Nose Examination
Objective
To visualize the floor medial and lateral walls of nasal cavity.
The examination of nose comprises of:
• External examination
• Anterior rhinoscopy, and
• Posterior rhinoscopy.
Position
Sitting.
Procedure
It is used to examine the anterior part of nasal cavity (Anterior rhinoscopy):
1. The thudichum nasal speculum is held in left hand.
2. The light beam reflected from the head mirror is directed on to the patient’s nostril.
3. The speculum is closed and gently introduced into the patient’s nostril.
4. The spring is allowed to open a little to observe the anterior part of:
• Floor of nasal cavity
• Nasal septum and
• Lateral wall of nasal cavity (Middle and inferior turbinates and meati).
Posterior Rhinoscopy
1. A posterior rhinoscopy mirror and a tongue depressor are needed for this examination.
2. The mirror is heated gently to avoid fogging and the temperature is tested on the back of the hand before introducing it into the mouth of the patient.
3. Patient is asked to open his mouth and the tongue is depressed sideways using Lack’s spatula.
4. The warmed mirror is passed behind the uvula without touching it and is turned upwards and forwards behind palate into the nasopharynx.
5. The light is focussed onto the mirror and can be reflected from there onto the structures to be visualized.
6. Care is taken not to touch the posterior pharyngeal wall at any time, as it induces gagging.
7. The posterior free part of nasal septum and posterior nasal apertures, lower two turbinates and meati are observed for any pathology.
8. The eustachian tube opening and adenoids are also visualized.
Instruments
• Thudichum’s nasal speculum
• St. Clair Thomson nasal speculum
• Posterior rhinoscopy mirror
Any questions be sent to drmmkapur@gmail.com
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