Purple= graded aspect. Always say the cranial nerve number & name!
Red = FNPS script.
(black in parentheses)= patient script.
Sanitize hands. Hello, ______ my name is ____ and I will be assessing you today. I need you sitting up for the exam.
HEAD AND FACE Inspects facial skin – note abnormal lesions; Inspect head for size, symmetry, midline position
I will begin by inspecting your face, and I don't see any discolorations, or any lesions and your head is midline and
symmetrical.
Palpates lymph nodes of the head and neck: Preauricular, Postauricular, Occipital, Tonsillar,
Submandibular, submental, Anterior Cervical, Posterior Cervical, Supraclavicular (verbalize these) PPOTSS AC PC S
I will palpate your lymph nodes. First, I will begin with the preauricular lymph nodes, right in front of the ear, and
postauricular, right behind the ear. Then I will palpate your occipital lymph nodes in the back of the head. And then
I will move forward and palpate your 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 do not feel any enlargement, and they are equal bilaterally
CN 5 (Trigeminal) Motor – palpate over the masseter muscle as patient clenches jaw
I will test the trigeminal nerve, which is cranial nerve number five. It has a motor component, and I will palpate
over the masseter muscle as you clench your jaw. And I don't feel any distortions, and you have great strength
CN 5 (Trigeminal) Sensory – light touch sensation to forehead, cheeks, chin, nose (patient closes eyes)
Now I am testing the sensory portion of the Trigeminal nerve, which is cranial nerve 5. Please close your eyes and
let me know where you feel me touch. Forehead, right cheek, left cheek, chin, nose. You have correctly identified
where you are being touched.
CN 7 (Facial) Inspect for facial symmetry with smile, frown, raise eyebrows, puff cheeks, pucker lips
Next, I will test your facial nerve, which is cranial nerve number seven. And I will ask you to do some facial
expressions. Please begin with a smile, and I see that it is symmetrical. Next, frown for me. OK. Now raise your
eyebrows and go ahead and puff up your cheeks, and I notice they’re equal bilaterally. And now I want you to
pucker your lips, very tight pucker. All of your expressions are bilaterally symmetrical.
EAR Inspect outer ear for skin lesions and symmetry
I’m will inspect your ears for any nodules or any skin lesions. I look at both ears and note that they are symmetrical
without any nodules or lesions. Now I am going to look inside your ear canal with the otoscope.
Inspect auditory canal and TM (using otoscope). Palpate pinnae and tragus for nodules & tenderness.
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