Health Assessment Exam 2

Front 1

Describe assessment technique and normal findings of the face.

Back 1

GENERAL INSPECTION AND PALPATION
Look at Facial expression & appearance: Inspect for symmetry
N = approp. to situation, generally symmetrical
Cultural variations important to remember

Front 2

Describe assessment technique of the facial features

Back 2

Inspect eyebrows, eyes, palpebral fissure (CN III), mouth, nasolabial fold for symmetry, involuntary movement, edema, masses or lesions

Front 3

Describe normal findings of the facial features

Back 3

head upright, still features or slightly asymmetrical
no edema, no masses, lesions

Front 4

Describe assessment technique and normal findings of the skin of the face

Back 4

Inspect for color, pigmentation, texture, lesions
Normal findings:
texture smooth (age variation)
no masses,lesions,tenderness
Variation: jaundice, cyanosis, pallor

Front 5

Describe assessment technique for CN VII and V

Back 5

Inspect and palpate for involuntary movements
CN VII (Facial) Sensory and motor assessment:
Sensory: apply sugar or salt to ant. 2/3 of tongue on each side (not routinely tested)
Motor: facial movements: wrinkle forehead, close eyes, show teeth, puff cheeks, whistle. Observe for symmetry, tremor.

Front 6

what would normal findings be for CN VII

Back 6

Approp. identification of substance. Execution of movements without tremor, movements symmetrical.

Front 7

describe appropriate exam techniques for the sensory aspect of CN V

Back 7

Trigeminal
Sensory: Test tactile and pain sensation of all three branches: ophthalmic, maxillary, mandibular. Apply sharp & dull sensation with pt. eyes closed; ask pt. to localize & describe sensation (what and where to you feel it). Note symmetry. (tell your pt what is sharp and what is dull first to define)

Front 8

describe appropriate exam techniques for the motor aspect of CN V

Back 8

Palpate masseter & temporal muscles as client bites down; palpate jaw resistance. Corneal reflex not routinely tested (done to assess brain death, less reflex in contact wearers). (looking for bilaterally equally strong contraction of the masseter and temporal muscles)

Front 9

what are the three branches of the Trigeminal Nerve (CN V)

Back 9

Ophthalmic branch
Maxillary branch
Madibular branches

Front 10

what are normal findings for CN V

Back 10

Sensory perception approp. for all three branches bilaterally. Looking for Equal, strong contraction of masseter & temporal muscles bilaterally.

Front 11

describe assessment techniques for general inspection and palpation of the head starting with the temporal arteries

Back 11

Temporal arteries: Palpate for hardness, tenderness. Auscultate for bruit (turbulent blood flow) with bell of stethoscope.

Front 12

what are normal findings upon inspection of the temporal arteries

Back 12

Normal findings:
palpable
reg. rhythm
no tenderness, no bruit
symmetrical, “intensity 2+”, rate and rhythm

Front 13

describe assessment techniques for general inspection and palpation of the head: tempromandibular joint

Back 13

Palpate joint for swelling, tenderness while patient moves through range of motion (ROM): opens and closes mouth, moves joint from side to side

Front 14

what are normal findings upon inspection of the TMJ?

Back 14

smooth movement
no swelling, tenderness
snap, click may be present normally (be concerned if pain with clicking)
Variation: arthritis

Front 15

describe assessment techniques for the general inspection and palpation of the head in general

Back 15

Inspect size, shape, symmetry, position, unusual movement, contour.

Front 16

whatare normal findings upon inspection of the head in general?

Back 16

normocephalic with gently curved frontal & parietal prominences
symmetrical, midline
no involuntary movements
may see some irregularities near suture lines
abnormal variation: hydrocephalus (water on the brain)

Front 17

acromegaly and paget's disease may exhibit what signs

Back 17

abnormalties in head size and contour

Front 18

describe general inspection and palpation techniques for the hair.

Back 18

Inspect by parting in several places and observing for quantity, distribution, texture, pattern of loss, color of hair. Remove hair piece if approp. Observe use of dyes, cleanliness of hair/scalp.

