title: HEENT examination
text: # HEENT examination
  
  A HEENT examination is a portion of a physical examination that principally concerns the head, eyes, ears, nose, and throat.
  
  ## Steps
  
  * IPPA
     * Inspection of scars or skin changes
     * Palpation of temporomandibular joint, thyroid, and lymph nodes
     * Percussion may involve the skin above the frontal sinuses and paranasal sinuses to detect any signs of pain
     * Auscultation for carotid bruits
  * Tests specific to HEENT examination
     * Eyes: eye examination and acuity (including ophthalmoscope)
     * Ears: hearing examination and evaluation of tympanic membrane (TM) (otoscope used in evaluation of ears, nose, and mouth)
  
  A neurological examination is usually considered separate from the HEENT evaluation, although there can be some overlap in some cases.
  
  ## Sample write-up
  
  | Category | Item | Sample text |
  | - | - | - |
  | Head | | "NC/AT" or "Normocephalic, atraumatic" |
  | Eyes | ophthalmoscope | "EOM intact, PERRLA, anicteric, no injection, fundus WNL (within normal limits), no papilledema" |
  | Ears | otoscope | "TM intact, noninflamed" |
  | Nose | otoscope | "No congestion" |
  | Throat | otoscope | "Oropharynx WNL" or "no erythema or exudate" |
  | Mouth | otoscope | "Moist mucous membranes, no thrush, no vesicles, no lesions, good dentition" |
  | Neck | | "No LAD, thyroid WNL, neck supple" (JVD and bruit may be reported here or in CV) |
  