Immersion HEENT Intro

After Immersion, you should be able to:

  • Inspect the head and the scalp

     Eyes

  • Measure visual acuity
  • Inspect the external eye
  • Observe corneal light reflex
  • Assess size and reactivity of pupils
  • Assess the red reflex with the ophthalmoscope

    Ears

  • Assess hearing
  • Inspect and palpate the auricle and mastoid
  • Perform otoscopy

     Nose

  • Inspect the external nose for symmetry & discharge

     Mouth

  • Inspect the oral cavity, including the teeth and gums
  • Palpate salivary glands
  • Palpate temporomandibular joints (TMJ)

      Neck

  • Inspect the neck for symmetry and masses
  • Palpate the cervical lymph nodes
  • Palpate the thyroid gland
  • Auscultate the carotid artery
  • Palpate the carotid pulse

 

A comprehensive head and neck exam evaluates the eyes, ears, nose, mouth, throat, and neck. Experienced clinicians may also test the cranial nerves, depending on the chief concern.  In Immersion, you will learn cranial nerve testing as part of the Neurologic exam, which we’ve found is less confusing for novices.

The HEENT exam is usually performed in the seated position but in the hospital, it may be done reclining. Because the complete head and neck examination is long, it is often tailored to the patient’s history and presenting concern.  Begin by explaining what you plan to do and obtaining your patient’s permission, then inspect the head and the skin of the scalp.

The eye, ear, nose, mouth and throat, and neck and thyroid exams are each described in the following chapters. Use the arrows at the bottom of the page or the menu at left to view each of these chapters before the PE lab.

Sample documentation:

Precise and descriptive language should be used to describe your exam findings. Each physical exam chapter includes sample documentation for a comprehensive exam without abnormal findings.

Although you may eventually present normal findings more concisely, you will still need to provide this level of detail for body regions or organ systems that might be involved in a patient’s presenting concern.

Head: Scalp and skull without lesions or tenderness.

Eyes: Vision 20/20 in each eye with corrective lenses. Conjunctivae without injection. No scleral icterus. Lids without lesions. Corneal light reflection symmetric. Pupils equal, round, and reactive to light directly and consensually. Red reflex present bilaterally. 

Ears: Hearing intact to finger rub bilaterally. External auditory canals are free of wax. Tympanic membranes pearly white and intact, with cone of light.

Nose: External nose symmetric.

Mouth: Mucosa pink with no ulcers. Normal dentition. Gums without erythema or bleeding. Tonsils symmetric without erythema or exudate.

Neck: Full range of motion. No cervical lymphadenopathy. Thyroid smooth, non-tender, without masses or thyromegaly

HEENT Exam Video

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The Foundations of Clinical Medicine Copyright © by Karen McDonough. All Rights Reserved.