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Clinical Methods in ENT
PT Wakode
PART I:
ONE:
introduction
TWO:
history taking
COMPLAINTS
History of Present Illness
Past History
Personal History
Family History
PHYSICAL EXAMINATION
THREE:
examination of swelling, ulcer and fistula
HISTORY
Duration
Mode of Onset
Associated Symptoms
Exact Site
Other Swellings over Body
GENERAL EXAMINATION
LOCAL EXAMINATION
INSPECTION
Site
Size
Shape
Surface
Margins
Skin over Swelling
Pulsations
Colour
Change in Size of Swelling on Coughing/Straining or Valsalva
PALPATION
Fixity to Skin
Mobility of Swelling
Fluctuation
Transillumination Test
Reducibility
Compressibility
Pulsatile Swelling
PERCUSSION
AUSCULTATION
Regional Lymph Nodes
Examination of Sinus or Fistula
Sinus
Fistula
Examination of Ulcer
History
Examination of Ulcer
PART II:
FOUR:
examination of ear
PAST HISTORY (HISTORY OF MAJOR ILLNESSES)
FAMILY HISTORY
PERSONAL HISTORY
GENERAL EXAMINATION
LOCAL EXAMINATION
Examination of Ear
Examination of Pinna, Pre- and Post-aural Area
Examination of External Auditory Canal
Examination of Ear with Aural Speculum
Examination of Tympanic Membrane
Mobility of TM
Abnormalities of Tympanic Membrane
Fistula Test
Fallacy
Tips
Tuning Fork Tests
Rinnie's Test
Weber Test
Absolute Bone Conduction (ABC) Test
SYSTEMIC EXAMINATION
RADIOLOGICAL EXAMINATION OF THE EAR
A. AUDIOMETRY
Pure Tone Audiometry (PTA)
FEW EAR CONDITIONS
Congenital
Anotia
Microtia
Meatal Atresia
Treacher Collin's Syndrome (mandibulo-facial dysostosis)
Pre-auricular Sinus
Dermoid Cyst
Traumatic
Infective
Diffuse Otitis Externa
Post-aural Intertrigo
Otomycosis
Malignant Otitis Externa
COMMON CONDITIONS OF MIDDLE EAR
Suppurative Otitis Media
Acute
Chronic Suppurative Otitis Media
Safe ear (Tubo-tympanic disease)
Non-Suppurative Otitis Media
Otosclerosis
Common Conditions of Inner Ear
FEW COMMON PROCEDURES
Syringing
PART III:
FIVE:
examination of nose and paranasal sinuses
NASAL OBSTRUCTION
Duration
Laterality
Latency
Severity
Character
NASAL DISCHARGE (RHINORRHOEA)
Duration
Laterality
Severity
Latency
Character
Watery
Mucoid
Mucopurulent
Purulent
Blood Stained Discharge
BLEEDING PER NOSE [EPISTAXIS]
SNEEZING
NASAL MASS
CRUSTING
DISTURBANCES OF SMELL
ITCHING IN NOSE
NASAL REGURGITATION
FOREIGN BODY IN NOSE
SWELLING OVER NOSE AND FACE
PAIN IN AND AROUND NOSE
Headache
Epiphora (Watering from Eyes)
Alteration in Voice
Snoring
CLINICAL EXAMINATION OF NOSE AND PNS
Instruments
EXAMINATION OF EXTERNAL NOSE AND FACE
Inspection
Palpation
ANTERIOR RHINOSCOPY
Structures to be seen in A/R
POSTERIOR RHINOSCOPY
Procedure
SINUS TENDERNESS
COLD SPATULA TEST
TRANSILLUMINATION TEST
Radiological Examination of Nose and Paranasal Sinuses
Occipito-mental View (Water's View) (Figures 5.8 and 5.9)
Occipito-frontal View (Caldwell View) (Figures 5.10 and 5.11)
X-ray Base Skull (Submento-vertical View) (Figures 5.12A and B)
Few Conditions of Nose and Paranasal Sinuses
ATROPHIC RHINITIS
RHINOLITH
ADENOIDITIS
SINUSITIS
DEVIATED NASAL SEPTUM
NASAL POLYPS
Antrochoanal Polyp
Ethmoidal Polyposis
Rhinosporidiosis
Rhinoscleroma
Stages
Juvenile Nasopharyngeal Angiofibroma
Some Tumours Seen in Nose and PNS