Front 19

describe normal findings upon inspection of head hair

Back 19

Hair covers scalp (Variation: alopecia - may be normal or assoc. with disease) ( distribution)
Hair neither excessively oily or dry; note if change in texture of hair -
Color variation: graying associated with age or may be assoc. with illness

Front 20

describe assessment techniques for inspection of the scalp and normal findings

Back 20

nspect scalp for coverage, masses, lesions, scaliness; palpate for masses, lesions, tenderness
Normal Findings:
Scalp is freely moveable over skull, no masses, lesions or tenderness

Front 21

describe assessment techniques for inpection and palpation of the lymph nodes, sublinqual area, and salivary glands
Normal Findings

Back 21

Inspect & palpate for visible lymph nodes, symmetry, stability, (salivary glands: parotid and submandibular gland
sublingual, enlargement, masses, lesions, tenderness
Normal Findings:
symmetrical, no masses, lesions, no glandular enlargement
or tenderness

Front 22

Back 22

Front 23

describe how to assess the sternocleidomastoid & trapezius muscles

Back 23

Test muscle function by performing ROM of neck:
flexing chin to chest, lateral rotation, hyperextension of neck backward, lateral bending.

Front 24

Back 24

Front 25

How to assess CN XI? (spinal accessory)

Back 25

Sternocleidomastoid: Turn head side to side against resistance
Trapezius: Shrug shoulders (CN XI) against resistance

Front 26

what do normal findings look like for CN XI strength and function assessment?

Back 26

Muscle function: N = smooth, coordinated movements bilaterally without pain
Muscle strength (CN XI) : N = strong contraction of muscles bilaterally without pain, spasm, tenderness

Front 27

How to assess the midline cartilages of the neck?

Normal Findings

Back 27

Inspect/palpate thyroid cartilage, cricoid cartilage, tracheal rings for symmetry & tenderness.
Normal findings: smooth, nontender, symmetrical

Front 28

Back 28

Front 29

How to inspect the trachea and normal findings

Back 29

Inspect/palpate for midline position

Normal Findings: trachea midline

Front 30

How to inspect the posterior neck

Back 30

Inspect/palpate for masses, swelling, tenderness, symmetry
cervical vertebrae and related soft tissue
trapezius & sternocleidomastoid muscles
occipital area, mastoid process

Front 31

normal findings for the posterior neck

Back 31

symmetrical
no masses, lesions, tenderness
no swelling

Front 32

How to assess the thryroid gland?
Normal findings?

Back 32

Inspect first, then palpate:
Assess for size, symmetry, consistency, enlargement swelling, nodules or masses, bruits, tenderness. Also note systemic effects.
As client sips water, observe rise and fall of gland. Tangential (from the side) lighting may help to observe gland.
N = no bulging, symmetrical

Front 33

Back 33

Front 35

Back 35

Front 36

when palpating the thyroid gland, what do you feel for?

Back 36

Palpate for size, shape, consistency, tenderness, nodules.

Front 37

what are normal findings for thryroid gland assessment?

Back 37

nonpalpable, or only slightly palpable
no nodules/masses, nontender
moveable
if palpable, meaty/rubbery consistency; size = distal phalanx of thumb
Auscultate: If necessary for bruits; normally none

Front 38

what do you need to tell about the function of the thyroid gland?

Back 38

The physical characteristics (size, shape) of the thyroid gland are diagnostically important, but tell you little about thyroid function. (Get a blood work up to diagnose fxn of the gland)

Front 39

where are lymph nodes located in the head?

Back 39

preauricular (in front of ears), postauricular, occipital, parotid, submandibular, submental, sublingual

Front 40

where are lymph nodes located in the neck?

Back 40

ant. and post. cervical chain (lie on either side of the sternocleidomastoid muscle), internal jugular chain, posterior cervical spinal nerve chain, supraclavicular

Front 41

Back 41

Front 42

how to assess lymph nodes of head and neck

Back 42

Inspect/palpate for size, shape, mobility, consistency, tenderness. (matted together or discreet?)
Use pads of fingers in circular motion; palpate simultaneously (except carotid).
N = nonpalpable, nonvisible
If you find a lymph node, report where it is, how big is it, mobility, tenderness, matted together or discreet, etc.

Front 43

how should you inspect/palpate lymph nodes of head and neck?
What's normal, what do you do if you find a lymph node?

Back 43

Inspect/palpate for size, shape, mobility, consistency, tenderness. (matted together or discreet?)
Use pads of fingers in circular motion; palpate simultaneously (except carotid).
N = nonpalpable, nonvisible
If you find a lymph node,Look for source of infection or neoplasm in the area that the lymph node drains and report where it is, how big is it, mobility, tenderness, matted together or discreet, etc.

Front 44

what are some variations from the normal lymph nodes?

