Assessment of Ear, Eye, Nose and Throat

THE EYE,EAR,NOSE AND THROAT
Anatomy and Physiology

MARY MUSEMBI
UMMA UNIVERSITY
Anatomy and Physiology of the EAR
• The ears are located on either side of the cranium

at approximately eye level.
• The external ear, housed in the temporal bone,
includes the auricle, pinna and the external
auditory canal.
• The external ear is separated from the middle ear
by a disk-like structure, the tympanic membrane
which is also known as the eardrum.
• The auricle, attached to the side of the head

by skin, is composed mainly of cartilage,
except for the fat and subcutaneous tissue in
the earlobe.
• The auricle collects the sound waves and
directs vibrations into the external auditory
canal.
• The external auditory canal is approximately
2.5cm long.
• The lateral third is an elastic cartilaginous and
dense fibrous framework to which thin skin is
attached.
• The medial two thirds is bone lined with thin
skin.
• The external auditory canal ends at the
tympanic membrane.
• The skin of the canal contains hair, sebaceous
glands and ceruminous glands, which secrete a
brown, wax-like substance, the cerumen (ear
wax).
• The ear’s self-cleaning mechanism moves old
skin cells and cerumen to the outer part of the
ear.
• Just anterior to the external auditory canal is
the temporomandibular joint
• The middle ear, an air-filled cavity, is

connected by the Eustachian tube to the
nasopharynx and is continuous with air-filled
cells in the adjacent mastoid portion of the
temporal bone.
• The Eustachian tube, approximately 1mm
wide and 35mm long, connects the middle ear
to the nasopharynx.
• The Eustachian tube is closed, but it opens by

action of the tensor veli palatini muscle when
performing a Valsalva manoeuvre or when
yawning or swallowing.
• The tube serves as a drainage channel for
normal and abnormal secretions of the middle
ear and equalises pressure in the middle ear
with that of the atmosphere
• The tympanic membrane, about 1cm in diameter and
very thin, is normally pearly grey and translucent.
• The tympanic membrane consists of three layers of
tissue:
• An outer layer, continuous with the skin of the ear
canal.
• A fibrous middle layer.
• An inner mucosal layer, continuous with the lining of
the middle ear cavity.
Ear
• Approximately 80% of the tympanic membrane is
composed of all three layers and is called the pars
tensa.
• The other 20% of the tympanic membrane lacks
the middle layer and is called the pars flaccida.
• The absence of this fibrous middle layer makes
the pars flaccida more vulnerable to pathologic
disorders than the pars tensa.
• Distinguishing landmarks of the tympanic

membrane include:
• The annulus, the fibrous border that attaches
the eardrum to the temporal bone.
• The short process of the malleus.
• The long process of the malleus.
• The umbo of the malleus, which attaches to

the tympanic membrane in the centre.
• The pars flaccida.
• The pars tensa.
• The tympanic membrane protects the middle
ear and conducts sound vibrations from the
external canal to the ossicles.
• The middle ear contains the three smallest bones
(ossicles) of the body, that is, malleus, incus, and
stapes.
• The ossicles, which are held in place by joints,
muscles, and ligaments, assist in the transmission of
sound.
• Two small fenestrae (that is, oval and round
windows), located in the medial wall of the middle
ear, separate the middle ear from the inner ear.
• The footplate of the stapes sits in the oval

window, secured by a fibrous annulus, or ring-
shaped structure.
• The footplate transmits sound to the inner ear.
• The round window, covered by a thin
membrane, provides an exit for sound
vibrations.
• The inner ear is housed deep within the temporal
bone.
• The organs for hearing (cochlea) and balance (semi-
circular canals), as well as cranial nerves VII (that is,
facial nerve) and VIII (that is, vestibulocochlear
nerve) are housed in the bony labyrinth.
• The bony labyrinth surrounds and protects the
membranous labyrinth, which is bathed in a fluid
called perilymph.
• The inner ear is housed deep within the temporal
bone.
• The organs for hearing (cochlea) and balance (semi-
circular canals), as well as cranial nerves VII (that is,
facial nerve) and VIII (that is, vestibulocochlear
nerve) are housed in the bony labyrinth.
• The bony labyrinth surrounds and protects the
membranous labyrinth, which is bathed in a fluid
called perilymph.
• The organ of Corti is located in the cochlea, a

