Lekcja 3: Badanie i Ocena Stanu Pacjenta | Patient Examination and Assessment

Vision Disorders

Examination and Diagnostic Tests

  1. Visual Acuity Testing
    • Description: Measures the clarity or sharpness of vision by having patients read letters from an eye chart at a standardized distance. Results are recorded as a fraction, such as 20/20. The test is performed monocularly and binocularly, and corrective lenses are used if necessary to assess the effectiveness of vision correction.
  2. Fundoscopic Examination
    • Description: Evaluates the health of the retina and optic nerve using an ophthalmoscope to visualize the retina, optic disc, macula, and blood vessels. Pupil dilation with mydriatic drops is often employed to enhance the view of retinal structures.
  3. Optical Coherence Tomography (OCT)
    • Description: Provides cross-sectional images of the retina using light waves. This test helps assess macular degeneration and retinal detachment by capturing detailed images of retinal layers.
  4. Visual Field Testing
    • Description: Assesses the full extent of a patient’s peripheral vision through automated or manual perimetry, where patients focus on a central point and respond to visual stimuli presented in their peripheral vision.
  5. Slit-Lamp Examination
    • Description: Examines the anterior segment of the eye, including the cornea, iris, and lens, using a slit lamp that provides a magnified view of these structures. The patient places their chin on a rest while the examiner uses the slit lamp to perform the examination.

Hearing Disorders

Examination and Diagnostic Tests

  1. Audiometry
    • Description: Measures hearing sensitivity and identifies hearing loss by having patients respond to sounds at various frequencies and volumes presented through headphones. Both air conduction and bone conduction tests are performed to determine the type and extent of hearing loss.
  2. Tympanometry
    • Description: Assesses middle ear function and eardrum mobility by measuring the response of the eardrum to changes in air pressure. A probe is inserted into the ear canal to record these changes.
  3. Otoscopy
    • Description: Visualizes the ear canal and tympanic membrane using an otoscope. The examiner gently pulls the ear to straighten the ear canal and inspects it for abnormalities.
  4. Auditory Brainstem Response (ABR)
    • Description: Evaluates the auditory nerve and brainstem function by recording electrical activity in response to sound stimuli using electrodes placed on the scalp. This test helps assess the auditory pathway from the ear to the brainstem.
  5. Electrocochleography (ECOG)
    • Description: Measures electrical potentials generated in the inner ear and auditory nerve by placing electrodes on the eardrum or near the cochlea. Electrical responses to sound stimuli are recorded to assess cochlear function.

Taste Disorders

Examination and Diagnostic Tests

  1. Taste Sensitivity Testing
    • Description: Evaluates the ability to detect and differentiate tastes by applying solutions with different concentrations of taste stimuli (e.g., sweet, salty, sour, bitter) to the tongue and recording the patient’s responses.
  2. Lick Test
    • Description: Assesses taste function by having patients lick a stick dipped in a taste solution. Responses are observed to determine taste perception.
  3. Salivary Flow Rate Measurement
    • Description: Evaluates the function of salivary glands by measuring the amount of saliva produced over a given period. This test can identify issues affecting taste perception.
  4. Endoscopic Examination
    • Description: Visualizes the oral cavity and pharynx to identify structural issues affecting taste using an endoscope inserted through the mouth to inspect the tongue, palate, and throat.
  5. Blood Tests
    • Description: Identifies nutritional deficiencies or systemic conditions affecting taste by analyzing blood samples for deficiencies in vitamins and minerals.

Touch Disorders

Examination and Diagnostic Tests

  1. Semmes-Weinstein Monofilament Test
    • Description: Assesses sensitivity to light touch and pressure by applying monofilaments of varying thickness to the skin and measuring the patient’s response to different levels of force.
  2. Two-Point Discrimination Test
    • Description: Measures the ability to distinguish between two close points of contact by applying two points simultaneously to the skin at varying distances and asking the patient whether they feel one or two points.
  3. Vibration Sensation Testing
    • Description: Evaluates the ability to sense vibration using a tuning fork to provide vibratory stimuli to the skin. The patient reports when the vibration is felt and when it disappears.
  4. Temperature Sensation Testing
    • Description: Assesses the ability to detect temperature changes by applying hot and cold stimuli to the skin and asking the patient to identify the sensations.
  5. Neurological Examination
    • Description: Provides a comprehensive assessment of sensory and motor functions by performing tests for reflexes, muscle strength, and coordination to detect neurological abnormalities.

Smell Disorders

Examination and Diagnostic Tests

  1. Olfactory Testing
    • Description: Evaluates the ability to detect and identify odors by exposing patients to different odorants and asking them to identify them. Odorants are presented to one nostril at a time.
  2. Sniffin’ Sticks Test
    • Description: Measures the sense of smell using standardized odor-dispensing pens. Patients sniff pens with different odors and identify them in a randomized order.
  3. Rhinomanometry
    • Description: Assesses nasal airflow and resistance by measuring the flow of air through the nasal passages to evaluate airflow resistance.
  4. Endoscopic Examination
    • Description: Visualizes the nasal cavity and olfactory structures using an endoscope inserted through the nostrils to inspect the nasal and olfactory regions for abnormalities.
  5. CT or MRI of the Sinuses
    • Description: Identifies structural abnormalities affecting the sense of smell by providing detailed images of the sinuses and nasal cavity through CT or MRI scans.