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Examination of the Ears, Nose, Mouth and Throat – Health History • Present Health History – Hearing loss – Pain or discomfort in ears, nose, mouth, throat, pressure around eyes, cheeks or forehead – Drainage from ears or nose – Seasonal allergies or allergies to medications or food – Condition of teeth, gums, presence of dentures, ability to chew – Reduced ability to smell or presence of unusual odours – Unusual tastes or reduced ability to taste – Difficulty swallowing – Dental hygiene practices and frequency of checkups – Ear wax build-up Examination of the Ears, Nose, Mouth and Throat – Health History • Past Health History – Injury to nose, ears, mouth or teeth – Previous surgery of ears, nose, mouth or teeth, including tonsillectomy – Ringing in ears or dizziness – History of frequent nosebleeds – History or ear infections • Family History – hearing loss Examination of the Ears, Nose, Mouth and Throat – Health History • • • • Other Conditions Exposure to loud noise Exposure to fumes or dust Use of protective gear for work or hobbies: ear wear, safety goggles, face mask Examination of the Ears, Nose, Mouth and Throat – Examination Technique • External Ear (determine horizontal and vertical position, size, symmetry, skin colour, presence of deformities, lesions or nodules) – Palpate auricles and mastoid areas for evidence of swelling, tenderness or nodules – Manipulate the auricles • External auditory canal (Inspect for erythema, swelling, narrowing of the canal, foreign body, discharge, odour, cerumen) • Tympanic membrane • Testing auditory function (acuity = Weber and Rinne) Examination of the Ears, Nose, Mouth and Throat – Examination Technique • Nose and Paranasal Sinuses (Inspect for deviations in shape, size or colour, check nares for flaring or discharge, palpate ridge and soft tissues for displacement of bone and cartilage and for tenderness or masses) • Assess ability to smell and the patency of the nasal cavities Examination of the Ears, Nose, Mouth and Throat – Examination Technique • Mouth and Oropharynx (Inspect lips for symmetry, colour, oedema, surface abnormalities) – – – – – – – – Open and close = Test for crepitus in the temporomandibular joint Palpate lips for induration Oral mucosal surfaces (Stensen’s duct, submandibular glands) Tongue (Swelling, variation in size, swelling, coating or ulceration) Varicosities Caries, missing teeth, malocclusions Gingivitis (inflammation or haemorrhage) Tonsils (exudate or postnasal discharge) ... nose, mouth or teeth, including tonsillectomy – Ringing in ears or dizziness – History of frequent nosebleeds – History or ear infections • Family History – hearing loss Examination of the Ears,... size or colour, check nares for flaring or discharge, palpate ridge and soft tissues for displacement of bone and cartilage and for tenderness or masses) • Assess ability to smell and the patency
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