Physical Examination
1. Start with a 360-degree room scan
2. Hello! My name is Allyson Pannell, and this is my physical
examination assignment for NR 509. I am not using any aids/ notes/
assistive devices to complete this assignment
3. "My name is Matthew Hansen and I permit this examination to be recorded and
submitted to Chamberlain College of Nursing for grading purposes
Head and Face
1. Inspect head and facial skin for size, symmetry, midline position – note abnormal lesions
(verbalize findings)
a. Verbalization: I will begin by inspecting your face, and I do not see any
discolorations or lesions. I will also assess your head, and I note that it is
midline and symmetrical
2. Palpate lymph nodes of the head and neck bilaterally:
a. Verbalization : please let me know if any tenderness is present
i. Preauricular
ii. Postauricular
iii. Occipital
iv. Tonsillar
v. Submandibular
vi. Submental
vii. anterior cervical
viii. posterior cervical
ix. supraclavicular:
1. Verbalization : I
do not note any
enlargement, and
they equal
bilaterally
2. (verbalize these
with correct
pronunciation)
, 3. Verbalization: Next I will be Testing Cranial Nerve 5 the Trigeminal
Nerve
a. To test the motor I will be palpating over the masseter muscle
as the patient clenches his jaw
b. I do not feel any distortions and there is great strength present
c. to test the sensory portion of the trigeminal nerve , I will have
the patient close his eyes and let me know where he feels my
touch
i. Forehead
ii. Chin
iii. Cheeks
iv. Nose
d. Great job! Based on this assessment the trigeminal nerve is
intact.
4. Continuing with cranial nerves, I will now be assessing cranial nerve 7
: the facial nerve
a. In this portion I am going to have the patient smile (note that it
is symmetrical)
b. Frown
c. raise the eyebrows
d. puff the cheeks and pucker the lips ( great symmetrical mouth
closure, and strong pucker is present)
Ears
5. Next we will be examining the patients ears bilaterally for skin lesions
and symmetry – the ears look great no discoloration, or lesions
present, and the ears are symmetrical
6. Using the otoscope I will begin to inspect the patients auditory canal
and tympanic membrane bilaterally , this will be done by pulling the
ear back and up
a. Right ear: "The external auditory canal is clear. The tympanic membrane is pearly
gray with no swelling or redness."
b. Left ear: "The external auditory canal is clear. The tympanic membrane has a
small perforation noted at the 5 o’clock position."
Palpation
"I am palpating the pinnae and tragus bilaterally — no nodules or tenderness noted."
Now we will be testing cranial nerve #8 : This cranial nerve is the acoustic nerve, and will be
tested by utilizing the whisper test.
, Have the patient sit upright.
o Explain the test: “I’m going to check your hearing by whispering some words.
Please cover one ear, and with the other ear, repeat back what you hear.”
Position yourself
Stand about 1–2 feet (30–60 cm) behind the patient so they cannot read your lips.
Make sure the ear you are testing is uncovered and the opposite ear is covered with the
patient’s hand.
"Hearing is intact bilaterally by whispered voice test."
Eyes
Inspection
"The conjunctiva are pink and moist, sclera white without injection or lesions."
CN 2 (Optic) — Visual Acuity
1. We will now be assessing cranial nerve number 2 – the optic nerve by
testing gross visual acuity and central/ periphereal vision
(Using Snellen chart, patient reads lines correctly.)
"Vision is 20/20 bilaterally."
CN 2 — Peripheral Vision
(Confrontation test — patient identifies fingers entering visual field appropriately.)
- Have the patient look straight ahead and assess when they see your hands
You must :
Come from above
Below the chin
To the side, and toward the nose
"Peripheral vision intact bilaterally, cranial nerve II – optic nerve –
is functioning normally."
CN 3 (Oculomotor) — Pupillary Response
Using the opthoscope I will be testing the cranial nerve #3 Oculomotor and pupillary
response .
