Physical Diagnosis Scalp, Ears, Nose and Sinuses

Physical DiagnosisPhysical Diagnosis

Scalp, Ears, Nose and SinusesScalp, Ears, Nose and Sinuses

Describe the patient’s scalp. Describe the patient’s scalp. Diagnosis?Diagnosis?

PsoriasisPsoriasis

Describe findings.

Normal TMNormal TM

• MalleusMalleus(short process & handle)(short process & handle)

• Cone of lightCone of light• IncusIncus• Pars tensaPars tensa• The unbelievable UMBOThe unbelievable UMBO

Describe findings.

Otitis MediaOtitis Media

• Red and bulgingRed and bulging• HyperemiaHyperemia• Dullness of light Dullness of light

reflexreflex• OpaqueOpaque

Describe findings.Describe findings.

Serous OMSerous OM

• Bulging, amber drumBulging, amber drum• Decreased mobilityDecreased mobility

Describe findings.Describe findings.

Cerumen in CanalCerumen in Canal

• Parents may be advised Parents may be advised to soften firstto soften first

• May remove yourself in May remove yourself in physician’s officephysician’s office

• VA patients: May remove VA patients: May remove a lot of ear wax in the ERa lot of ear wax in the ER

Describe findings.

Bullous MyringitisBullous Myringitis

• Large vesicles/bullae Large vesicles/bullae visible on the drumvisible on the drum

• Landmarks obscuredLandmarks obscured• Drum is reddenedDrum is reddened• Viral infection Viral infection

characterized by painful characterized by painful hemorrhagehemorrhage

Traumatic PerforationTraumatic Perforation

• Usually result from Usually result from purulent infection of purulent infection of the middle earthe middle ear

• Central perforation or Central perforation or marginalmarginal

Tympanostomy TubeTympanostomy Tube

• May be placed in children May be placed in children with a series of ear with a series of ear infectionsinfections

• The major goal is to The major goal is to prevent conductive prevent conductive hearing loss to prevent hearing loss to prevent delayed language delayed language developmentdevelopment

• ““Mom, the TV is so loud!”Mom, the TV is so loud!”

Nose and SinusesNose and Sinuses

Sinus Anatomy: Front View

• Frontal sinus = black Frontal sinus = black checkcheck

• Maxillary sinus=red Maxillary sinus=red • Anterior ethmoid Anterior ethmoid

sinuses = greensinuses = green• Posterior ethmoid Posterior ethmoid

sinuses = purple sinuses = purple • Sphenoid sinus = Sphenoid sinus =

yellowyellow

Sinus Anatomy: Side ViewSinus Anatomy: Side View

• Frontal sinus = black check

• Maxillary sinus = red • Anterior ethmoid

sinuses = green• Posterior ethmoid

sinuses = purple • Sphenoid sinus =

yellow

Observe the turbinates.Observe the turbinates.Diagnosis?Diagnosis?

Nasal PolypNasal Polyp