Question

each assessment, please be sure to name the instruments that would be used in the process.

1. Head, Face, and Neck, including Regional Lymphatics

Describe in brief the assessment of the head in a 27 year-old male patient; include one usual abnormal finding

2. Eyes & Ears

How to assess the ears of a 2 year-old boy; include one usual abnormal finding

3. Nose, Mouth, and Throat

How to assess the mouth of an 80 year-old patient with complaint of “I cannot eat, it hurts” (not a swallowing problem); include one usual abnormal finding

Answer 1

1. Head and Face

-Inspect and palpate the head and scalp

-Inspect the hair; color, distribution, infestations

-Palpate the hair for texture and scalp for texture, lesions and masses

-Inspect face: expression, skin color, lesions, shape/posture

-If Indicated: Face (CN V), assess superficial pain (sharp and dull), assess two-point discrimination

Symmetry (CN VII)

-Eyes, eyebrows, ears, nose and mouth

-Instruct client to raise eyebrows, from, smile, wrinkle forehead, show teeth, purse lips, puff cheeks, and if indicated whistle

If Indicated: Palpate the temporal pulses

Palpate the temporomadibular joints (CN V)

Abnormal finding - patchy round dryness and hair loss

2. Ears

The ear canal in infants and young children is shorter, wider, and more horizontally positioned than in older children. To adequately examine the tympanic membrane in young children. the pinna must be pulled back and down. In older children and adults, the pinna is pulled up and back. The pinna is not held in its normal position, and the child is not positioned prone.

Abnormal finding - a hole in tympanic membrane

3. Mouth and Throat

-Ask pt about appetite, indigestion, and difficulty with chewing or swallowing. Observe difficulty with chewing and for sign of aspiration (coughing after drinking liquids)

-Inspect teeth; note teeth missing and oral care

-Inspect mucous membranes and tongue; ask pt to stick tongue out (CN XII)

-If Indicated: inspect the uvula; note movement when pt says aah

-Inspect sputum if indicated

Abnormal finding - candidias present