Sensory Assessment Worksheet (Student) – Eyes and Ears - Including Cranial Nerves lll, lV, Vl & Vlll – *See “Cranial Nerves Chart” Word Doc*
Skill Pg How to perform assessment Expected Finding What does this tell me about my patient?
Inspection 293 -symmetry of the face especially the - if eyeballs protrude could be thyroid problems, an
External ocular eyes eye injury, or an eye tumor.
-eyebrows should be symmetrical, raise -if sclera is yellow indicates Jaundice=liver disease
General up and down at the same time when the (high bilirubin levels) (patient might also have ascites
Eyelids and Lashes patient is talking and making expressions with a very large protruding abdomen and lots of
Palpebral fissure -eyelids and lashes should be veins)
symmetrical, including palpebral -ectropian: more common in elderly due to loss of
CN lll (3) - fissure(distance between upper and collagen tissue, upper eyelid sags so you can’t see it,
Oculomotor lower lids), should be even. can see lower lid (also sags) and conjunctiva seen. If
-top eyelid covers the iris just a little bit, patient closes eye there would still be an area of the
Motor - opening of
whereas the bottom eyelid goes just to eye that would be open and at risk for dust, dirt,
eyelids the lower part of the limbus over drying, because they eyelid can’t close very well
-eyeballs should not protrude (may need eyedrops, may complain of dry or itchy
-sclera should be white eyes).
Eyebrows
-melanosis: ethnic variation in sclera -entropian: the lower eyelid turns/sags inward, and
Eyeballs (doesn’t impact vision), may be a little the lashes on the lower lid are constantly brushing
Conjunctiva, Sclera brown, dark red, or grey color splotch in against the eyeball (either at cornea or sclera), can
sclera (expected in patients with dark cause scratches on eyelid (can cause eye trauma
colored skin) over time).
-ptosis: (CN 3 deficit) distance between the upper
and lower eyelid is greater on one side than the
other (more common in older patients) (left eyelid
cant hold itself up)
PERRLA 295 PER: (pupils round and equal) -pupils are round and equal in size -unequal pupils could be a neurological disease or
CN lll (3) - Inspect in a regularly lit room, see -pupil size expected: 3-5mm trauma to the pupil or could be born like that.
Oculomotor that patients pupils are the same -pupils constrict consensually with light -glaucoma: clouding of the lens
Parasympathetic - size bilaterally by measuring with bilaterally (should be brisk) -laceration: from injury causing pupil not to be round
pupil constriction
pen light -pupils dilate when looking far away, -if sluggish, or pupils didn’t constrict, then there’s a
Pupils
Equal and constrict when looking close up neurological problem caused by brain injury or
Round RL: (react to light) two pen swipes -pupils dilate and diverge when looking medication, or perhaps some street drugs.
to each eye. The room is dim. in distance
R - pupillary light Shine light around temple area Pupils constrict and converge when
reflex(react) across patients eye (not directly in looking close up
L -consensual & direct? eye) (called direct light reflex).
(light)
Shine second time across eye, but
, A - (3Ds & 3 Cs) look at other eye for constriction.
(accommodation) Do for both sides (4 total swipes)
How do opioids ** make sure to remove glasses
Skill Pg How to perform assessment Expected Finding What does this tell me about my patient?
Inspection 293 -symmetry of the face especially the - if eyeballs protrude could be thyroid problems, an
External ocular eyes eye injury, or an eye tumor.
-eyebrows should be symmetrical, raise -if sclera is yellow indicates Jaundice=liver disease
General up and down at the same time when the (high bilirubin levels) (patient might also have ascites
Eyelids and Lashes patient is talking and making expressions with a very large protruding abdomen and lots of
Palpebral fissure -eyelids and lashes should be veins)
symmetrical, including palpebral -ectropian: more common in elderly due to loss of
CN lll (3) - fissure(distance between upper and collagen tissue, upper eyelid sags so you can’t see it,
Oculomotor lower lids), should be even. can see lower lid (also sags) and conjunctiva seen. If
-top eyelid covers the iris just a little bit, patient closes eye there would still be an area of the
Motor - opening of
whereas the bottom eyelid goes just to eye that would be open and at risk for dust, dirt,
eyelids the lower part of the limbus over drying, because they eyelid can’t close very well
-eyeballs should not protrude (may need eyedrops, may complain of dry or itchy
-sclera should be white eyes).
Eyebrows
-melanosis: ethnic variation in sclera -entropian: the lower eyelid turns/sags inward, and
Eyeballs (doesn’t impact vision), may be a little the lashes on the lower lid are constantly brushing
Conjunctiva, Sclera brown, dark red, or grey color splotch in against the eyeball (either at cornea or sclera), can
sclera (expected in patients with dark cause scratches on eyelid (can cause eye trauma
colored skin) over time).
-ptosis: (CN 3 deficit) distance between the upper
and lower eyelid is greater on one side than the
other (more common in older patients) (left eyelid
cant hold itself up)
PERRLA 295 PER: (pupils round and equal) -pupils are round and equal in size -unequal pupils could be a neurological disease or
CN lll (3) - Inspect in a regularly lit room, see -pupil size expected: 3-5mm trauma to the pupil or could be born like that.
Oculomotor that patients pupils are the same -pupils constrict consensually with light -glaucoma: clouding of the lens
Parasympathetic - size bilaterally by measuring with bilaterally (should be brisk) -laceration: from injury causing pupil not to be round
pupil constriction
pen light -pupils dilate when looking far away, -if sluggish, or pupils didn’t constrict, then there’s a
Pupils
Equal and constrict when looking close up neurological problem caused by brain injury or
Round RL: (react to light) two pen swipes -pupils dilate and diverge when looking medication, or perhaps some street drugs.
to each eye. The room is dim. in distance
R - pupillary light Shine light around temple area Pupils constrict and converge when
reflex(react) across patients eye (not directly in looking close up
L -consensual & direct? eye) (called direct light reflex).
(light)
Shine second time across eye, but
, A - (3Ds & 3 Cs) look at other eye for constriction.
(accommodation) Do for both sides (4 total swipes)
How do opioids ** make sure to remove glasses
