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Transcription:

Otorhinolaryngologic Approach Sasan Dabiri, M.D. Department of Otorhinolaryngology Head & Neck Surgery Amir A lam hospital Tehran University of Medical Sciences

General Notes Parts of an : Inspection Palpation Percussion (not indicated in ENT) Auscultation (in neck mass & pulsatile tinnitus) Gentle (very important) Attention to patient s rights Don t miss any part due to this

Face Deformity Asymmetry Skin lesion Eye movement

Face Deformity Asymmetry Skin lesion Eye movement Palpation Tenderness Fracture Muscle force Mass

Neck Skin lesion (including fistula) Asymmetry (mass, LAP, muscle, )

Neck Skin lesion (including fistula) Asymmetry (mass, LAP, muscle, ) Palpation Tenderness (abcess) Mass (where, specify, ) Lymphadenopathy Thyroid Laryngo-trachea Auscultation

Ear Auricle External Auditory Canal Tympanic Membrane

Ear Auricle External Auditory Canal Tympanic Membrane

Ear Palpation Auricular tenderness Tragus sign

Ear Palpation Auscultation Pulsatile tinnitus (periauricular auscultation)

Ear Palpation Auscultation Auditory Evaluation Without tuning fork Whispered voice With tuning fork (512 Hz) Weber test o NL : midline o SNHL : lateralized to other o CHL : lateralized to same Rinne test o NL or SNHL : AC > BC (+) o CHL : BC > AC (-) Schwabach test

Ear Palpation Auscultation Auditory Evaluation Vestibular Evaluation R/O central etiology Romberg test Finger to Nose test Dix-Hallpike test Caloric test Head Thrust test Head Shake test

Nose Deformity Septum Turbinate Cavity Palpation Fracture Tenderness

Throat Tongue (lesion, movement) Oropharynx ( including tonsils & parapharynx) Uvula & Palate (including movement) Buccal (including Stensen s orifice) Mouth floor (including Warthon s orifice) Gingiva & Dentoalveolar area

Throat Tongue (lesion, movement) Oropharynx ( including tonsils & parapharynx) Uvula & Palate (including movement) Buccal (including Stensen s orifice) Mouth floor (including Warthon s orifice) Gingiva & Dentoalveolar area

Throat Tongue (lesion, movement) Oropharynx ( including tonsils & parapharynx) Uvula & Palate (including movement) Buccal (including Stensen s orifice) Mouth floor (including Warthon s orifice) Gingiva & Dentoalveolar area

Throat Tongue (lesion, movement) Oropharynx ( including tonsils & parapharynx) Uvula & Palate (including movement) Buccal (including Stensen s orifice) Mouth floor (including Warthon s orifice) Gingiva & Dentoalveolar area

Throat Tongue (lesion, movement) Oropharynx ( including tonsils & parapharynx) Uvula & Palate (including movement) Buccal (including Stensen s orifice) Mouth floor (including Warthon s orifice) Gingiva & Dentoalveolar area

Throat Tongue (lesion, movement) Oropharynx ( including tonsils & parapharynx) Uvula & Palate (including movement) Buccal (including Stensen s orifice) Mouth floor (including Warthon s orifice) Gingiva & Dentoalveolar area Palpation Tongue (induration, force) Mouth floor (submandibular gland, mass)

Larynx (Indirect Laryngoscopy [IDL]) With mirror With lens (rigid or flexible)

hanks for your attention