snail-shaped, bony tube about 3.5cm long
with two and one-half spiral turns.
• Membranes separate the cochlear duct (that
is, scala media) from the scala vestibuli, and
the scala tympani from the basilar membrane.
• .
• The organ of Corti is located on the basilar

membrane stretching from the base to the
apex of the cochlea.
• As sound vibrations enter the perilymph at the
oval window and travel along the scala
vestibuli, they pass through the scala tympani,
enter the cochlear duct, and cause movement
of the basilar membrane
• The organ of Corti, also called the end organ

for hearing, transforms mechanical energy
into neural activity and separates sounds into
different frequencies.
• This electrochemical impulse travels through
the acoustic nerve to the temporal cortex of
the brain to be interpreted as meaningful
sound.
• In the internal auditory canal, the cochlear

(acoustic) nerve, arising from the cochlea, joins
the vestibular nerve, arising from the semi-
circular canals, utricle, and saccule, to become
the vestibulo-cochlear nerve (cranial nerve
VIII).
• This canal also houses the facial nerve and the
blood supply from hearing is conducted over
two pathways, that is, air and bone.
• Sounds transmitted by air conduction travel

over the air-filled, external ear and middle ear
through vibration of the tympanic membrane
and ossicles.
• Sounds transmitted by bone conduction travel
directly through bone to the inner ear,
bypassing the tympanic membrane and
ossicles
• Normally, air conduction is the more efficient pathway.
• However, defects in the tympanic membrane or
interruption of the ossicular chain disrupt normal air
conduction, which results in a loss of the sound-to-
pressure ratio and subsequently in a conductive hearing
loss.
• Sound enters the ear through the external auditory canal
and causes the tympanic membrane to vibrate. These
vibrations transmit sound through the lever action of the
ossicles to the oval window as mechanical energy
• This mechanical energy is then transmitted through
the inner ear fluids to the cochlea, stimulating the hair
cells, and is subsequently converted to electrical
energy.
• The electrical energy travels through the vestibulo-
cochlear nerve to the central nervous system, where it
is analysed and interpreted in its final form as sound.
• Vibrations transmitted by the tympanic membrane to
the ossicles of the middle ear are transferred to the
cochlea, lodged in the labyrinth of the inner ea
• The stapes rocks, causing vibrations (waves) in

fluids contained in the inner ear.
• These fluid waves cause movement of the
basilar membrane to occur that then
stimulates the hair cells of the organ of Corti
in the cochlea to move in a wavelike manner.
membrane
• The movements of the tympanic membrane set up
electrical currents that stimulate the various areas of
the cochlea.
• The hair cells set up neural impulses that are
encoded and then transferred to the auditory cortex
in the brain, where they are decoded into a sound
message.
• The footplate of the stapes receives impulses
transmitted by the incus and the malleus from the
tympanic
• The round window, which opens on the opposite
side of the cochlear duct, is protected from
sound waves by the intact tympanic membrane,
permitting motion of the inner ear fluids by
sound wave stimulation.
• For example, in the normally intact tympanic
membrane, sound waves stimulate the oval
window first, and a lag occurs before the terminal
effect of the stimulus reaches the round window.
• This lag phase is changed, however, when a
perforation of the tympanic membrane is large
enough to allow sound waves to impinge on the
oval and round windows simultaneously.
• This effect cancels the lag and prevents the
maximal effect of inner ear fluid motility and its
subsequent effect in stimulating the hair cells in
the organ of Corti.
• The result is a reduction in hearing ability.
• Body balance is maintained by the cooperation