1. Start with a 360-degree room scan
2. Hello! My name is Allyson Pannell, and this is my physical
examination assignment for NR 509. I am not using any aids/ notes/
assistive devices to complete this assignment
3. "My name is Matthew Hansen and I permit this examination to be recorded and
submitted to Chamberlain College of Nursing for grading purposes
Head and Face
1. Inspect head and facial skin for size, symmetry, midline position – note abnormal lesions
(verbalize findings)
a. Verbalization: I will begin by inspecting your face, and I do not see any
discolorations or lesions. I will also assess your head, and I note that it is
midline and symmetrical
2. Palpate lymph nodes of the head and neck bilaterally:
a. Verbalization : please let me know if any tenderness is present
i. Preauricular
ii. Postauricular
iii. Occipital
iv. Tonsillar
v. Submandibular
vi. Submental
vii. anterior cervical
viii. posterior cervical
ix. supraclavicular:
1. Verbalization : I
do not note any
enlargement, and
they equal
bilaterally
2. (verbalize these
with correct
pronunciation)
, 3. Verbalization: Next I will be Testing Cranial Nerve 5 the Trigeminal
Nerve
a. To test the motor I will be palpating over the masseter muscle
as the patient clenches his jaw
b. I do not feel any distortions and there is great strength present
c. to test the sensory portion of the trigeminal nerve , I will have
the patient close his eyes and let me know where he feels my
touch
i. Forehead
ii. Chin
iii. Cheeks
iv. Nose
d. Great job! Based on this assessment the trigeminal nerve is
intact.
4. Continuing with cranial nerves, I will now be assessing cranial nerve 7
: the facial nerve
a. In this portion I am going to have the patient smile (note that it
is symmetrical)
b. Frown
c. raise the eyebrows
d. puff the cheeks and pucker the lips ( great symmetrical mouth
closure, and strong pucker is present)
Ears
5. Next we will be examining the patients ears bilaterally for skin lesions
and symmetry – the ears look great no discoloration, or lesions
present, and the ears are symmetrical
6. Using the otoscope I will begin to inspect the patients auditory canal
and tympanic membrane bilaterally , this will be done by pulling the
ear back and up
a. Right ear: "The external auditory canal is clear. The tympanic membrane is pearly
gray with no swelling or redness."
b. Left ear: "The external auditory canal is clear. The tympanic membrane has a
small perforation noted at the 5 o’clock position."
Palpation
"I am palpating the pinnae and tragus bilaterally — no nodules or tenderness noted."
Now we will be testing cranial nerve #8 : This cranial nerve is the acoustic nerve, and will be
tested by utilizing the whisper test.
, Have the patient sit upright.
o Explain the test: “I’m going to check your hearing by whispering some words.
Please cover one ear, and with the other ear, repeat back what you hear.”
Position yourself
Stand about 1–2 feet (30–60 cm) behind the patient so they cannot read your lips.
Make sure the ear you are testing is uncovered and the opposite ear is covered with the
patient’s hand.
"Hearing is intact bilaterally by whispered voice test."
Eyes
Inspection
"The conjunctiva are pink and moist, sclera white without injection or lesions."
CN 2 (Optic) — Visual Acuity
1. We will now be assessing cranial nerve number 2 – the optic nerve by
testing gross visual acuity and central/ periphereal vision
(Using Snellen chart, patient reads lines correctly.)
"Vision is 20/20 bilaterally."
CN 2 — Peripheral Vision
(Confrontation test — patient identifies fingers entering visual field appropriately.)
- Have the patient look straight ahead and assess when they see your hands
You must :
Come from above
Below the chin
To the side, and toward the nose
"Peripheral vision intact bilaterally, cranial nerve II – optic nerve –
is functioning normally."
CN 3 (Oculomotor) — Pupillary Response
Using the opthoscope I will be testing the cranial nerve #3 Oculomotor and pupillary
response .
