Check symmetry (proptosed auricle may indicate mastoiditis)
Position (low-set ears may indicate genetic syndromes)
Comment on whether hearing aids are being used
Comment on skin changes
Comment on pinna deformities
Comment on external auditory meatus
Comment on mastoid area
Gently tug pinna (tenderness may suggest mastoiditis)
tenderness may suggest mastoiditis
Examine auditory canal (wax, foreign bodies, skin quality), tympanic membrane (color, structure, fluid), and visible features behind tympanic membrane (pars tensa, pars flaccida, handle/lateral process of malleolus, cone of light)
Check for discharge, foreign bodies, inflammation, or stenosis
Check for color, structure, fluid, and visible features behind the tympanic membrane
Check for pars tensa, pars flaccida, handle/lateral process of malleolus, cone of light
Cover one ear and softly whisper a number in the other ear
Use 256Hz tuning fork on mastoid process then in front of ear. Normally, air conduction > bone conduction (Rinné positive)
Place 256Hz tuning fork on center of forehead. Sound should be heard centrally in normal hearing
Sit facing the patient and ask them to look forward with their head neutral. Lift the tip of the nose with your thumb, use a light source, and inspect the nasal mucosa for abnormalities like bleeding, septal deviation, or enlarged turbinates.
Check for symmetry, proptosis, nasal flaring
Check for skin changes (rosacea, skin cancers, scarring), symmetry, septal deviation, nasal mucosa abnormalities (bleeding, enlarged turbinates)
Palpate nasal bones, assess for obstruction by blocking each nostril, percuss frontal and maxillary sinuses if concerned about sinusitis
Palpate the nasal bones
Block each nostril to assess any obstruction by asking the patient to inhale
Palpate frontal and maxillary sinuses for tenderness (sinusitis)
Check for swelling at cheeks or mandible, drooling, skin changes (cancers, cyanosis of lips, angular stomatitis, ulcers)
Examine buccal mucosa, palate, teeth, tongue, hard and soft palates for signs of inflammation, infection, or abnormalities
Use tongue depressor if needed, identify soft palate and uvula, ask patient to say 'ah', inspect tonsils for size, symmetry, and evidence of infection
Check for deviation or swelling
Check for size, symmetry, and evidence of infection
Check for symmetry and evidence of infection
Bimanual palpation of submandibular glands, palpate tongue and floor of mouth with gloved hand
Bimanual palpation of submandibular glands
Palpate tongue and floor of mouth with gloved hand
Items Completed: 0 / 46
Score: 0%