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