KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN

UNIVERSITAS TADULAKO
FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN
Kampus Bumi Tadulako Tondo
JI. Soekarno Hatta Km. 9 Telp : (0451) 422611 – 422355 Fax: (0451) 422844
email : fkik_untad@yahoo.co.id
UNTAD Palu - Sulawesi Tengah 94118

CHECKLIST ENT EXAMINATION

dddddddddd Score
Point of Ajustment Feedback
No.
0 1 2
Developping interpersonal relationship (See global rating
1. scale for Doctor-Patient interaction)

Explaning the objective of the Exam. to the Patient

2.
Sitting in the right Position ( Patient and examiner sit face
to face obliquely with examiner's knee attached closely
3.
to the patient's knee

Put the headlamp on head examer by the right position

4.
Ear Examination

Checking auricle of ear and the surrounding

5.
Pressing the Tragus and the back of the ears
6.
Setting the auricle's and canal Position to see ear canal
7. and Tympanic Membrane well

Putting ear speculum gently in the ear canal to see

8. Tympanic membrane well

Use otoscope gently to see ear canal and tympanic

9. membrane well

Hearing Test

Explaning the objective hearing test by Tuning fork

10.
Performing Rinne Test Correctly
11.
Performing Weber Test Correctly
12.
Performing Scwabach Test Correctly
13.
Nose and Paranasal Sinuses Examination

Checking the external nose ( Inspection and Palpation)

14
Choosing the appropriate nose speculum
15.
Setting the patient's head
16.
Put in the nose speculum gently into the nose of the
17. patient
 KEMENTERIAN PENDIDIKAN DAN KEBUDAYAAN
UNIVERSITAS TADULAKO
FAKULTAS KEDOKTERAN DAN ILMU KESEHATAN
Kampus Bumi Tadulako Tondo
JI. Soekarno Hatta Km. 9 Telp : (0451) 422611 – 422355 Fax: (0451) 422844
email : fkik_untad@yahoo.co.id
UNTAD Palu - Sulawesi Tengah 94118

Checking the vestibulum, mucosa of nasal cavity, conchae

18. and septum

Palpating frontal sinus by pressing the bone in eyebrow

19. area without pressing eyeball with the thumb dddddddddd

Palpating ethmoid sinus by pressing nasal bone in the

20. inter cantal area using the thumb-indicis

Palpating maxillary sinus by pressing the check area using

21. the thumb

Mouth and Pharynx Examination

checking the lips

22.
Asking the patient to open his/her mouth
23.
Inspecting the buccal mucous membrane using tonge
24. spatule

Checking gums, teeth, tongu and palate

25.
Asking the patient to say " aah"
26.
Checking Tonsil and Pharyngeal by Pressing tongue using
27. the spatula

cheking nasopharynx and chonae by nasopharyngeal

28. mirror (indirect nasopharyngoscope)

Checking hypopharynx and larynx by Mirror throat

29. (indirect laryngoscope)

Removing the used spatula to be cleaned and sterilized

30.
Checking neck regional limf by palpating jugular limf area
31.
Interpreting and explaining the result of the examination
32. to the patient

negotiaiton proper threatment and planning.

33.

Explanation :
score 0 : Not Performed at all
score 1 : Performed imperfectly
score 2 : Performed perfectly

% coverage skills = total score / 66 X 100% = .......%