Head, Neck and cranial Nerves

Equipment needed for physical examinations:

 Tuning fork
 Cotton wisp, paper clip
 Soap, coffee
 Salt, sugar, lemon
 Tongue depressor
 Coin
 Gloves
 Otoscope
 Penlight
 Exam light
 Magnifying glass
 Centimeter ruler
 Small glass of water
 Stethoscope

HEAD

CRANIUM

Inspection and palpation of the patient head;

Inspection for size, shape and configuration

Skull

 Head is symmetric, round, erect and in midline.

 Head is held still and upright.

Scalp

 Lighter in colour than the complexion

 Moist
 No scars
 Free from lice, nits and dandruff
  No lesions should be noted

Hair

 Black, thick and smooth

 Evenly distributed covers the whole scalp

Palpation for consistency

 Head is hard and smooth without lesions

 No tenderness

FACE

Inspection of the patient face;

Inspect for symmetry, features, movement, expression and skin condition

 The face is symmetric with an oval appearance (nasolabial fold)

 No abnormal movements noted
 Distance between the eye lids and equal in both eyes (Palpebral fissure)

Palpation of the temporal artery

 The temporal artery is elastic and not tender

Palpation of the temporomandibular joint (TMJ)

 No swelling, tenderness and crepitation with movement

 Normal Findings:
· Shape maybe oval or rounded.
· Face is symmetrical.
· No involuntary muscle movements.
· Can move facial muscles at will.
· Intact cranial nerve V and VII.
 CRANIAL NERVES

I Olfactory- Patient was able to correctly identify the smell of coffee and soap. This shows that
cranial nerve I is intact.

II Optic- using the snellen chart patient proved that he had 20/20 vision in both eyes.

III Oculomotor, IV Trochlear and VI Abducens- these three nerves were tested together using,
cover test ,

V Trigenminal

. Sensory Function
· Ask the client to close the eyes.
· Run cotton wisp over the fore head, check and jaw on both sides of the face.
· Ask the client if he/she feel it, and where she feels it.
· Check for corneal reflex using cotton wisp.
· The normal response in blinking.

2. Motor function
· Ask the client to chew or clench the jaw.
· The client should be able to clench or chew with strength and force.

VII Facial

1. Sensory function (This nerve innervate the anterior 2/3 of the tongue).
· Place a sweet, sour, salty, or bitter substance near the tip of the tongue.
· Normally, the client can identify the taste.

2. Motor function
· Ask the client to smile, frown, raise eye brow, close eye lids, whistle, or puff the cheeks.

VIII Acoustic vestibule cochlear

IX Glossopharyngeal

X Vagus

XI Spinal accessory

XII Hypoglossal
 NECK

Inspection of the patient neck

 Neck is straight, symmetrical with head centered

 No visible mass or lumps
 No jugular venous distension

Inspect movement of the neck structures

1. Thyroid cartilage, cricoids cartilage and thyroid gland move upward symmetrically as the
patient swallows

Inspection of the cervical vertebrae

 Is visible and palpable

Inspection for range of motion

 Neck movement smooth and controlled with 45-degree flexion, 55-degree extension and
40-degree rotation

Palpation of the patient neck

 Trachea is palpable and position in midline and straight.

Palpation of the Lymph nodes

 Not palpable with no enlargement, swelling, tenderness and no hardness present

No auscultation of the Thyroid was necessary because the thyroid was not enlargement.