HEENT Systems
Focus Points
Do not let this document intimidate you. It is detailed on purpose to assist your learning.
Add notes to help you with physical assessment.
You need to know how to perform a physical assessment on this body system – this means
practice each week! You also need to know the basics of which assessment findings are likely to
indicate a particular condition.
Mindset
o Take a deep breath
o You can do this �
o Prepare and plan for success
Anatomy and physiology
o Please review
o Structures & functions – asymmetry is a clue (for any body system)
Head
Eyes
Ears
Ossicles
Nose
Sinuses
Mouth
Throat
Health history
o Questions to ask (remember, you are the investigator)
o Past medical history
Medical
Surgical
Medications
Holistic – social, psychological, etc.
o Chief complaints
OLDCART
o Well visits
Annual eye exam
Ear audiology as needed
o Review of systems
Common questions to ask
Pertinent positives vs. negatives
Physical exam techniques (note the order performed):
o Equipment
Ophthalmoscope
, Otoscope
Nasoscope
o Tips to enhance the exam
New problems in older clients need to be thoroughly assessed (i.e., new
migraines in older client, new strabismus in older client)
o Specific areas:
Head
Symmetric
Hair
Scalp
Skull
Face
Eyes
Infant reflex – Hirschberg reflex (if +, ophthalmologist should be
consulted)
Internal
o Ophthalmoscope exam
Optic disc
Retina
o 20/20 is generally found in pediatric clients around 5-6 years old
External
o Position, alignment
o Eyebrows/lids
o Lacrimal apparatus
o Lumps/swellings
o Conjunctiva
o Sclera
o Cornea
o Lens
o Iris
o Pupil
o Extraocular muscles/movements
o Visual fields
Vision tests
o Visual acuity – Snellen Chart (20/30 means a client can see at 20
feet what a person with “normal” vision can see at 30 feet)
o Visual fields – 6 cardinal fields of gaze
o Color vision – Ishihara chart
o Contrast sensitivity
Ears
External
o Auricle
Internal
Focus Points
Do not let this document intimidate you. It is detailed on purpose to assist your learning.
Add notes to help you with physical assessment.
You need to know how to perform a physical assessment on this body system – this means
practice each week! You also need to know the basics of which assessment findings are likely to
indicate a particular condition.
Mindset
o Take a deep breath
o You can do this �
o Prepare and plan for success
Anatomy and physiology
o Please review
o Structures & functions – asymmetry is a clue (for any body system)
Head
Eyes
Ears
Ossicles
Nose
Sinuses
Mouth
Throat
Health history
o Questions to ask (remember, you are the investigator)
o Past medical history
Medical
Surgical
Medications
Holistic – social, psychological, etc.
o Chief complaints
OLDCART
o Well visits
Annual eye exam
Ear audiology as needed
o Review of systems
Common questions to ask
Pertinent positives vs. negatives
Physical exam techniques (note the order performed):
o Equipment
Ophthalmoscope
, Otoscope
Nasoscope
o Tips to enhance the exam
New problems in older clients need to be thoroughly assessed (i.e., new
migraines in older client, new strabismus in older client)
o Specific areas:
Head
Symmetric
Hair
Scalp
Skull
Face
Eyes
Infant reflex – Hirschberg reflex (if +, ophthalmologist should be
consulted)
Internal
o Ophthalmoscope exam
Optic disc
Retina
o 20/20 is generally found in pediatric clients around 5-6 years old
External
o Position, alignment
o Eyebrows/lids
o Lacrimal apparatus
o Lumps/swellings
o Conjunctiva
o Sclera
o Cornea
o Lens
o Iris
o Pupil
o Extraocular muscles/movements
o Visual fields
Vision tests
o Visual acuity – Snellen Chart (20/30 means a client can see at 20
feet what a person with “normal” vision can see at 30 feet)
o Visual fields – 6 cardinal fields of gaze
o Color vision – Ishihara chart
o Contrast sensitivity
Ears
External
o Auricle
Internal