Back 44

“Shotty nodes”: small (less than 1 cm), moveable, separate (discrete), nontender nodes found in normal healthy person

Infection: Enlarged, tender, matted or discrete

Malignancy: Hard, nontender, discrete or matted

Front 45

what are the four parts of vision that form the retinal image?

Back 45

refraction
accommodation
constriction of the pupil
convergence of the eyes

Front 46

describe refraction in the formation of the retinal image
what structures are used and must be clear healthy and in tact?

Back 46

Bending of light rays from one transparent medium to another. (the following must be clear, healthy and in tact)
In the eye, the structures used are:
cornea
aqueous humor (btw cornea and lens
lens
vitreous humor (behind lens)

Front 47

Back 47

Front 48

describe accommodation in the formation of the retinal image

Back 48

Allows the eye to focus on near objects by increasing the curvature of the lens.
This is accomplished by contraction of the ciliary muscles that causes the elastic lens to bulge.

Front 49

describe constricting the pupils in the formation of the retinal image

Back 49

Prevents divergent light rays from coming in through peripheral portion of cornea & lens.
- Pupillary constriction is accomplished by contraction of the iris
- Pupil also constricts with bright light and near objects

Front 50

describe converging the eyes inward in the formation of the retinal image

Back 50

Allows single, binocular vision
- Accomplished by six extraocular eye muscles – 4 rectus and 2 oblique

Front 51

Back 51

Front 52

Trace the path of an image through the eye to the brain

Back 52

Refraction, accommodation, pupillary constriction, convergence

Image formed on retina (reversed, upside down

Optic Nerve (CNII)

Optic Chiasm

Optic tract

Occipital lobe of brain

Front 53

Back 53

Front 54

how to assess eyes, begin with:

Back 54

Assess macular area of retina, transparent structures of eye

Front 55

How to assess CN II

Back 55

Snellen Chart = Standardized numbers at end of each line of letters which indicate degree of visual acuity
With client 20 feet from chart, ask client to read smallest line of print possible, one eye at a time – then both (with and without correction).
Record reading at end of line which client can
read more than 1/2 the letters.
Numerator is always “20” (standard testing distance)
Denominator is distance from which the normal eye can read letters on that line.

Front 56

what is normal findings in the Snellen Chart assessment?

Back 56

N = 20/20 without corrective lenses

Front 57

recording findings in the Snellen chart assessment should include:

Back 57

Note with or without correction
Abbreviations (these abbreviations NOT allowed in acute care environment):
O.D. ( oculus dexter – right eye)
O.S. ( oculus sinister – left eye )
O.U. (oculus uterque – both eyes)

Front 58

tips for using the Snellen Chart include:

Back 58

use well-lighted room
client must stand/sit 20 ft. from chart at eye level
test one eye at a time initially, then both eyes together
cover eye with opaque card
test with/without corrective lenses, except reading glasses
if unable to read largest letter, check for perception of hand or light at 12”

Front 59

How to test for near vision:
What is normal?

Back 59

Jaeger or Rosenbaum chart
Hold approx 14 inches from eye – this distance equals the print size on a 20-foot chart.
Normal = 14/14 in each eye

Front 60

what is hyperopia
what is myopia

Back 60

hyperopia (farsighted)
myopia (nearsighted)

Front 61

what is presbyopia
what is diplopia
what is considered legally blind?

Back 61

presbyopia - inability of lenses to accommodate due to weak ciliary muscles, and inability to bulge with near vision. Leads to hyperopia (farsighted).
diplopia - double vision due to weakness of extraocular muscles
legally blind -20/200 with correction

Front 62

how to assess for peripheral vision:

Back 62

Visual Fields Confrontation Test(CN II): Test for peripheral vision by comparing your own peripheral vision with that of your clients.

only estimates large field defects
assumes your vision is normal
N = you and client can see object enter at the same time (visual field equal to examiners)(assess from behind the pt.)

Front 63

What pneumonic can you use to remember the innervation of the extraocular muscles

Back 63

LR6SO4
lateral rectus innervated by cn 6, superior oblique innervated by cn 4, all the rest are innervated by cn 3

Front 64

how to assess extraocular muscle function

Back 64

(CN III, IV, VI): Test function of each muscle by asking client to move eyes (keep head still) through six cardinal positions of gaze.

Front 65

To test the extraocular muscle function:

Back 65

Test function of each muscle by asking client to move eyes (keep head still) through six cardinal positions of gaze.
Six cardinal positions of gaze: move clockwise or make ‘H’

Front 66

normal findings for extraocular muscle fxn:

Back 66

eyes parallel without nystagmus (rapid twitching of the eye)
small nystagmus is normal in lateral position

Front 67

assess the lids by?