of the muscles and joints of the body (that is,
proprioceptive system), the eyes (that is, visual
system), and the labyrinth (that is, vestibular
system).
• These areas send their information about
equilibrium, or balance, to the brain
(cerebellar system) for coordination and
perception in the cerebral cortex
• . The brain obtains its blood supply from the
heart and arterial system.
• A problem in any of these areas, such as
arteriosclerosis or impaired vision, can cause a
balance disturbance.
• The vestibular apparatus of the inner ear
provides feedback regarding the movements
and the position of the head and body in space.
Anatomy and physiology of the Nose
The Nose
• The nose consists of the external or outer
nose and the nasal fossae or internal nose.
• The outer nose is made up of bone and
cartilage and is divided internally into two
nasal fossae by the nasal septum, and
externally by the columella.
• Anterior openings into the nasal fossae are

nostrils, or nares.
• Each fossa has a lateral extended ‘wing’
portion called the ala nasi on the outside and
a vestibule just inside the nostril.
• Superior, middle and inferior measures or

grooves are located on the lateral walls of the
nostrils just below the corresponding conchae,
located on the lateral walls of nostrils just
below the corresponding conchae, or
turbinates.
• The nasal turbinates are covered by mucous

membranes and greatly increase the surface area
of mucus membrane of the the nose because of
their shape.
• Kiesselbach’s plexus is a vascular area on the

nasal septum, and a common site for nosebleeds
The pathophysiology of breathing through nostrils
• Air enters the anterior nares, passes through the
vestibule, and enters the fossa.
• The vestibule contains nasal hairs and sebaceous glands.
• The fossae have both olfactory and respiratory functions.
• To protect the lungs from noxious agents, these structures
of the nose clean, filter, humidify and control temperature
of inspired air.
.
The pathophysiology of breathing through

nostrils
• The mucous covering in the nose and sinuses

traps fine dust particles, and lysosomes kill most
of the bacteria.
• The tiny hairs of the nose (cilia) transport the
mucus and the particles to the pharynx to be
swallowed
• The nasal mucosa is capable of adding large

amounts of water to inspired air through
evaporation from its surface.
• The rich vascular supply to the turbinates radiates

heat to the incoming air as it passes through the
nasal cavity.
• Olfactory receptor cells are located in the upper parts

of the nasal cavity, the superior nasal conchae, and on
parts of the nasal septum and are covered by hair-like
cilia that project into the cavity.
• The chemical component of odours binds with the
receptors, causing nerve impulses to be transmitted to
the olfactory cortex, located in the base of the frontal
lobe.
• Sinuses
• Air-filled cavities lined with mucous
membranes are present in some of the cranial
bones and are referred to as paranasal
sinuses.
• These air-filled sinuses lighten the weight of
the skull and ensure resonance to the quality
of the voice.
The sinuses
• The frontal, maxillary, ethmoid and sphenoid
paranasal sinuses open into the nose.
• Only the frontal and maxillary sinuses can be
assessed in the physical examination
Anatomy and physiology of the Mouth
and Throat
Mouth and Throat
• The lips are sensory structures found at the
opening of the mouth.
• The labial tubercle is the small projected area
in the midline of the upper lip.
• The area where the upper and lower lips
meet is the labial commissure.
and Throat
• The cheeks form the lateral walls of the mouth and are
lined with buccal mucosa.
• The posterior pharyngeal wall is at the back of the
mouth.
• The roof of the mouth consists of the hard palate
anteriorly and the soft palate posteriorly.
• The linear raphe is a ridge in the middle of the hard
palate that is formed by two palatine bones and part of
the superior maxillary bone.
and Throat
• The tongue assists with mastication,
swallowing, speech and mechanical cleansing of
the teeth.
• Two of the three pairs of salivary glands open
into the mouth on the ventral surface of the
tongue.
• Sub-maxillary glands secrete fluid through
Wharton’s ducts located both sides of the
frenulum.
and Throat
• Sublingual glands open into the floor of the
mouth posterior to Wharton’s ducts.
• These salivary glands produce 1,000 to
1,500ml of saliva per day to assist with
digestion of food and maintenance of oral
hygiene.
and Throat
• The tongue assists with mastication,
swallowing, speech and mechanical cleansing of
the teeth.
• Two of the three pairs of salivary glands open
into the mouth on the ventral surface of the
tongue.
• Sub-maxillary glands secrete fluid through
Wharton’s ducts located both sides of the
frenulum.
and Throat
• Sublingual glands open into the floor of the
mouth posterior to Wharton’s ducts.
• These salivary glands produce 1,000 to
1,500ml of saliva per day to assist with
digestion of food and maintenance of oral
hygiene.
and Throat
• Saliva prevents dental caries by washing away
bacteria and destroying it with antibodies and
proteolytic enzymes.
• Gums, or gingivae, hold the teeth in place.
• Adults have thirty two permanent teeth
composed of four incisors, two canines, four
premolars and six molars in each half of the
mouth.
and Throat
• The three parts of the tooth are the top, or
the crown, the root, which is embedded in the
gum, and the neck, which connects the root
and the crown.
• The teeth are well designed for chewing.
• The uvula is a finger-like projection of tissue
that hangs down from the centre of the soft
palate.
Overview of ENT Disorder Symptoms
• The kind of information to be obtained while

