06. Examining the Eyes, Ears, Nose and Throat

## **This Usually Takes Place Immediately After Taking The Vital Signs.**

**ASSIGNMENT**

**READ THE SECTION How To Examine a Sick Person**

**STUDY the following, compare..**

**WRITE A ONE PAGE ESSAY on your BLOG Page (Its in your profile page) with a Paragraph on each of the BIG FOUR.. how you would do it. Have Fun. Leave a comment here and I will check it and give you a grade.**

.

.

#### Different Practitioners do this in a different order and this is the order I usually do it. As i explain it I will also explain why.

**EYES**

If you have more complex diagnostic equipment you will examine the exterior and interior of the eye. Most Nurses and Paramedics examine the exterior of the eye. We will not check vision here in the general exam. The following tests will tell us a lot about Brain functions. That's why I check Eyes First, especially if there was some kind of accident or fall.

1. Using the Pen Light i turn it on at the side of the patients head and move the light over the eye and away medium speed. Did the eye Dilate? (did the pupil shrink?) If not there might be indication of concussion. The indication is always the opposite side of the brain from the eye being tested.
2. Test the other eye the same way. Was the response the same or different? If neither eye Dilates well there is a strong indication of possible concussion. If only one eye was less responsive it is a good indication of a hard thump on the opposite side of the head. If there was no accident, than there is indication of an internal problem.
3. If response is normal than take a finger and hold it vertical in front of the nose. Ask the patient to follow your finger with their eyes and tell you when they can no longer see it. That is peripheral vision and it should be about the same for both eyes. Write all this down.
4. Does the patient have something in their eye? NOW check the procedure in Where There is No Doctor.. find it? Its here... **THE EYE**

**MOUTH AND THROAT**

1. Have the Patient OPEN WIDE (you know the drill). First look with the light is there redness, bleeding or inflammation? What color is the tongue? Use a tongue depressor or handle of your spoon and press the tongue down to see farther back. Is the back throat red? swollen? tell them to say AHHH do the tonsils look inflamed? This might be enough for you to diagnose Strep Throat or Tonsillitis by educated guess. THIS is what doctors did in 19th century medicine. We practice a lot of 19th century medicine in the jungle away from technology.

**EARS**

I look in the ears for two or three things. Ask if they have trouble hearing.

1. Is there redness, infection or oozing? If so than ear drops are the treatment and maybe oral antibiotics.
2. Is there an accumulation of ear wax? This can impair hearing as much as 50% so removing is necessary. There are commercial solvent drops to dissolve ear wax. An old remedy was to warm mineral oil in a cup of very warm not too hot water have them lie on their opposite side and squirt a dropper of warm oil in the ear. Warn them it may tickle or feel funny. After 5 minutes have them hold a tissue and roll over. A lot of melted wax will drain out
3. Check Your Textbook again and read more about the Ear here on these pages.

* **Ears**
* how to examine a sick person’s, 34
* infections of, 309
* nodes behind, 88
* ringing of, 107, 327
* Earwax, 405

**NOSE**

This is a simple external examination.

1. Is the nose clogged and congested? Cold symptom
2. Is the nose draining and running a lot? More allergy but also cold symptom
3. is the bottom red from rubbing and wiping? Cold symptoms.

Go ahead and treat for Cold and give relief.

.

© Copyright 2018 by Daniel Blankley. All rights reserved.

.