1. Physical Diagnosis Scalp, Ears, Nose and Sinuses

2. Describe the patients scalp. Diagnosis?

3. Psoriasis

4. Describe findings.

5. Normal TM Malleus (short process & handle) Malleus (short process & handle) Cone of light Cone of light Incus Incus Pars tensa Pars tensa The unbelievable UMBO The unbelievable UMBO

6. Describe findings.

7. Otitis Media Red and bulging Red and bulging Hyperemia Hyperemia Dullness of light reflex Dullness of light reflex Opaque Opaque

8. Describe findings.

9. Serous OM Bulging, amber drum Bulging, amber drum Decreased mobility Decreased mobility

10. Describe findings.

11. Cerumen in Canal Parents may be advised to soften first Parents may be advised to soften first May remove yourself in physicians office May remove yourself in physicians office VA patients: May remove a lot of ear wax in the ER VA patients: May remove a lot of ear wax in the ER

12. Describe findings.

13. Bullous Myringitis Large vesicles/bullae visible on the drum Large vesicles/bullae visible on the drum Landmarks obscured Landmarks obscured Drum is reddened Drum is reddened Viral infection characterized by painful hemorrhage Viral infection characterized by painful hemorrhage

14. Traumatic Perforation Usually result from purulent infection of the middle ear Usually result from purulent infection of the middle ear Central perforation or marginal Central perforation or marginal

15. Tympanostomy Tube May be placed in children with a series of ear infections May be placed in children with a series of ear infections The major goal is to prevent conductive hearing loss to prevent delayed language development The major goal is to prevent conductive hearing loss to prevent delayed language development Mom, the TV is so loud! Mom, the TV is so loud!

17. Nose and Sinuses

18. Sinus Anatomy: Front View Frontal sinus = black check Frontal sinus = black check Maxillary sinus=red Maxillary sinus=red Anterior ethmoid sinuses = green Anterior ethmoid sinuses = green Posterior ethmoid sinuses = purple Posterior ethmoid sinuses = purple Sphenoid sinus = yellow Sphenoid sinus = yellow

19. Sinus Anatomy: Side View Frontal sinus = black check Maxillary sinus = red Anterior ethmoid sinuses = green Posterior ethmoid sinuses = purple Sphenoid sinus = yellow

20. Observe the turbinates. Diagnosis?

21. Nasal Polyp