taking history includes:
• The client's signs and symptoms.

• Current health patterns.
• Previous illnesses.
Key signs and symptoms of ENT problems include:

• Epistaxis (bleeding from the nose)
• Sore throat
• Nasal congestion
• Hoarseness
• Dysphagia (difficulty swallowing)
• Odynophagia (painful swallowing)
• Globus (something in throat) sensation
Key signs and symptoms of ENT problems include
• Sore throat
• Weight loss
• Otalgia (ear pain)
• Neck lump
• Earache
• Tinnitus (ringing in the ears)
• Otorrhea (discharge from the external ear)
• Hearing loss
• Dizziness
To find out about current health patterns carry

out the following:
• Inquire about nutrition, dental care, normal
mouth care habits, dental caries, use of partial
or full dentures, stress-related grinding,
clenching, or clamping of teeth.
• Ask about consumption of alcohol, smoking,
use of a pipe, and smokeless tobacco.
To find out about current health patterns carry out the
following
• Determine personal hygiene about ears.
• Are cotton swabs or other objects used for cleaning?
• Is there any loud noise exposure?
• Does the client frequently strain voice through talking,
singing, or shouting?
• What medications is the client taking? Have antibiotics
been used? For how long have they been used?
To find out about current health patterns carry out the
following
• Determine personal hygiene about ears. Are cotton
swabs or other objects used for cleaning?
• Is there any loud noise exposure?
• Does the client frequently strain voice through talking,
singing, or shouting?
• What medications is the client taking? Have antibiotics
been used? For how long have they been used?
• Find out about Previous Illnesses by asking on the
following:
• Is there a history of allergies?
• Is there any immunosuppressive illness, such as diabetes
mellitus, cancer, and human immunodeficiency virus (HIV)
infection?
• Has there been any trauma?
• Is there a history of rhinitis, sinusitis, or ear infections?
• Is there a family history of any ENT problems or cancer?
• Surgeries done for example, adenotonsillectomy.
Assessment of the ENT
• Assessment of the ENT includes the following
areas:
• Assessment of the ear
• Assessment of the nose
• Assessment of the sinuses
• Assessment of the mouth and throat
Assessment of the Ear
• Physical assessment of the ear consists of
three parts:
• Inspection and palpation of the external ear
• Auditory screening (CN VIII)
• Otoscopic assessment
Assessment of the Ear
• Some of the Equipment to be used in this include:
• Otoscope with ear pieces of different sizes
• Nasal speculum
• Penlight
• Tuning fork, 512 Hz
• Tongue blade
• Watch
• Gauze
• Clean gloves
General Approach to ENT Assessment
• The following is the approach used for ENT

assessment:
• Greet the client and explain the assessment
techniques that you will be using.
• Use a quiet room that will be free from
interruptions.
General Approach to ENT Assessment
• Ensure that the light in the room provides

sufficient brightness to allow adequate
observation of the client.
• Place the client in an upright sitting position,
preferably.
• Always compare right and left ears, as well as
right and left sides of the nose, sinuses, mouth
and throat.
• Examining the Ear
• To examine your client’s ears, you need a
thorough understanding of the organ’s anatomic
structure as well as the mechanisms that allow
hearing.
• The external ear is examined by inspection and
direct palpation, and the tympanic membrane is
inspected with an otoscope.
•
• Evaluation of gross auditory acuity also is
included in every physical examination.
• The auricle and surrounding tissues should be