Back 67

assess for lid lag and ptosis by observing eyes in neutral position
Variation: lid lag (wide open eye – can see the schlera), ptosis (eyelid drooping) , diplopia

Front 68

Back 68

Front 69

Which cranial nerve is likely to be paralized in this photo?

Back 69

Ptosis b/c cnIII innervates the eyelid
Pupillary dilation b/c cn III innervates the pupil?

Front 70

Describe the Corneal Light Reflex

Back 70

Assesses parallelism of anterior & posterior axes of two eyes by observing reflection of light from cornea. Shine light toward bridge of nose from 12-15”.

Front 71

what are normal findings for the corneal light reflex test?
what should you do if not normal?

Back 71

N = light reflected symmetrically (12:00 bilaterally)
If unsymmetrical, perform cover-uncover test

Front 72

How to assess the external eye structures: eyelids

Back 72

inspect/palpate for symmetry, edema, color, masses, lesions, tenderness, coverage

Front 73

what are normal findings for the eyelid assessment?

Back 73

palpebral fissue (space btw upper and lower lid) equal
no edema
no masses, lesions, tenderness
Variation:exopthalmos

Front 74

what are normal findings for:

eyelashes
eyebrows

Back 74

Eyelashes: (inspect)
N = evenly distributed, symmetrical, curve outward

Eyebrows: (inspect)
N = evenly distributed, symmetrical

Front 75

How to assess the conjuctiva:

Back 75

Bulbar conjunctiva (lies over sclera & merges with cornea) & palpebral conjunctiva (lines eyelids).
Inspect for color, discharge, lesions, thickening, masses, vascular pattern. Separate eyelids - look up down and to each side. DO NOT perform upper eyelid eversion!

Front 76

Back 76

Front 77

what are normal findings for the palpebral conjunctiva assessment

Back 77

N = transparent; shiny pink/red vascular bed visible underneath
no lesions, masses, no discharge, moist, no excessive redness; may see few small blood vessels

Front 78

what are normal findings for the bulbar conjunctiva assessment

Back 78

N = transparent; white visible from sclera underneath
no lesions, masses, no discharge, moist, no excessive redness; may see few small blood vessels

Front 79

what are normal findings for the sclera assessment

Back 79

N = white, no swelling/lesions, smooth

Front 80

How to assess the cornea

normal findings?

Back 80

inspect using oblique lighting

N = shiny, transparent , smooth, no irregularities

Front 81

what are some variations of the cornea?

Back 81

Variation: arcus senilis (white ring around cornea) (normal in elderly, not normal in young = high lipids) (corneal arcus), astigmatism

Front 82

How to inspect the lens.

Normal findings?

Variations?

Back 82

Lens: (inspect using oblique lighting) N = transparent, shiny Variation: cataract - opacities in the lens

Front 83

how to assess the anterior chamber of the eye
Normal findings?
variations?

Back 83

use oblique lighting
N = transparent
Variation: glaucoma. Start screening at age 20.

Front 84

How to assess the lacrimal apparatus.

Back 84

Inspect for dryness, excessive tearing; palpate for blockage
Inspect and palpate puncta for swelling, redness, d/c
Inspect & palpate sac for tenderness, patency, regurgitation (use gloved finger to press against sac)

Front 85

normal findings in the lacrimal apparatus assessment?

Back 85

no excessive tearing, dryness
puncta without swelling or tenderness, no D/C, color pink
sac patent, nontender, no regurgitation

Front 86

Back 86

Front 87

normal findings in iris assessment?

Back 87

N = round, clearly defined, regular borders
Size/shape: N = 2-6mm (with light), round, equal

Front 88

what are some variations in pupil assessments

Back 88

Variation: anisocoria (unequal), miotic (tiny pupils), mydriatic (big pupils)

Front 89

you can assess which cranial nerves by shining light from the side and observing whether the pupil receiving light constricts, and the other eye should be equal

Back 89

CN II and III

Front 90

what is the difference between pupillary light reflection and corneal light reflection

Back 90

pupillary: light from side to observe pupil reactions
corneal light reflection: observing to see if the light dot in the two eyes are the same

Front 91

Back 91

Front 92

what is another assessment technique for the pupils?

Back 92

Accommodation: convergence of eyes, constriction of pupils as pt. shifts gaze from distant to near object.

Front 93

How do you document your assessment on the pupils?