Carcinoma of Maxillary Antrum
Some Common Procedures in Nasal Diseases
Local Anaesthesia for Nasal Procedures
Infiltration Anaesthesia
Antral Puncture (Antral lavage)
Anterior Nasal Packing
Postnasal Packing
FB Removal
PART IV: SECTION A
SIX:
oral cavity and oropharynx
EXAMINATION OF ORAL CAVITY AND OROPHARYNX
Inspection
Tongue
Teeth and Gums
Cheeks and Gingivo Labial Gutters
Hard Palate, Soft Palate, Uvula
Anterior Pillars, Tonsils and Posterior Pillars
Palpation
Tongue
Floor of Mouth
Tonsils and its Bed
Base of Tongue
Swelling in Oral Cavity
Percussion and Auscultation
Pharyngitis
Tonsillitis
Quinsy (Synonyms- paratonsillar abscess, peritonsillar abscess)
Retropharyngeal Abscess
Parapharyngeal Abscess
Ludwig's Angina
Aphthous Stomatitis
Leucoplakia
Cleft Palate
Malignancy
Submandibular Siloadenitis
SEVEN:
examination of larynx and laryngopharynx
CHANGE IN VOICE
DIFFICULTY IN BREATHING
STRIDOR
DIFFICULTY IN SWALLOWING
Causes
PAIN IN THROAT
Causes
FOREIGN BODY (FB)
FB Inhalation
FB Ingestion
Causes
COUGH
NECK MASS
INDIRECT LARYNGOSCOPY
COMMON CONDITIONS INVOLVING LARYNX AND LARYNGOPHARYNX
Laryngotracheobronchitis
FB in Larynx and Laryngopharynx
Juvenile Laryngeal Papillomatosis
Laryngomalacia
Vocal Nodule
Vocal Cord Palsy
Malignancy of Larynx
SECTION B
EIGHT:
examination of neck
INSPECTION
PALPATION
In
Tenderness over Laryngeal Cartilages
Laryngeal Widening
Laryngeal Crepitus
To Test Relationship of Swelling with Sternomastoid Muscle
Interpretation
Ectopic Thyroid
Thyroglossal Duct Cyst
Dermoid Cyst
Clinical Features
Thyroid Swelling
Ludwig's Angina
Symptoms
Treatment
Sebaceous Cyst
Clinical Features
Branchial Cyst
Lipoma
Cystic Hygroma (Lymphangioma)
Carotid Body Tumour (Chemodectoma)
Lymphomas
Secondary Deposits in Neck
Laryngocoele
NINE:
examination of salivary glands
PAROTID GLAND
SECTION C
TEN:
diseases of oesophagus
DYSPHAGIA
REGURGITATION
BLEEDING
RESPIRATORY SYMPTOMS
FB IN OESOPHAGUS
Clinical Examination
Investigations
a. Radiography
Oesophagoscopy
Procedure:
Diseases of Oesophagus
Treatment:
Carcinoma of oesophagus:
Treatment:
ELEVEN:
tracheo-bronchial tree
EXAMINATION OF TRACHEA AND BRONCHI
Palpation of Trachea in Neck
DISEASES OF TRACHEA AND BRONCHI
Foreign Bodies in Trachea and Bronchii
Factors for FB Lodgement in Respiratory Tract
Pathophysiology
Investigations
Complications
Bronchiectasis
Carcinoma Bronchus
Investigations:
Treatment:
PART V:
TWELVE:
examination of cranial nerves
OLFACTORY NERVE
Clinical Examination
OPTIC NERVE
OCULOMOTOR NERVE
Pupillary Light Reflex
Clinical Examination
TROCHLEAR NERVE
TRIGEMINAL NERVE
Introduction
Applied Anatomy
Clinical Examination
Sensory Functions
Corneal Reflex
Motor Function
Trigeminal Neuralgia (Tic Doloureux)
ABDUCENT NERVE
Causes of lesion:
FACIAL NERVE
Motor Functions
Clinical Examination
Sensory Function Testing
Secreto-motor Function
VESTIBULOCOCHLEAR NERVE
Cochlear Nerve
GLOSSOPHARYNGEAL NERVE
Clinical Examination
VAGUS NERVE
Clinical Examination
Results
SPINAL ACCESSORY NERVE
Anatomy
Clinical Examination
Causes for Lesion
HYPOGLOSSAL NERVE
Clinical Examination
INDEX
TOC
Index
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