Epistaxis physical examination: Difference between revisions

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{{Epistaxis}}
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'''Editor in Chief''': [[User:Ludi|Liudvikas Jagminas, M.D., FACEP]] [mailto:LJagminas@mhri.org] Phone: 401-729-2419
 
== Physical Examination ==
'''Editor in Chief''':''':''' [[User:C Michael Gibson|C. Michael Gibson, M.S., M.D.]] , {{AE}} [[User:Amir Bagheri|Amir Behzad Bagheri, M.D.]
===Ear Nose and Throat (ENT)===
 
* Evidence of setpal perforation
==Overview==
* Washing area may increase visibility
[[Patients]] with [[epistaxis]] are usually well-appearing. [[Physical examination]] of [[patients]] with [[epistaxis]] is usually remarkable for [[bleeding]] from [[nostrils]] and [[posterior]] [[nose]] [[bleeding]].
* Blood in mouth (without obvious nasal bleed) indicative of a posterior bleed
 
==Physical Examination==
[[Physical examination]] of [[patients]] with [[epistaxis]] is usually remarkable for [[bleeding]] from [[nostrils]] and [[posterior]] [[nose]] [[bleeding]].<ref name="BeckSorge2018">{{cite journal|last1=Beck|first1=Rafael|last2=Sorge|first2=Martin|last3=Schneider|first3=Antonius|last4=Dietz|first4=Andreas|title=Current Approaches to Epistaxis Treatment in Primary and Secondary Care|journal=Deutsches Aerzteblatt Online|year=2018|issn=1866-0452|doi=10.3238/arztebl.2018.0012}}</ref> <ref name="El-DaroutiAl-Ali2019">{{cite journal|last1=El-Darouti|first1=Mohammad Ali|last2=Al-Ali|first2=Faiza Mohamed|title=Epistaxis with Vascular Papules of Skin and Mouth|year=2019|pages=479–483|doi=10.1007/978-3-030-21855-3_63}}</ref> <ref name="KrulewitzFix2019">{{cite journal|last1=Krulewitz|first1=Neil Alexander|last2=Fix|first2=Megan Leigh|title=Epistaxis|journal=Emergency Medicine Clinics of North America|volume=37|issue=1|year=2019|pages=29–39|issn=07338627|doi=10.1016/j.emc.2018.09.005}}</ref> <ref name="TunkelAnne2020">{{cite journal|last1=Tunkel|first1=David E.|last2=Anne|first2=Samantha|last3=Payne|first3=Spencer C.|last4=Ishman|first4=Stacey L.|last5=Rosenfeld|first5=Richard M.|last6=Abramson|first6=Peter J.|last7=Alikhaani|first7=Jacqueline D.|last8=Benoit|first8=Margo McKenna|last9=Bercovitz|first9=Rachel S.|last10=Brown|first10=Michael D.|last11=Chernobilsky|first11=Boris|last12=Feldstein|first12=David A.|last13=Hackell|first13=Jesse M.|last14=Holbrook|first14=Eric H.|last15=Holdsworth|first15=Sarah M.|last16=Lin|first16=Kenneth W.|last17=Lind|first17=Meredith Merz|last18=Poetker|first18=David M.|last19=Riley|first19=Charles A.|last20=Schneider|first20=John S.|last21=Seidman|first21=Michael D.|last22=Vadlamudi|first22=Venu|last23=Valdez|first23=Tulio A.|last24=Nnacheta|first24=Lorraine C.|last25=Monjur|first25=Taskin M.|title=Clinical Practice Guideline: Nosebleed (Epistaxis)|journal=Otolaryngology–Head and Neck Surgery|volume=162|issue=1_suppl|year=2020|pages=S1–S38|issn=0194-5998|doi=10.1177/0194599819890327}}</ref>
===Appearance of the Patient===
[[Patients]] with [[epistaxis]] are usually well-appearing.
 
==='''Vital Signs'''===
Vital signs in [[patients]] with [[epistaxis]] are usually normal.
 
In heavy [[epistaxis]] [[patients]] may have [[hypotension]] and [[tachycardia]] due to [[hypovolemia]].
 
===Skin===
[[Patients]] with [[epistaxis]] may have vascular malformation.
 
