Neurotologic and Otologic History and Physical Examination
History and physical examination are essential parts in the evaluation of patients with otologic or neurotologic disorders. The information gleaned during history taking is more useful and important in establishing the diagnosis and will guide towards proper physical examination and ordering appropriate and essential paraclinical tests. Moreover the interaction during history-taking is important which can form the strong doctor-patient relationship. This will lead to effective treatment plan offered by the doctor.
History of the present illness
History taking starts by asking the patient’s chief complaint. Thereafter details of main signs and symptoms, their nature and duration, associated, predisposing, alleviating and precipitating factors should be explored. Sometimes patients think that symptoms are unimportant; therefore it is necessary to ask appropriate and detailed questions about signs and symptoms.
A general medical history should be taken that includes present illness, past medical history (medical conditions that may be relevant to present illness), drug history (ototoxic drugs), allergy reactions (adverse drug reactions), social history (alcohol consumption and smoking).
Examination of the Ear
The ear exam may be performed if the patient has an otalgia, hearing loss, infection or other symptoms pertaining to ear disorders. It starts by inspection of the external ear. The form, size and position of the auricle should be observed for any deformity (traumatic or congenital). Presence of surgical scars around the ear, skin tags, pre-auricular sinuses should be noted.
Palpation of the external ear structures is the next step. The main purpose of palpat...
... middle of paper ...
...ziness
Of all of the problems facing the otologist, dizziness and vertigo can be the most perplexing and frustrating. The history is extremely important to establish the probable cause and character of the problem. Because the patient's definition of dizziness may not be the same as that of the examiner, defining the patient's thoughts and feelings is important. Establishing the nature of the problem often takes great patience and involves spending considerable time with the patient.
The four steps in the management of the dizzy patient are (1) definition of the problem, (2) evaluation of the problem, (3) thorough explanation and reassurance, and (4) treatment and follow-up. These steps help to manage the dizzy patient with maximal efficiency and compassion. Regardless of the cause of the problem, follow-up and emotional support are important
Tinnitus
Facial Nerve
Purpose- To identify the functions of the cranial nerve of the peripheral nervous system such as the olfactory, optic, oculomotor, trochlear, trigeminal, abducens, facial, vestibulocochlear, glossopharyngeal, vagus, accessory, and the hypoglossal nerves. I will examine these functions with a series of behavior tests on my partner who is Jazmine Cooley to see if all nerves are functioning properly and if they are not, then this will be considered an identified dysfunction of a cranial nerve which is a diagnosis.
BPPV (Benign Proximal Positional Vertigo) is the most common disorder associated with the vestibular system which plays a pivotal role in balance (Timothy & Hain, 2009). Parnes & Nabi (2009) defined BPPV as: “A peripheral vestibular disorder that manifests as sudden short-lived episodes of vertigo precipitated by certain head movements” (p. 287). This definition can be supplemented by Timothy & Hain, 2009) who described BPPV as sudden vertigo that is positional and paroxysmal. According to Parnes, Agrawal & Atlas (2003), benign means that the pathology is not cancerous or due to a serious cause. The word proximal refers to a recurring sudden episode of symptoms. Positional refers to the triggering of symptoms being dependent on a certain position or movement and vertigo is the sensation of the surroundings spinning around relative to the person and vice versa. The two major pathophysiological BPPV mechanisms that will be discussed include canalithiasis and cupulithiasis (Parnes & Nabi, 2009). These are distinguished by the pathophysiology involved.
