ENT Exam

[checkbox memo="Short Version" name="short" value="ENT: Ear canals and tympanic membranes are clear, and hearing is grossly intact. Nose reveals no obstruction or discharge. Oropharynx reveals no inflammation, swelling, exudate or lesion. Lips, teeth and gums are in good general condition."][conditional field="short" condition="(short).is('')"][textarea cols=80 rows=5 default=""][/conditional][checkbox memo="Long Version" name="long" value=""][conditional field="long" condition="(long).is('')"][text default="EARS:"]
[textarea cols=80 rows=5 default="Right ear: ***tympanic membrane is gray, non-bulging and freely mobile/tympanic membrane is erythematous, bulging and non-mobile/tympanic membrane is erythematous, but is non-bulging and is mobile/tympanic membrane is gray, with air-fluid levels behind it/tympanic membrane is perforated/tympanic membrane has a patent PE tube with no drainage/tympanic membrane has a patent PE tube with purulent drainage/external canal is erythematous/external canal is swollen/cerumen impaction/foreign body in ear canal***"]
[textarea cols=80 rows=5 default="Left ear: ***tympanic membrane is gray, non-bulging and freely mobile/tympanic membrane is erythematous, bulging and non-mobile/tympanic membrane is erythematous, but is non-bulging and is mobile/tympanic membrane is gray, with air fluid levels behind it/tympanic membrane is perforated/tympanic membrane has a patent PE tube with no drainage/tympanic membrane has a patent PE tube with purulent drainage/external canal is erythematous/external canal is swollen/cerumen impaction/foreign body in ear canal***"]
[textarea cols=80 rows=5 default="NOSE: ***nares patent bilaterally/pale, boggy anterior turbinates/epistaxis/rhinorrhea/purulent discharge/sinus tenderness/deviated nasal septum***"]
[textarea cols=80 rows=5 default="THROAT: ***lips, teeth, and gums are in good general condition/posterior oropharynx has no erythema, exudate, lesions, or cobblestoning/posterior oropharynx is erythematous without exudate or lesions/posterior oropharynx is erythematous with white exudate/posterior oropharynx has clear drainage and cobblestoning/tonsillar pillars are 1+/tonsillar pillars are 2+/tonsillar pillars are 3+/tonsillar pillars are covered with exudate/tonsils are cryptic/tonsils are surgically absent***"][/conditional]
Short Version Long Version

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Sandbox Metrics: Structured Data Index 0.25, 10 form elements, 1 text boxes, 5 text areas, 2 checkboxes, 2 conditionals, 8 total clicks
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