1 I am ________________________. I am a FNP student at Chamberlain University, and I will be doing your examination today. I will begin with inspecting the face. I see no discolorations or any lesions; the head is midline, normocephalic and symmetrical. Next, I will proceed into palpating the lymph nodes, and I will begin with the preauricular lymph nodes , right in front of the ear, and postauricular , right behind the ear. Then I will palpate the occipita l lymph nodes in the back of the head. And then I'm gonna move forward and palpate the tonsillar lymph nodes, come under the jawline, the submandibular lymph nodes, and the submental . Now I will go to the anterior cervical lymph nodes , and the posterior cervical lymph nodes . And I will end with the supraclavicular lymph nodes right about the clavicles. I did not feel any enlargement, and they are equal bilaterally. Next, I will test the trigeminal nerve, which is cranial nerve number 5. It has a motor component, and I will palpate over the masseter muscle as she clenches her jaw. I don't feel any distortions, and she has great strength. Please open your mouth and move your jaw from side to side. I do not see any jaw weakness or deviation. Next, I will test the sensory portion of the trigeminal nerve. Please close your eyes, and let me know where you feel my touch. Swipe with 1 finger over forehead, right cheek (over cheek bone), left cheek (over cheek bone), chin, nose (bridge). Next, I will test your facial nerve, which is cranial nerve number 7. I'm gonna ask you to do some facial expressions. Can you smile? Frown? Raise your eyebrows? Puff up your checks? And pucker your lips. All facial expressions are symmetrical and equal bilaterally. No weakness, tics and abnormal movements noted. Now, I'm gonna inspect the ears , and I'm looking for any nodules or any skin lesions. Please turn your head so I can look at your other ear. Ears are symmetrical and no lesions noted. Now, I'm going to look inside your ear canal with the otoscope. I pull her ear up and back, and as I look in, I see that the external auditory canal is clear, there's no swelling or redness or drainage or cerumen. The tympanic membrane is pearly gray, and there is no effusion in the middle ear. I will do the same for her left ear, pull the ear up and back, looking into the external auditory canal. I see there is no swelling or redness or drainage or cerumen. The tympanic membrane is pearly gray, and there is no fluid in the external auditory canal. Now I'm going to palpate the pinna. And now the Tragus in front of the ears. I do not palpate any nodules. Did you feel any tenderness? Thank you. Next I will be testing the acoustic nerve, which is cranial nerve number 8, and that is her hearing. I will be performing a whisper test; please cover your other ear. And then I will stand behind her, cover my mouth, and whisper three words. Can you repeat what I said? And let's do the other side. Whisper 3 words and patient repeats them. The hearing is intact bilaterally.
2 Now I'm going to assess the eyes, First I'm gonna look at her conjunctiva. I notice that they're pink and
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- Fall '15
- trigeminal nerve