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Aural speculum
Suction apparatus
perforated TM
( 2+ , 3+ , 4+ ➾ Acute Infection )
Tell the patient to stay his tongue in
the mouth and not to protrude. Gently
depress the tongue with a wooden or
metal depressor. The palatine arch
palatine tonsils, and posterior
pharyngeal
If walls are usually easily
not, ask the
visible. to say
patient
“ah”,this makes
the palate move
upward, the
tongue move
downward, and
exposes more of
The tonsillar pillars, the palatine
tonsils, soft palate and uvula can
then be inspected. The tonsils
sould be symmetrical and any gross
asymmetry should be viewed with
suspicion.
Likewise the
soft palate
should be
symmetrical
and the gag
reflex
present
Hypopharynx and larynx
Examine the hypopharynx and larynx
together by indirect laryngoscopy
using a large angled mirror.
The patient should sit upright with
neck straight and the head thrust
forward, encourage the patient to
relax and breathe deeply and
rhythmically.
Have him stike out his tongue and
gently but firmly grasp it with gauze
sponges. Introduce the warm mirror,
make it reach the soft palatine, rotate
it ,focus the light on the mirror, ask
him to say “ee”.
The following structures should
come into view insequence.
The patient is asked to protrude the
tongue,any dentures having been
removed, and it is grasped with a
gauze swab. The thumb may be
above or below the tongre according
to the preference of the examiner, but
one finger should be able to raise the
upper lip if necessary.
A large size of laryngeal mirror is
warmed and placed firmly but gently
on the soft palate just above the
base of the uvula. The light then
directed to the varousp arts of the
larynx and hypopharynx by tilting the
mirror.The patient is asked to
breathe easily and steadily
throughout.
The first structure to come into view
is the epiglotis which usually
overhangs the superior of the larynx.
The epiglottis sometimes overhangs
to such a degree that it is impossible
to view the larynx with a mirror, and
flexible nasolaryngoscopy is used
Fibreoptic examination
Fibreoptic examination is now commonly used in the
assessment of laryngeal and pharyngeal disease. A
good mirror examination provide a better view than
fibreoptic examination but the latter is especially
useful in those with an overhanging Epiglottis and a
prominent gag reflex. It can be used in young infants
and has the added advange of providing a
comprehennsive view of at least one nasal cavity and
the postnasal spacee as well as the larynx and
pharynx.
硬管喉镜检查法
直接喉镜
支撑喉镜
Question
How to examine the nasal cavity?
Which methods can be used to do
the laryngeal examination?
What is the essential steps for
external canal exam?
How to distinguish between the
various type of hearing loss?