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PHYSICAL EXAM
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GENERAL EXAM
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Appearance
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Head/Face Skin Inspection
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Facial Nerve
• • •
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Cranial Nerves
• • •
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Respiratory Effort
• • •
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Cranial Nerve Abnormality
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Voice Quality
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Additional findings
• • •
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EARS
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External Ears
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Canals
• • •
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TM's
• • •
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Middle Ear
• • •
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Other Ear Finding(s)
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Hearing
• • •
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Vestibular Exam
• • •
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Other Vestibular Abnormality
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NOSE
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External Nose
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Turbinates
• • •
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Anterior Rhinoscopy
• • •
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Septum
• • •
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Additional Findings Nose
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THROAT
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Mouth
• • •
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Mouth Abnormal Finding(s)
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Tongue
• • •
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Tongue Abnormal Finding(s)
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Tonsils
• • •
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Tonsil(s) Abnormal Finding(s)
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Palate
• • •
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Palate Abnormal Finding(s)
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Throat
• • •
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Throat Abnormal Finding(s)
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OTHER:
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Mirror Laryngoscopy
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Larynx
• • •
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Hypopharynx
• • •
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NECK
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Neck
• • •
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Thyroid
• • •
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Adenopathy
• • •
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Salivary Glands
• • •
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Parotid - Abnormal Description
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Submandibular Gland - Abnormal Description
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OTHER:
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ANTERIOR CHEST WALL
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ANTERIOR CHEST WALL FINDINGS:
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ENDOSCOPY:
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Diagnostic Nasal Endoscopy
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R Inf. Turb
• • •
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L Inf. Turb
• • •
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Mid Turb
• • •
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OTHER:
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Right middle meatus
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Left middle meatus
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% Occlusion - Right
• • •
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% Occlusion - Left
• • •
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Diagnostic Nasopharyngoscopy
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Eustachian Tubes
• • •
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Eustachian Tubes - Abnormal Description
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Nasopharynx
• • •
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Nasopharynx - Abnormal Description
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Diagnostic Laryngoscopy
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Right Vocal Cord
• • •
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Right Vocal Cord Abnormal Finding(s)
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Left Vocal Cord
• • •
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Left Vocal Cord Abnormal Finding(s)
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Epiglottis
• • •
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Epiglottis Abnormal Finding(s)
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Post-Glottic Finding(s)
• • •
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Supraglottic findings
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Other Pertinent Finding(s)
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PROCEDURE(S):
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CERUMENECTOMY
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Cerumenectomy (w/ Audiogram - Medicare)
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MASTOID CAVITY DEBRIDEMENT (RIGHT)
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MASTOID CAVITY DEBRIDEMENT (LEFT)
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BINOCULAR MICROSCOPY
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Myringotomy with tube (Right)
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Myringotomy with tube (Left)
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RIGHT EAR FB REMOVAL
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LEFT EAR FB REMOVAL
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RIGHT EAR TRANSTYMPANIC STEROID
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LEFT EAR TRANSTYMPANIC STEROID
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EPISTAXIS CONTROL (simple)
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EPISTAXIS CONTROL (complex)
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EPISTAXIS CONTROL (w/ endoscopic assistance)
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Needle aspiration peritonsillar abscess (no pus obtained)
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I&D peritonsillar abscess (pus obtained)
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LINGUAL FRENULOTOMY
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UPPER LIP FRENULOTOMY
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AUDIOGRAM
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