ENT & Ophthalmology Elective

Selective director - Otorhinolaryngology:

Name: Carol MacArthur, MD

Email: macarthc@ohsu.edu

Selective director - Ophthalmology:

Name: Leah Reznick, MD

Email: reznickl@ohsu.edu

pager: 14752

phone: 503-494-5631 (Kathleen Bartell, administrative assistant)

Selective duration:

1 week for each

Selective objectives:

Otorhinolaryngology

1. Describe an optimal means of holding the child and the optimal equipment necessary for visualization of the TM in an infant, including type of speculum, light source, and use of the bulb to observe for TM mobility.

2. Describe an optimal means of holding the child and the optimal equipment necessary for visualization of the TM in an infant, including type of speculum, light source, and use of the bulb to observe for TM mobility.

3. Demonstrate correct interpretation of the tympanogram for a child with: AOM, middle ear effusion, obstruction of the ear canal, ossicular disruption, and perforation of the TM.

4. Describe the generally accepted criteria for insertion of pressure equalizing tubes (PET) in children.

5. Screen for tonsillar and adenoidal hypertrophy at health maintenance visits, using information from the physical examination and history

6. Recognize the clinical findings associated with cholesteatoma

7. Understand the indications for PET placement and potential complications

8. Recognize clinical findings associate with nasal or otic foreign body and techniques for removal by general pediatrician vs. referral to otorhinolaryngology.

9. Understand the causes of noisy breathing in children, including the difference between stridor and stertor, and be able to take a good history in children with airway concerns.

10. Know how to assess respiratory distress in children, and understand the role and limitations of bedside laryngoscopy in evaluation.

11. Be able to generate a differential diagnosis for neck masses in children.

Ophthalmology

1. Practice and master basic evaluation of ocular function.

a. Vision Evaluation

i. Infant to 3 years of age – 15 patients

ii. 3-6 years of age (subjective visual acuity) – 15 patients

b. Pupillary Exam – 15 patients

c. Strabismus Evaluation

i. Corneal Light Reflex – 20 patients

ii. Cover Testing – 20 patients

iii. Ductions/Versions – 20 patients

d. Red Reflex Testing – 20 patients

e. Ophthalmoscopy – 20 patients

2. Identify and discuss patients with the following clinical diagnoses:

a. Amblyopia

b. Refractive Errors

c. Strabismus

i. Pseudostrabismus

ii. Esotropia

iii.Exotropia

iv. Cranial Nerve Deficits

d. Ptosis

e. Cataract

f. Nasolacrimal Duct Obstruction

g. Pediatric Glaucoma

h. Nystagmus

i. Papilledema

Selective overview:

This selective has been put together to provide basic skills in pediatric otoscopic and ophthalmoscopic examination of children. In addition, common problems and diagnoses will be evaluated.

Resident expectations on selective:

1. On time appearance for clinical duties

2. Presence in the operating room may be required to optimize physical examination

Selective schedule:

• • On the first day of the ORL portion of your rotation, please ***

  • On the first day of the ophthalmology portion of your rotation, please ***