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Evaluation Head, Face And Neck

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Evaluation of the Head, Face and Neck


Inspection: Position patient upright and still.

1. Observe facial features. Eyelids, eyebrows, palpebral fissures, nasolabial folds and mouth for shape and symmetry with rest, movement and expression.

2. Test cranial nerve V (Trigeminal) by touching forehead/maxillary cheek and mandible with cotton, sharp, dull, hot and cold objects. Assess jaw opening, clenching of teeth, mastication and jaw jerk.

3. Test cranial nerve VII (Facial) by assessing symmetry in frown, smile, wrinkling of forehead, puffing out of cheeks and raising eyebrows. Assess eyelid closure and speech sounds b,m,w, and rounded vowels. Assess taste with salt, sugar, and sour over anterior 2/3rds of tongue.

4. Assess for tics, nodding movement and horizontal jerking of head.

5. Inspect skull for size, shape and symmetry, examine scalp from frontal to occipital regions noting hair and skin.

6. Note skin of face, edema, hair loss, lack of expression and excessive perspiration.

Palpation: Palpate skull in gentle rotary movement from front to back.

1. Assess bones, scalp should move freely over skull.

2. Palpate hair for texture, color and distribution.

3. Palpate temporal arteries and note for thickening, hardness or tenderness.

4. Palpate temporomandibular joint space bilaterally.

5. Inspect for asymmetry or enlargement of salivary glands.

Percussion: Not routinely performed in this system.

Auscultation: Not routinely performed in this system.

1. If you suspect vascular anomalies of the brain, listen for bruits over skull and eyes.




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