NR 509 Week 7 Assignment; Physical Examination Video Evaluation
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Inspect outer ear for skin lesions and symmetry Now, I'm going to inspect Sarah's ears, and I'm looking for any nodules or any skin lesions. Let's look at your other ear, Sarah, and they look nice and are symmetrical. Inspect auditory canal and TM (using otoscope) Now I’m going to look inside her ear canal with the otoscope. I'm going to 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 cerumen, there's no swelling or redness, there is no drainage. Palpate pinnae and tragus for nodules and tenderness Her tympanic membrane is pearly grey, and there's no fluid in the external auditory canal. So you have very normal eardrums and ears. Now I'm going to palpate Sarah's pinna, [BLANK_AUDIO] For any nodules or tenderness, any tenderness, Sarah? No. And now her tragus, in front of the ear, any tenderness? No. Thank you CN 8 (Acoustic) Whisper Test (whisper words out of patient’s sight, and patient repeats words back) Test one ear at a time. Next I will be testing her acoustic nerve, which is cranial nerve number eight, and that is her hearing. So I will be performing a whisper test, so I'm going to ask Sarah to cover one of her ears. And then I will stand behind her, cover my mouth, and whisper three words. One, two, three. One, two, three. And let's do the other side. Four, five, six. Four, five, six. And her hearing is intact bilaterally EYE Inspects sclera and conjunctiva Now I'm going to assess Sarah's eyes, and first I'm going to look at her conjuctiva. I notice that they're pink and clear, no drainage or lesions. And I'll also note that her sclera is white and clear CN 2 (Optic) Assess gross visual acuity and peripheral/central vision Now I'm going to test Sarah's cranial nerve number two, the optic nerve, and this covers central vision. And I will use this Snellen eye pocket chart. And I'll stand six feet away and ask Sarah to cover one eye. And now read the lowest line possible. LTFPH. Repeat with the other eye. LTFPH. And now with both eyes. LTFPH. And Sarah has normal vision, 20/20 in her left eye, right eye, and with both eyes. CN 2 (Optic) Check pupillary response to light [PERRL] And now I will continue checking cranial nerve number two, the optic nerve Let me know if you feel any tenderness there, Sarah. No. And her maxillary sinuses, any tenderness? No. Thank you THROAT AND MOUTH Inspect lips, teeth, gums, buccal mucosa, palate, tongue, the floor of the mouth (under t he tongue), posterior pharynx, and tonsils ( grade tonsils,
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