requiered to determine treatment. Lab tests or imaging is often requiered as well. It’s chronic,
These symptoms include: two or more episodes of vertigo lasting approximately 20 minutes each, tinnitus (ringing or buzzing of the ear), temporary episodes of hearing loss, as well as a feeling of “fullness” in the ear. In terms of assessment, the NIDCD asserts that some physicians will implement the use of hearing tests to determine the extent of the hearing loss that has occurred due to Ménière’s disease
Generally, the context in such texts is the background information of the patient, subjective/objective finding, previous therapy/medical conditions, and history of present illness(es). History and background information of the patient differs from the rest of the document because it “lays the foundation”. It is written like an introduction, with such a purpose. These areas of the report are delving into the past, while the treatment plan and goals refer to the future. The context provided in reports and evaluations lets the audience, who is the patient or other doctors and specialists, know the circumstances of the situation. This is an example of a patient history section in a progress report (MT Sample
In physical therapy, patients come to the clinic with a long list of symptoms and a specific mechanism of injury. It is the physical therapists job to take this information and form hypotheses of what pathology may be affecting the patient. With the patient that has been presented in this case, a full history shows a very good description of symptoms and what the patient remembers happening when the injury occurred. With this history, an examination plan can be created in order to make this examination process thorough, but efficient.
The doctor might also conduct a physical examination to confirm the diagnosis. This is carried out by listening...
The purpose of the paper is to discuss the activities involved during the evaluation of a patient. Evaluation of a patient can be seen as the process of examining a patient critically. It comprises of gathering and analyzing data about a patient and the illness (Allan, 2012). The core reason is to make judgment about the disease one is suffering from. Such judgment will guarantee proper treatment and diagnosis. Typically, gathering of information from the patient is the role of nurses while making judgment and prescription is the doctor’s role (Jacques, 1988). In any case all practitioners are required to know how to evaluate a patient.
“The physician performs a variety of tests to evaluate mental, emotional and language functions, movement and coordination, balance, vision, and the other four senses (Diagnosing
Vertigo can influence the sense of time and place. As an example with vertigo regarding in time, a person facing a threat can have their sense of time in a highly attentive to the other party of what they are saying, doing, and feeling. In addition, vertigo in space can influence emotions between parties can feel compressed and concentrated. Vertigo can negatively impact by having the past pain which can bring memories of fears and worries of the future as well. Vertigo has the ability to shorten the view of the range of feelings, thoughts, and actions which requires plans to break free of vertigo. Being aware of the symptoms, shake roughly of the relationships from state of consciousness, enlarging the scope of vision, and focusing on the negative to externalize from the distressing emotions. Vertigo can explain why certain dispute happen and as how emotional condition can impact a person’s
Ongoing, clear, open, and transparent communication between physicians seeing the same patient is critical since this can reduce medical errors, improve quality of care, and increase patient safety (Institute of Medicine, 2000). In this case study, no type of formal or informal communication between this patients’ PCP, internist, and the neurologist was reported.
An Occupational Therapist has several responsibilities when it comes to taking care of their patient. Before they can do anything, they must review the patient’s history. They do this by asking the patient
Vertigo and Its Treatment In our everyday lives, we almost take for granted this idea of balance or equilibrium that is maintained within our bodies. In general, no real thought processes are required. It is only when something is disturbed within our balance system that one is able to take notice of changes in the equilibrium. There may be several different factors that cause a disturbance to our bodies.
... environment. In order to do that we must know the anatomy of our ear and how it functions. An important function is how the sound wave is transmitted into meaningful information through means of frequency, amplitude, and location. By understanding how the ear functions people are able to understand and prevent hearing loss.
Paramedics are frequently presented with neurological emergencies in the pre-hospital environment. Neurological emergencies include conditions such as, strokes, head or spinal injuries. To ensure the effective management of neurological emergencies an appropriate and timely neurological assessment is essential. Several factors are associated with the effectiveness and appropriateness of neurological assessments within the pre-hospital setting. Some examples include, variable clinical presentations, difficulty undertaking investigations, and the requirement for rapid management and transportation decisions (Lima & Maranhão-Filho, 2012; Middleton et al., 2012; Minardi & Crocco, 2009; Stocchetti et al., 2004; Yanagawa & Miyawaki, 2012). Through a review of current literature, the applicability and transferability of a neurological assessment within the pre-hospital clinical environment is critiqued. Blumenfeld (2010) describes the neurological assessment as an important analytical tool that evaluates the functionality of an individual’s nervous system. Blumenfeld (2010) dissected and evaluated the neurological assessment into six functional components, mental status, cranial nerves, motor exam, reflexes, co-ordination and gait, and a sensory examination.