inspected for deformities, lesions, and
discharge, as well as size, symmetry, and angle
of attachment to the head.
• Manipulation of the auricle does not normally
elicit pain. If this manoeuvre is painful, acute
external otitis is suspected.
• Tenderness on palpation in the area of the
mastoid process may indicate acute
mastoiditis or inflammation of the posterior
auricular node.
• Occasionally, sebaceous cysts and tophi
(subcutaneous mineral deposits) are present
on the pinna.
• A flaky scaliness on or behind the auricle
usually indicates seborrhoeic dermatitis and
can be present on the scalp and facial
structures as well.
Examining the Outer Ear
• You need to carry out the following in the
examination of the outer ear:
• Inspect the auricle of each ear for size, shape,
symmetry, colour, and position.
• The skin should be the same colour as the facial skin.
• Observe for moles, cyst, deformities, or altered skin
integrity.
• Note any drainage from the ear canal.
• To check the ears position, draw an imaginary
line from the outer canthus of the eye to the
protuberance of the occiput.
• The ear should touch or sit just above this line.
• Expect the ear to be almost vertical, with no
more than a 100 posterolateral slant.
• Palpate the auricle (pinna) for tenderness,
swelling, or nodules.
• Gently pull on the tragus and again on the
helix to check for pain and tenderness.
• Gloves are optional for this examination.
• Palpate the mastoid process. Be alert for pain,
tenderness, swelling, nodules, or lesions.
Performing an Otoscopic Examination
• To begin, assemble the otoscope.
• Attach the handle housing the battery pack to
the otoscope’s head, which contains a light
source and magnifying lens.
• Select and attach a speculum large enough to
fit the client’s ear canal comfortably.
• out will additionally need to carry out the
following:
• Gently insert the otoscope into the ear canal
using one of two techniques.
• Hold the handle of the otoscope with the handle
facing up to allow you to brace your hand against
the client’s head to stabilise the instrument
• . This helps to prevent injury if the client moves their
head quickly.
• Inspect the auditory canal for the cerumen, redness or
swelling.
• You will see hairs and cerumen in the ear canal distal
two-thirds.
• Note excessive cerumen that may obstruct your view.
• You may need to remove it to complete your inspection.
• Performing an Otoscopic Examination
• Inspect the tympanic membrane.
• Typically, middle ear problems will be evident by
the tympanic membrane’s appearance.
• Focus on the membrane’s colour and contour. It
should be pearly grey and appear concave at the
umbo, handle of malleus, and cone of light.
• Be alert for perforations, bulging, missing
landmarks, or a distorted cone of light.
• Have the client sit in a comfortable position or

lie down on the side opposite the ear you wish
to examine.
• Hold the otoscope handle in the space
between your thumb and index finger.
• Assist the client to tilt their head toward the

shoulder opposite the ear you are examining.
• Keeping in mind how the ear canal curves in an
adult.
• Gently grasp the auricle and pull it up and back to
straighten the ear canal before inserting the
speculum.
Auditory Testing
• After the otoscopic examination, you will have
the idea of how well the client hears.
• If they often ask you what you said or speak
extra loudly, in a monotone, or with erratic
volume, you may rightly suspect a hearing
problem.
• To investigate further, use a tuning fork to assess
hearing acuity.
Auditory Testing
• You will then carry out a voice – whisper test.
• Begin estimating hearing acuity by checking whether the client can

hear you whisper by carrying out the following:
• Instruct the client to occlude one ear with a finger.
• Stand two feet behind the client’s other ear and whisper a two-syllable
word or phrase that is evenly accented.
• Ask the client to repeat the word or phrase.