===HEENT===
 
*[[Septal perforation]]
 
*Evidence of [[trauma]] such as nasal deformity
 
*[[Foreign body]]
 
*Discoloration of [[Mucous membrane|mucosa]]
 
*Active [[bleeding]] [[vessel]]
 
===Lungs===
Lungs examination in [[Patient|patients]] with [[epistaxis]] is usually normal.
 
===Abdomen===
[[Abdomen]] examination in [[Patient|patients]] with [[epistaxis]] is usually normal.
 
===Back===
[[Human back|Back]] examination in [[Patient|patients]] with [[epistaxis]] is usually normal.
 
===Genitourinary===
[[Genitourinary system|Genitourinary]] examination in [[Patient|patients]] with [[epistaxis]] is usually normal.
 
===Neuromuscular===
[[Neuromuscular]] examination of [[Patient|patients]] with [[epistaxis]] is usually normal.
 
===Extremities===
[[Extremities]] examination of [[Patient|patients]] with [[epistaxis]] is usually normal.


==References==
==References==
{{Reflist|2}}
{{Reflist|2}}
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[[Category:Rhinology]]
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Latest revision as of 20:48, 11 January 2021

Epistaxis Microchapters

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Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Epistaxis from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

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Electrocardiogram

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Editor in Chief:: C. Michael Gibson, M.S., M.D. , Associate Editor(s)-in-Chief: Amir Behzad Bagheri, M.D.

Overview

Patients with epistaxis are usually well-appearing. Physical examination of patients with epistaxis is usually remarkable for bleeding from nostrils and posterior nose bleeding.

Physical Examination

Physical examination of patients with epistaxis is usually remarkable for bleeding from nostrils and posterior nose bleeding.[1] [2] [3] [4]

Appearance of the Patient

Patients with epistaxis are usually well-appearing.

Vital Signs

Vital signs in patients with epistaxis are usually normal.

In heavy epistaxis patients may have hypotension and tachycardia due to hypovolemia.

Skin

Patients with epistaxis may have vascular malformation.

HEENT

  • Evidence of trauma such as nasal deformity

Lungs

Lungs examination in patients with epistaxis is usually normal.

Abdomen

Abdomen examination in patients with epistaxis is usually normal.

Back

Back examination in patients with epistaxis is usually normal.

Genitourinary

Genitourinary examination in patients with epistaxis is usually normal.

Neuromuscular

Neuromuscular examination of patients with epistaxis is usually normal.

Extremities

Extremities examination of patients with epistaxis is usually normal.

References

  1. Beck, Rafael; Sorge, Martin; Schneider, Antonius; Dietz, Andreas (2018). "Current Approaches to Epistaxis Treatment in Primary and Secondary Care". Deutsches Aerzteblatt Online. doi:10.3238/arztebl.2018.0012. ISSN 1866-0452.
  2. El-Darouti, Mohammad Ali; Al-Ali, Faiza Mohamed (2019). "Epistaxis with Vascular Papules of Skin and Mouth": 479–483. doi:10.1007/978-3-030-21855-3_63.
  3. Krulewitz, Neil Alexander; Fix, Megan Leigh (2019). "Epistaxis". Emergency Medicine Clinics of North America. 37 (1): 29–39. doi:10.1016/j.emc.2018.09.005. ISSN 0733-8627.
  4. Tunkel, David E.; Anne, Samantha; Payne, Spencer C.; Ishman, Stacey L.; Rosenfeld, Richard M.; Abramson, Peter J.; Alikhaani, Jacqueline D.; Benoit, Margo McKenna; Bercovitz, Rachel S.; Brown, Michael D.; Chernobilsky, Boris; Feldstein, David A.; Hackell, Jesse M.; Holbrook, Eric H.; Holdsworth, Sarah M.; Lin, Kenneth W.; Lind, Meredith Merz; Poetker, David M.; Riley, Charles A.; Schneider, John S.; Seidman, Michael D.; Vadlamudi, Venu; Valdez, Tulio A.; Nnacheta, Lorraine C.; Monjur, Taskin M. (2020). "Clinical Practice Guideline: Nosebleed (Epistaxis)". Otolaryngology–Head and Neck Surgery. 162 (1_suppl): S1–S38. doi:10.1177/0194599819890327. ISSN 0194-5998.

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