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