• Repeat the test with the other ear.
Auditory Testing
• Normal finding is that the client should be able

to repeat words whispered from a distance of
two feet.
• Abnormal findings include the client being
unable to repeat the words correctly or stating
that they were unable to hear anything. This
indicates hearing loss.
Tuning Fork Tests
• Rinne and Weber tests help to determine
whether the type of hearing loss the client is
experiencing is conductive or sensorineural.
• In order to understand how these tests are
evaluated, it is important to know the
difference between air and bone conduction.
Tuning Fork Tests
• Air conduction refers to the transmission of

sound through the ear canal, tympanic
membrane and ossicular chain to the cochlea
and auditory nerve.
• Bone conduction refers to the transmission of
sound through the bones of the skull to the
cochlea and auditory nerve.
Tuning Fork Tests
• Tuning fork tests include:

• Rinne test
• Weber test
• Schwabach test
A. Performing the Rinne Test
• If you suspect a hearing loss, perform the Rinne test.
• This test will help determine whether the loss is conductive or
sensor neural.
You will need to follow these steps:
• Without touching the tunes, hold a tuning fork by its base with
one hand.
• Activate the fork by striking it.
• Place the base of the vibrating tuning fork against the client’s
mastoid process, and ask the client to tell you when they no
longer hear the sound.
Performing the Rinne Test
• Begin timing the interval (counting the
number of seconds) until the client no longer
hears the sound.
• Then carry out the following:
• Quickly change the forks position to about 1 to
2cm from the auditory canal.
• Hold the fork so that the tines face forward,

maximising the sound.
• Continue timing the interval to determine how

long the client hears this sound by air
conduction.
• The following is a diagram illustrating this.
B. Performing the Weber Test
• To perform this test, activate the tuning fork as
before.
• Place the base of the fork midline on the client
head or forehead.
• Ask whether they hear the sound in one ear or
both. Normally, they should hear the sound
equally in both ears.
• If they do not, ask them which ear hears well.
• An abnormal finding is when sound lateralises
to the affected ear indicating unilateral
conductive hearing loss.
• When sound lateralises to the unaffected ear,
this occurs with sensorineural loss related to
nerve damage in the impaired ear.
The diagram that follows illustrates the Weber test.
C. Performing the Schwabach Test
• To perform this test:
• Occlude one of the client’s ears by gently
placing your finger in the ear canal and
moving it up and down to block hearing.
• Activate the tuning fork and place it on the
mastoid process behind the opposite ear.
Performing the Schwabach Test
• If the client hears the sound, remove the tuning fork from
their mastoid process, occlude one of your own ears, and
place the tuning fork behind the mastoid process of your
other ear.
• Alternate the tuning fork between your mastoid process and
the client’s, and count the number of seconds until one of
you no longer hears the sound.
• Normally, you and the client will stop hearing the sound
after the same interval.
Assessment of the Nose

• Inspect the nose, noting any trauma, bleeding,
lesions, masses, swelling and asymmetry.
• The normal finding includes the nose being located
symmetrically in the midline of the face and is
without swelling, bleeding, lesions or masses.
• Abnormal finding includes a broken or swollen
nose.
• Each nostril should be patent.

• Common abnormal findings include a nostril
with a deviated septum, foreign body, upper
respiratory tract infection allergies or polyps.
• A nasal speculum is also used to aid in viewing
the nostrils.
• Inspect the mucus membranes for colour and

