Head & Neck

Head, Neck, and Cranial Nerves

Prof. Jessica Mitchell

Head & Neck Assessment - Inspection

• Shape/contour of the head/scalp, hair distribution and color

• Skin, color, lesions, dryness, any markings

• Structures of the eye, conjunctiva (pinks)/sclera (whites), iris, pupils

• Pupils/Occular movements will be covered during inperson lab as well

Inspection, cont

• Ears for shape, symmetry (do they sit at the same level bilaterally?) Is there any drainage?

• Nose shape, symmetry/septum, turbinates, and any drainage?

• Mouth for moistness of the mucosa, teeth (are they in good repair, any missing?) - hygeine, odor

• Floor of the mouth, tongue, and palate

• Neck - is the trachea midline? Is the thyroid visible?

Head & Neck: Palpation

• Temporal pulses (lateral to the eyes)

• TMJ, Frontal and Maxillary Sinuses - tapping technique

• Ears - auricle and tragus

• *Carotid pulses covered previously, but ONE AT A TIME :)

Ear anatomy

• Note Tragus

Multiple Choice

How many cranial nerves will be learning to examine today?

• 3

• 6

• 11

• 12

Cranial Nerve 1

• Olfactory

• "sniff test" for sense of smell and nasal patency

Open Ended

What type of smells might be used to test cranial nerve 1 (olfactory)?

Cranial Nerves 2, 3, 4, & 6

• Optic (2), Oculomotor (3), Trochlear (4), Abducens (6)

• Test - visual acuity and peripheral vision, 6 cardinal fields of gaze, accommodation, convergence, extra ocular movements, and light response (will be done in person)

Poll

Up/down each side or bilaterally returning to center with each motion?

• up/down

• return to center

Cranial Nerve 5

• Trigeminal

• Palpate temporal and messeter muscles while your patient "clenches"

• Sensory - light vs painful touch

Cranial Nerve 7

• Facial

• Facial symmetry with smile, frown, raised eyebrows, puff cheeks, and pucker lips 

Cranial Nerve 8, 9, 10, 11, 12

• Acoustic (8) - assess by conversation

• Glossopharyngeal (9) - gag reflex

• Vagus (10) - Uvula Rise

• Spinal Accessory (11) - not tested here

• Hypoglossal (12) - Inspect the tongue, test movement and strength

Poll

Cranial Nerves will be easy?

• Super Easy

• Not easy at all

• I'm on the fence