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ENT Examination

ENT & OphthalmologyYear 3

The ENT station bundles three examinations. This checklist covers otoscopy technique, the Rinne and Weber tuning fork tests with their interpretation table, anterior rhinoscopy and oropharyngeal inspection.

Marking points
46
Run-through
~12m
Progress
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2

Ear Examination

0/20

    • Check symmetry (proptosed auricle may indicate mastoiditis)

    • Position (low-set ears may indicate genetic syndromes)

    • Comment on whether hearing aids are being used

    • Comment on skin changes

    • Comment on pinna deformities

    • Comment on external auditory meatus

    • Comment on mastoid area

    • Gently tug pinna (tenderness may suggest mastoiditis)

    • tenderness may suggest mastoiditis

  • Examine auditory canal (wax, foreign bodies, skin quality), tympanic membrane (color, structure, fluid), and visible features behind tympanic membrane (pars tensa, pars flaccida, handle/lateral process of malleolus, cone of light)

    • Check for discharge, foreign bodies, inflammation, or stenosis

    • Check for color, structure, fluid, and visible features behind the tympanic membrane

    • Check for pars tensa, pars flaccida, handle/lateral process of malleolus, cone of light

    • Cover one ear and softly whisper a number in the other ear

    • Use 256Hz tuning fork on mastoid process then in front of ear. Normally, air conduction > bone conduction (Rinné positive)

    • Place 256Hz tuning fork on center of forehead. Sound should be heard centrally in normal hearing

3

Nose and Sinuses Examination

0/10

  • Sit facing the patient and ask them to look forward with their head neutral. Lift the tip of the nose with your thumb, use a light source, and inspect the nasal mucosa for abnormalities like bleeding, septal deviation, or enlarged turbinates.

    • Check for symmetry, proptosis, nasal flaring

    • Check for skin changes (rosacea, skin cancers, scarring), symmetry, septal deviation, nasal mucosa abnormalities (bleeding, enlarged turbinates)

  • Palpate nasal bones, assess for obstruction by blocking each nostril, percuss frontal and maxillary sinuses if concerned about sinusitis

    • Palpate the nasal bones

    • Block each nostril to assess any obstruction by asking the patient to inhale

    • Palpate frontal and maxillary sinuses for tenderness (sinusitis)

4

Mouth and Throat Examination

0/10

  • Check for swelling at cheeks or mandible, drooling, skin changes (cancers, cyanosis of lips, angular stomatitis, ulcers)

  • Examine buccal mucosa, palate, teeth, tongue, hard and soft palates for signs of inflammation, infection, or abnormalities

  • Use tongue depressor if needed, identify soft palate and uvula, ask patient to say 'ah', inspect tonsils for size, symmetry, and evidence of infection

    • Check for deviation or swelling

    • Check for size, symmetry, and evidence of infection

    • Check for symmetry and evidence of infection

  • Bimanual palpation of submandibular glands, palpate tongue and floor of mouth with gloved hand

    • Bimanual palpation of submandibular glands

    • Palpate tongue and floor of mouth with gloved hand

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