1
COMPREHENSIVE HEAD TO TOE EXAM
-dress, posture, grooming, hygiene
-stature, build
-nutritional state
aspects of appearance
-degree of cooperativeness
and behavior to comment
-state of distress
on
-affect
-eye contact
-motor activity
aspects of mood to congruence with situation and aspect
comment on
-contour
aspects of the skull, scalp, -lesions
and hair to comment on -hair
-tenderness
instruct patient to:
-frown
-elevate forehead/raise eyebrows
CN VII (Facial) test -clench and show teeth
-smile
-puff and blow out cheeks
-close eyes firmly (try to open against resistance)
,2
-place hands on patient's cheek's and temples
-instructs patient to contract and relax masseter
CN V (trigeminal) test -
muscles by clenching teeth
motor
-tests strength by pushing down on the mandible against
resistance
, 3
-instructs patient to close eyes and say "now" when
CN V (trigeminal) test - feeling cotton touch their face
sensory -use a light wisp of cotton over 3 nerve distributions
bilaterally
-distribution of eyebrows
-orbital edema, sagging tissue, lesions, nodules
aspects of the eyebrows,
-ptosis
orbital areas, and eyelids
-completeness of lid closure
to comment on
-erythema
-discharge/tearing
aspects of the bulbar and -color
palpebral conjunctivae -edema
and sclerae to comment
on
aspects of the lacrimal -edema
glands/sac to comment -tenderness
on
-instructs patient to focus on a far fixed point, then on a
near fixed point; observes pupillary response
CN II, III (optic, -inspects B/L eyes with pen light; observes pupillary
oculomotor) test response
-performs swinging light test; observes pupillary
response
-corneal clarity
aspects to comment on -pupillary size and shape
after CN II, III test -pupillary reflex, direct, consensual, and afferent
accommodation
COMPREHENSIVE HEAD TO TOE EXAM
-dress, posture, grooming, hygiene
-stature, build
-nutritional state
aspects of appearance
-degree of cooperativeness
and behavior to comment
-state of distress
on
-affect
-eye contact
-motor activity
aspects of mood to congruence with situation and aspect
comment on
-contour
aspects of the skull, scalp, -lesions
and hair to comment on -hair
-tenderness
instruct patient to:
-frown
-elevate forehead/raise eyebrows
CN VII (Facial) test -clench and show teeth
-smile
-puff and blow out cheeks
-close eyes firmly (try to open against resistance)
,2
-place hands on patient's cheek's and temples
-instructs patient to contract and relax masseter
CN V (trigeminal) test -
muscles by clenching teeth
motor
-tests strength by pushing down on the mandible against
resistance
, 3
-instructs patient to close eyes and say "now" when
CN V (trigeminal) test - feeling cotton touch their face
sensory -use a light wisp of cotton over 3 nerve distributions
bilaterally
-distribution of eyebrows
-orbital edema, sagging tissue, lesions, nodules
aspects of the eyebrows,
-ptosis
orbital areas, and eyelids
-completeness of lid closure
to comment on
-erythema
-discharge/tearing
aspects of the bulbar and -color
palpebral conjunctivae -edema
and sclerae to comment
on
aspects of the lacrimal -edema
glands/sac to comment -tenderness
on
-instructs patient to focus on a far fixed point, then on a
near fixed point; observes pupillary response
CN II, III (optic, -inspects B/L eyes with pen light; observes pupillary
oculomotor) test response
-performs swinging light test; observes pupillary
response
-corneal clarity
aspects to comment on -pupillary size and shape
after CN II, III test -pupillary reflex, direct, consensual, and afferent
accommodation
