NR 509 Physical exam rubric and transcript to memorize
NR 509 Physical Examination Grading Rubric
Grades are awarded as follows:
2 = Demonstrated thoroughly with correct
technique 1 = Demonstrated Partially
0 = Did not demonstrate
*A head to toe (cephalo-caudal), and anterior-posterior approach should be used when conducting the
exam. No deductions given for exam steps out of order. Students should verbalize each exam step
and
must identify cranial nerves by name and number.
# 1. Introduce myself to the patient. Have patient sit up
HEAD AND FACE
Inspects facial skin – note abnormal lesions. 2 1 0
I will begin by inspecting the face and there are no discolorations or
lesions.
Inspect head for size, symmetry, midline position. 2 1 0
Head is normal size, symmetrical and in the midline position.
Palpates lymph nodes of the head and neck: 2 1 0
I will start off by checking the preauricular lymph nodes, postauricular
lymph nodes, occipital lymph nodes, tonsillar lymph nodes,
submandibular lymph nodes, submental lymph nodes, anterior cervical
lymph nodes, posterior cervical lymph nodes, and supraclavicular
lymph nodes.
CN #5 (Trigeminal nerve) 2 1 0
Cranial nerve number 5 is the trigeminal nerve, and I will check the Motor
component and have the patient clench his jaw (palpate over the
masseter muscle as patient clenches jaw)
Next is the sensory component of the cranial nerve number 5. I will ask the
patient to close his eyes and touch the face in areas and have the patient
identify where I am touching (forehead, cheeks, chin, nose…patient identifies
where they are being touched)
CN 7 (Facial) 2 1 0
Next, I will inspect cranial nerve number 7 and assess for facial symmetry.
I will ask the patient to smile, frown, raise eyebrows, puff cheeks, and
pucker lips. Pt can perform all tasks.
, NR 509 Physical exam rubric and transcript to memorize
EAR
Inspection of the outer Ears. 2 1 0
Now I will inspect outer ear for skin lesions and symmetry. The ears are
symmetrical, and no lesions are seen.
Inspect auditory canal and TM using otoscope. 2 1 0
Next, I will use the otoscope to inspect the auditory canal and Tympanic
Membrane. I will pull up and back, the external auditory canal is free of
swelling or redness, or drainage. The tympanic membrane is pearly grey
with no effusion. Cerumen is seen. And now I will do the same for the
other ear.
Palpate pinnae and Tragus for nodules or tenderness. 2 1 0
I will now palpate the pinnae and tragus for nodules and tenderness.
No nodules, do you feel any tenderness?
CN 8 (Acoustic nerve) 2 1 0
Cranial nerve number 8 is the acoustic nerve, and I will assess this
nerve by doing a Whisper Test on both the left and right ear
separately. (Whisper words 1, 2, and 3 on the left and 4, 5, 6 on the right…
out of patient’s sight, and patient repeats words back) Test one ear at a time.
EYE
Inspection of the eyes 2 1 0
It is now time to inspect the eyes, I see the sclera is white and
conjunctiva is pink and moist. No lesions and they eyes are
symmetrical.
CN 2 (Optic) 2 1 0
Cranial nerve number 2 is the optic nerve, and I will assess gross visual
acuity and peripheral/central vision. I will use the Snellen chart and
have the patient cover one eye at a time and call out the first line and
then use both eyes to check vision.
The patient has 2020 vision bilaterally.
I will now check for pupillary response to light which is also cranial
nerve #2 and I will ask the patient to tell me when he sees my hands on
the side of his head, above his head and below his head.
CN 2 (Optic). Check pupillary response to light [PERRL] 2 1 0
Using the pen light, I will check the pupillary response to light. Pupils
are equal, round, and reactive to light.
CN 3, 4, 6 (Oculomotor, Trochlear, Abducens). Test for conjugate gaze with EOM 2 1 0
NR 509 Physical Examination Grading Rubric
Grades are awarded as follows:
2 = Demonstrated thoroughly with correct
technique 1 = Demonstrated Partially
0 = Did not demonstrate
*A head to toe (cephalo-caudal), and anterior-posterior approach should be used when conducting the
exam. No deductions given for exam steps out of order. Students should verbalize each exam step
and
must identify cranial nerves by name and number.
# 1. Introduce myself to the patient. Have patient sit up
HEAD AND FACE
Inspects facial skin – note abnormal lesions. 2 1 0
I will begin by inspecting the face and there are no discolorations or
lesions.
Inspect head for size, symmetry, midline position. 2 1 0
Head is normal size, symmetrical and in the midline position.
Palpates lymph nodes of the head and neck: 2 1 0
I will start off by checking the preauricular lymph nodes, postauricular
lymph nodes, occipital lymph nodes, tonsillar lymph nodes,
submandibular lymph nodes, submental lymph nodes, anterior cervical
lymph nodes, posterior cervical lymph nodes, and supraclavicular
lymph nodes.
CN #5 (Trigeminal nerve) 2 1 0
Cranial nerve number 5 is the trigeminal nerve, and I will check the Motor
component and have the patient clench his jaw (palpate over the
masseter muscle as patient clenches jaw)
Next is the sensory component of the cranial nerve number 5. I will ask the
patient to close his eyes and touch the face in areas and have the patient
identify where I am touching (forehead, cheeks, chin, nose…patient identifies
where they are being touched)
CN 7 (Facial) 2 1 0
Next, I will inspect cranial nerve number 7 and assess for facial symmetry.
I will ask the patient to smile, frown, raise eyebrows, puff cheeks, and
pucker lips. Pt can perform all tasks.
, NR 509 Physical exam rubric and transcript to memorize
EAR
Inspection of the outer Ears. 2 1 0
Now I will inspect outer ear for skin lesions and symmetry. The ears are
symmetrical, and no lesions are seen.
Inspect auditory canal and TM using otoscope. 2 1 0
Next, I will use the otoscope to inspect the auditory canal and Tympanic
Membrane. I will pull up and back, the external auditory canal is free of
swelling or redness, or drainage. The tympanic membrane is pearly grey
with no effusion. Cerumen is seen. And now I will do the same for the
other ear.
Palpate pinnae and Tragus for nodules or tenderness. 2 1 0
I will now palpate the pinnae and tragus for nodules and tenderness.
No nodules, do you feel any tenderness?
CN 8 (Acoustic nerve) 2 1 0
Cranial nerve number 8 is the acoustic nerve, and I will assess this
nerve by doing a Whisper Test on both the left and right ear
separately. (Whisper words 1, 2, and 3 on the left and 4, 5, 6 on the right…
out of patient’s sight, and patient repeats words back) Test one ear at a time.
EYE
Inspection of the eyes 2 1 0
It is now time to inspect the eyes, I see the sclera is white and
conjunctiva is pink and moist. No lesions and they eyes are
symmetrical.
CN 2 (Optic) 2 1 0
Cranial nerve number 2 is the optic nerve, and I will assess gross visual
acuity and peripheral/central vision. I will use the Snellen chart and
have the patient cover one eye at a time and call out the first line and
then use both eyes to check vision.
The patient has 2020 vision bilaterally.
I will now check for pupillary response to light which is also cranial
nerve #2 and I will ask the patient to tell me when he sees my hands on
the side of his head, above his head and below his head.
CN 2 (Optic). Check pupillary response to light [PERRL] 2 1 0
Using the pen light, I will check the pupillary response to light. Pupils
are equal, round, and reactive to light.
CN 3, 4, 6 (Oculomotor, Trochlear, Abducens). Test for conjugate gaze with EOM 2 1 0