discharge.
• Normal otoscopic findings include the nasal
mucosa being be pink or dull red without swelling
or polyps.
• The septum is at the midline and without
perforation, lesions or bleeding.
• Assessment of the Sinuses
• Observe the client’s face for any swelling
around the nose and eyes. Normal findings
include there being no swelling around the nose
and eyes.
• When swelling is noted especially below the
eyes, this may be indicative of acute sinusitis
that is characterised by accumulation of
purulent material in the paranasal sinuses.
• On palpation and percussion, the client should
experience no discomfort during palpation or
percussion.
• The sinuses should be air-filled and therefore
resonant to percussion.
• Abnormal findings on percussion include
dullness sound produced is indicative of fluid or
cells present in the sinus cavity from an
infectious or allergic process.
Assessment of the Mouth and Throat
• This assessment involves smelling the client’s breath,
lips, tongue, buccal mucosa, gums and teeth, and
throat.
• The breath should smell fresh.
• A foul smell of halitosis can be a symptom of tooth
decay, poor oral hygiene, diseases of the gums, tonsils
or sinuses.
• Breath that smells of acetone is common in
malnourished clients or those who have DKA.
• The lips and membranes should be pink and
moist with no evidence of lesions or
inflammation.
• Pallor of the lips is an indicator of anaemia.
• Central cyanosis assessed on the lips signifies
chronic pulmonary disease or circulatory
failure.
• Swollen lips could be due to allergic reactions
to medication, food or other allergens.
• Cracked corners of the mouth on the lips, is a
condition referred to as angular cheilosis.
• It is either due to accumulation of saliva in
the corners of the mouth or nutritional
deficiencies such as lack of riboflavin.
• The tongue should be in the midline of the
mouth.
• It should be pink moist, rough (from the taste
buds) and without lesions.
• The ventral surface of the tongue has prominent
blood vessels and should be moist without
lesions.
• The lateral aspects of the tongue should be pink,
smooth and lesion free.
• The tongue should be in the midline of the
mouth.
• It should be pink moist, rough (from the taste
buds) and without lesions.
• The ventral surface of the tongue has prominent
blood vessels and should be moist without
lesions.
• The lateral aspects of the tongue should be pink,
smooth and lesion free.
• The buccal mucosa (inside of the cheeks) can be
assessed using a penlight.
• It should be pink, moist, smooth and free of
inflammation and lesions.
• An adult normally has 32 teeth which should be white
with smooth edges in proper alignment and without
caries.
• Black patches on the surface of the teeth may
indicate dental caries or cavities resulting from poor
oral hygiene.
• The throat can be assessed by asking the
client to tilt the head back and open the
mouth widely.
• Ask the client to say, ‘ah’.
• A penlight is necessary during this assessment
or a good source of light.
• The throat should be pink and vascular and
without swelling, exudates or lesions.
• The client’s gag reflex should be present.
• Abnormal findings include the posterior pharynx
being red with white patches and this is a sign of
infection (tonsillitis).
• A greyish membrane covering the tonsils, uvula
and soft palate is indicative of diphtheria

Assessment of Ear, Eye, Nose and Throat

Uploaded by

Copyright:

Available Formats

Assessment of Ear, Eye, Nose and Throat

Uploaded by

Document Information

Original Description:

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Assessment of Ear, Eye, Nose and Throat

Uploaded by

Copyright:

Available Formats

THE EYE,EAR,NOSE AND THROAT

Anatomy and Physiology

• The ears are located on either side of the cranium

• The auricle, attached to the side of the head

• The middle ear, an air-filled cavity, is

• The Eustachian tube is closed, but it opens by

• Distinguishing landmarks of the tympanic

• The umbo of the malleus, which attaches to

• The footplate of the stapes sits in the oval

• The organ of Corti is located in the cochlea, a

• The organ of Corti is located on the basilar

• The organ of Corti, also called the end organ

• In the internal auditory canal, the cochlear

• Sounds transmitted by air conduction travel

• The stapes rocks, causing vibrations (waves) in

• Body balance is maintained by the cooperation

• Anterior openings into the nasal fossae are

• Superior, middle and inferior measures or

• The nasal turbinates are covered by mucous

• Kiesselbach’s plexus is a vascular area on the

The pathophysiology of breathing through

• The mucous covering in the nose and sinuses

• The nasal mucosa is capable of adding large

• The rich vascular supply to the turbinates radiates

• Olfactory receptor cells are located in the upper parts

• The kind of information to be obtained while

• The client's signs and symptoms.

Key signs and symptoms of ENT problems include:

To find out about current health patterns carry

• The following is the approach used for ENT

• Ensure that the light in the room provides

• The auricle and surrounding tissues should be

• Have the client sit in a comfortable position or

• Assist the client to tilt their head toward the

• You will then carry out a voice – whisper test.

• Begin estimating hearing acuity by checking whether the client can

• Ask the client to repeat the word or phrase.

• Normal finding is that the client should be able

• Air conduction refers to the transmission of

• Tuning fork tests include:

• Hold the fork so that the tines face forward,

• Continue timing the interval to determine how

Assessment of the Nose

• Each nostril should be patent.

• Inspect the mucus membranes for colour and

You might also like