Physical examination in ENT

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Revision as of 13:15, 29 November 2023 by Nikolas (talk | contribs)
  • Weber and Rinne test
    • Used to distinguish between conductive and sensorineural hearing loss
    • Weber
      • Tuning fork placed on the forehead.
      • In case of conductive hearing loss, the tone is lateralised (louder) to the side with decreased hearing.
      • In case of sensorineural hearing loss, the tone is lateralised to the side opposite of the one with decreased hearing
    • Rinne
      • Tuning fork placed in front of ear opening and on the mastoid process.
      • In case of conductive hearing loss, the tone is heard best on the mastoid process (called Rinne negative)
      • In case of healthy ear or sensorineural hearing loss, the tone is heard best in front of the ear opening (called Rinne positive)
  • Spontaneous vestibular signs
    • Head impulse test
    • Romberg test
      • Stand with eyes closed for 30 seconds and observe for swaying to one side
    • Unterberger stepping test
      • 50 steps with eyes closed
    • Finger to nose test
    • Walking with eyes closed
    • Smooth eye tracking of objects
    • Horizontal and vertical tracking test
    • Dix-Hallpike manoeuvre
  • Examinations of the neck, lymph nodes, thyroid
  • Examinations of facial nerve
    • Forehead wrinkling
    • Closing eyes tightly
    • Nose wrinkling
    • Inflate cheeks
    • Smiling
    • Whistling
    • Taste
  • Examinations of meningeal signs
    • Triad
      • Nuchal rigidity (inability to flex neck forward)
      • Headache
      • Photophobia
    • Kernig sign
      • Supine patient
      • Flexion of hip joint with knees in 90 degrees -> painful passive extension of the knee joint
    • Brudzinski sign
      • Supine patient
      • Passive flexion of the neck -> patient involuntarily lifts legs‎