Head-to-Toe Physical Exam Script
With Equipment, Techniques, Patient Commands & Step-by-Step Directions
1. Introduction & General Survey
Equipment: Hand sanitizer, watch/clock
Say: Hello, my name is Dr. Donna Yvonne Preston. I’ll be performing your physical exam
today. It will take about 30 minutes. Please let me know if you feel any discomfort.
Technique: Hand hygiene, explanation, gain consent.
Observe: Posture, distress, hygiene, affect, gait, breathing effort.
2. Head & Face
Equipment: None
Inspection: Say: I’m checking your face for symmetry or lesions.
Lymph Node Palpation: Say: Tell me if this feels tender. Order: Preauricular → Postauricular
→ Occipital → Tonsillar → Submandibular → Submental → Anterior cervical → Posterior
cervical → Supraclavicular. Technique: fingertips, small circles.
CN V (Trigeminal): Motor: Say 'Clench your teeth tightly.' Palpate masseter & temporalis for
equal strength. Sensory: Cotton wisp. Say 'Close your eyes and tell me where you feel this:
forehead, cheek, or chin.'
CN VII (Facial): Say: Smile, Frown, Raise your eyebrows, Puff out your cheeks, Pucker your
lips. Look for symmetry.
3. Ears
Equipment: Otoscope with speculum
Inspect external ear: Say: I’m looking for nodules, swelling, or lesions.
Palpate pinna & tragus: Ask: Does this hurt?
Otoscope exam: How to: Pull ear up/back, insert gently. Look for pearly gray tympanic
membrane.
CN VIII (Acoustic): Whisper test. Say: Cover one ear. Repeat the words you hear. Whisper '1,
2, 3' and '4, 5, 6'.
With Equipment, Techniques, Patient Commands & Step-by-Step Directions
1. Introduction & General Survey
Equipment: Hand sanitizer, watch/clock
Say: Hello, my name is Dr. Donna Yvonne Preston. I’ll be performing your physical exam
today. It will take about 30 minutes. Please let me know if you feel any discomfort.
Technique: Hand hygiene, explanation, gain consent.
Observe: Posture, distress, hygiene, affect, gait, breathing effort.
2. Head & Face
Equipment: None
Inspection: Say: I’m checking your face for symmetry or lesions.
Lymph Node Palpation: Say: Tell me if this feels tender. Order: Preauricular → Postauricular
→ Occipital → Tonsillar → Submandibular → Submental → Anterior cervical → Posterior
cervical → Supraclavicular. Technique: fingertips, small circles.
CN V (Trigeminal): Motor: Say 'Clench your teeth tightly.' Palpate masseter & temporalis for
equal strength. Sensory: Cotton wisp. Say 'Close your eyes and tell me where you feel this:
forehead, cheek, or chin.'
CN VII (Facial): Say: Smile, Frown, Raise your eyebrows, Puff out your cheeks, Pucker your
lips. Look for symmetry.
3. Ears
Equipment: Otoscope with speculum
Inspect external ear: Say: I’m looking for nodules, swelling, or lesions.
Palpate pinna & tragus: Ask: Does this hurt?
Otoscope exam: How to: Pull ear up/back, insert gently. Look for pearly gray tympanic
membrane.
CN VIII (Acoustic): Whisper test. Say: Cover one ear. Repeat the words you hear. Whisper '1,
2, 3' and '4, 5, 6'.
