may be felt upon palpation over the maxillary sinuses if the client has a large amount of exudate?

• Not tender upon percussion

Normal finding when percussing the sinuses

• Allergies

• Sinus infection

Abnormal finding for percussing the frontal and maxillary sinuses

What does the frontal and maxillary sinuses tender on percussion indicate?

Red glow transilluminates indicating a normal, air-filled sinus

Normal finding for transilluminating the frontal and maxillary sinuses

Sinus filled with fluid, pus, or thick mucus

Abnormal finding for transilluminating the frontal and maxillary sinuses

What does absence of a red glow indicate?