Back 93

PERRLA -or- PERRL (Pupil Equal Round Reactive to Light and Accommodation)

Front 94

How to conduct an opthalmoscopic exam:

Back 94

Use large, round beam of light
Start at “0” diopters
Use your right hand and right eye for patient’s right eye; get close
Dark room important
Start by looking for
red reflex
examin the ocular fundus

Front 95

what are normal findings for the optic disc during an opthalmoscopic exam

Back 95

Optic disc: Normal Findings:
1.5 mm in size,round/sl.
oval
creamy yellow-pink
margins sharp
demarcated from retina

Front 96

what are normal findings for vessels during an opthalmoscopic exam?

Back 96

Vessels: Normal Findings:
arterioles brighter red
than veins,
25% smaller
A:V ratio 2:3
Arterioles and veins cross
and intertwine without
change in caliber

Front 97

Back 97

Front 98

what are normal findings for retinal background and macular area during an opthalmoscopic exam?

Back 98

Retinal background:
N = uniform color - light to dark red,
without patches of light/discoloration

Macular area:
N = same as retinal area, sl. darker

Front 99

trace the path of sound waves from the external ear to the brain

Back 99

1. Sound Waves Strike tympanic membrane
2. Vibrations transmitted through auditory ossicles of ear (malleus, incus, stapes) to
3. oval window
4. Vibrations travel to cochlea
5. then to the round window
6. CN VIII (acoustic)
7. Brain

Front 100

what is the air conduction hearing pathway

Back 100

Transmission of sound through the ear canal, tympanic membrane, and ossicles to the cochlea and the auditory nerve. (conductive phase) (external and middle ear)

Front 101

what is the bone conduction hearing pathway

Back 101

Transmission of sound through the bone of skull to the cochlea and auditory nerve. Bypasses the external & middle ear.

Front 102

what is a normal finding during a hearing assessment?

Back 102

AC > BC, bilaterally equal lateralization
(air conduction is greater than bone conduction)

Front 103

trace the path of sound waves from the external ear to the brain

Back 103

1. Sound Waves Strike tympanic membrane
2. Vibrations transmitted through auditory ossicles of ear (malleus, incus, stapes) to
3. oval window
4. Vibrations travel to cochlea
5. then to the round window
6. CN VIII (acoustic)
7. Brain

Front 104

what is the air conduction hearing pathway

Back 104

Transmission of sound through the ear canal, tympanic membrane, and ossicles to the cochlea and the auditory nerve. (conductive phase) (external and middle ear)

Front 105

what is the bone conduction hearing pathway

Back 105

Transmission of sound through the bone of skull to the cochlea and auditory nerve. Bypasses the external & middle ear.

Front 106

what is a normal finding during a hearing assessment?

Back 106

AC > BC, bilaterally equal lateralization
(air conduction is greater than bone conduction)

Front 107

Back 107

Front 108

how to assess the external ear

Back 108

Auricles (pinna): Inspect & Palpate. Manipulation of pinna can help detect external otitis – “swimmers ear very sensitive when touching the pinna)

Front 109

normal findings for external ear assessment

Back 109

helix should be at or slightly above a line extending from the eye to the occipital area
size appropriate to head
symmetrical
no masses, lesions,
no tenderness

Front 110

Back 110

Front 111

how to assess the external canal of the ear

Back 111

Inspect with and without otoscope – do this before auditory testing to make sure nothing blocking hearing

Front 112

what are normal findings for external ear canal assessment?

Back 112

sml. amt cerumen
no redness/swelling
no foreign bodies
no D/C

Front 113

how to assess the tympanic membrane

Back 113

Inspect color, light reflex, landmarks (umbo, malleus, annulus) with otoscope
Otoscope tips:
use largest speculum possible
grasp auricle up and back for adult, down in kids/infants

Front 114

normal findings for the tympanic membrane assessment

Back 114

Normal Findings:
shiny, transparent
pearl gray, sl. concave
conical, shiny, uniform light reflex:
5:00 (R) ear, 7:00 (L) ear
nonbulging umbo (point where the max amt of concaveness. (no fluid behind
Manubrium of malleus visualized
annulus without perforation (in tact)

Variation: otitis media

Front 115

Back 115

Front 116

how to assess CN VIII?

Back 116

Gross Hearing test (Auditory Nerve)
Occlude one ear at a time; stand 1 - 2 feet behind pt. Patient repeats whispered word.
Other test for CN VIII: Caloric test (not routinely done). Tests vestibular portion of CN VIII.

Front 117

normal findings for the CN VIII assessment?
variations?

Back 117

Client able to repeat whispered word correctly at 1 - 2 feet, bilaterally equal.
Variations: Tinnitus (ringing) Vertigo (spinning room) Dizziness (light headed)

Front 118

what is the 60/60 rule?

Back 118

Wear your earbuds no longer than 60 minutes at a level 60% of max volume. Dial down to a level “6” and take a break every hour!

Front 119

what test can be used to evaluate bone conduction

Back 119

Weber test: Used to evaluate bone conduction
Place activated tuning fork on skull; ask client if you can hear it, and if sound is clearer on one side or other
N = bilateral equal lateralization

Front 120

How will conductive hearing loss be identified during the weber test?

Back 120

problem with middle or external ear): sound lateralizes (travels laterally) to defective ear. (hear better on defective side)

Front 121

how will sensorineural hearing loss be identified during the weber test?

Back 121

problem with inner ear, CN VIII or auditory cerebral cortex due to aging, medications): sound lateralizes to better ear.

Front 122

Describe the Rinne Test

Back 122

also a technique to test for auditory acuity:
Used to evaluate bone and air conduction
Place activated tuning fork against mastoid process until client can no longer hear sound; then move the fork to the auditory meatus
N = AC > BC
or AC : BC = 2:1

Front 123

if there is conductive hearing loss, during the Rinne test, air conduction will be

Back 123

the same as or lesser duration than bone conduction

Front 124

during the Rinne test, if air conduction is greater than bone conduction but the duration is less than 2 to 1, there is __________ hearing loss

Back 124

sensorineural

Front 125

Back 125

Front 126

how to assess external nose?

Back 126

External Exam: Inspect bridge, tip, vestible (where naris is located), septum for shape, size, color masses, lesions.
Inspect nares for flaring, D/C
Inspect septum for deviation. (congenital)
Palpate ridge & soft tissue for displacement, tenderness, masses.

Front 127

normal findings for the external nose?

Back 127

septum with/without deviation
no masses, lesions, tenderness, no swelling
no discharge
no nasal flaring

Front 128

how to assess the internal nose?

Back 128

Inspect vestible, septum, turbinates for color, discharge, m/l, exudate, swelling

Front 129

normal findings for the internal nose?

Back 129

redder than oral mucosa
mucoid drainage
no masses, lesions, swelling

Front 130

how to assess CN I?

Back 130

Smell:(CN I) Test one nares at a time with eyes closed.
N = correct identification of smell

Front 131

what is patency? how to assess it?

Back 131

Patency: (openess) Occlude one nares at a time N = patent

Front 132

How to assess the sinuses, frontal and maxillary? Normal?

Back 132

Sinuses (frontal & maxillary): Palpate, percuss for tenderness
N = non tender

Front 133

Back 133

Front 134

Back 134

Front 135

how to assess lips:
normal findings,
variation

Back 135

Lips: Inspect & Palpate
Normal Findings:
symmetrical
no edema
no m/l/t
Variation: cyanosis

Front 136

Back 136

Front 137

how to asess the anteroinferior area
normal findings

Back 137

Anteroinferior area (between lower lip & gum):
N = no masses, lesions, tenderness, pink

Front 138

how to assess the buccal mucosa
normal findings

Back 138

Buccal mucosa (inside cheek):
N = no masses, lesions, tenderness, pink

Front 139

How to assess Stenson's duct
normal findings

Back 139

Stenson’s duct (opening of parotid gland; located opposite upper second molar):
N = patent, no inflammation

Front 140

How to assess the maxillary mucobuccal fold
normal findings

Back 140

Maxillary mucobuccal fold (area between upper lip & gum)
N = no masses, lesions, tenderness, pink

Front 141

Back 141

Front 142

how to assess the tonge

Back 142

Use gauze & gloves to lift tongue and examine post. & lateral surfaces. Inspect & Palpate.

Front 143

normal findings for the tongue assessment

Back 143

no swelling
size approp. for developmental age
color pink
no coating/ulceration (thin white coating is normal)
no masses, lesions, tenderness
texture sl. rough
Post and lateral tongue:
N = no masses, lesions, tenderness
Ventral tongue: Have pt. lift tongue to roof of mouth
N = no swelling, masses, lesions, tenderness

Front 144

How to asses CN XII

Back 144

CN XII (Hypoglossal):
Extend tongue - observe for deviation, tremors, limitation, midline
Tongue strength - move tongue side to side against resistance

N = no deviation/tremor/limitation; tongue midline and strong