The document provides a detailed guide on the general examination of head, face, eyes, ears, nose, and sinuses, focusing on various assessment techniques and procedures to identify abnormalities. It outlines the purpose of each examination, required equipment, and specific steps for inspection, palpation, and other assessment methods. The aim is to gather valuable information for diagnosis and treatment based on physical examination findings.

1. Start

2. General Examination
Of
Head & Face, Eyes, Ears, Nose
& Sinuses
Govt. College Of Nursing, Alwar
Submitted to:
Hemlata Ma’am
Batch IInd
Semester Year 2022-23
Submitted By :
Rahul Dhaked
Preeti Gurjar
Priya Jangir
Pooja Koted
Rahul Kumar Roat
Rahul Singh Kasana
Radhika Sharma

3. Topics
Head & Face Examination
 Eye Examination
Ear Examination
Nose & Sinuses

4. Introduction
General Physical Examination
• The General examination is the
Physical Examination. In this
examiner or nurse will observe the
patient’s overall appearance and
behaviour. The observation of
client starts as the client walks into
the examination room.
• It focus upon one area of body at a
time.

5. Steps
of
General Examination
• Perform hand Hygiene.
• Provide self introduction to the patient.
• The following things should be assessed
when patient first in the examination
room, :
a) Patient's grooming
b) Consciousness Level
c) Size of the body
d) Posture
e) Mood of the patient.
f) Emotional tone.
g) Look for the signs of stress
• Identify the patient & collect the
identification details,

6.  While performing the assessment of head & face
nurse will do inspection, palpation, percussion and
auscultation side by side.
 Observe the shape of head and circumference by
using measuring tape.
 Head and body ratio is important to determine
hormonal imbalance.
 While assessing the face check expression and
symmetry of face, eye, eyebrows and facial hairs.
Introduction
Assessment of head & face

7. Purpose
• To gather information of head & face from physical examination.
• To generate diagnosis and treatment according to condition of patient.
• Abnormalities present in these structure indicates anomalies or specific
syndrome.
Equipments
• Gloves
• Penlight
• Measuring tape
• Pen & record form

8. 8
Steps for Procedure
 Inspection of Head
• Check the size, shape, symmetry and
position.
• Newborn and infants assess and
translluminate fontanelles and
measure head circumference.
• Normal shape of head-Normocephalic
 Palpation of Head
• Check for masses, tenderness
and scalp mobility.
• In newborn and infants – palpate
anterior & posterior fontanelles.

9. Abnormal findings
Macrocephal
y
Microcephaly

10. • Note the
client's facial
expression.
• Pale, fatigue,
Pain, fear &
Anxiety etc.
• For symmetry,
tenderness, muscle
tone and
temporomandibular
joint function
Inspection of
face
Palpation of
face

11. Abnormal Findings
Nephrotic
syndrome
Cushing
syndrome
Acromegaly
Facial palsy

12. Assessment of eyes
• Eye assessment includes assessment
of the eye Symmetry, assessment of
conjunctiva, Lacrimal apparatus,
Cornea and lenses and assessment of
visual field.
Introduction

13. Purpose
• To gathered the information from the Physical examination of
Eye.
• Help as to detect certain eye condition such as cataract and age
related mascular degeneration.
Equipments
• Snellen chart
• Penlight
• Ophthalmoscope
• Pen & record form

14. Steps for
procedure
• Inspect the external structure
- General appearance
- Eyelids
- Eyelashes
- Lacrimal apparatus
- Eyebrows
- Conjunctivae
- Sclera
- Cornea & lens
- pupils
• Test distance vision
• Test color vision

15. A) Inspect the external structure
1) General appearance :
Check the color and alignment of the Eye.
Normally: Eye clear, bright and in parallel alignment.
Abnormal Findings : cross eyes or strabismus
2) Inspect the Eyelids :
Note the presence of any lesions, edema, Entropion
(Inversion) Ectropion (Eversion)
Abnormal Findings : Asymmetry of lids may result from CN III
damage or from stroke.
Inward rotation of Eyelids known as Entropion.
Outward rotation of eyelide known as Ectropion.
Entropion.
Ectropion
strabismus

16. 3) Inspect eyelashes & eyebrows:
Note infection, size, style, symmetry & distribution.
4) Lacrimal apparatus:
Note any edema, excessive tearing or drainage.
Abnormal findings: Presence of Swelling, lumps or Increase
production of tears indicates the increased production of
lacrimal fluid or infection.
5) Inspect the Eyebrows:
Note normal, symmetrical or Absent.
6) Inspect the Conjunctivae & sclera:
Normally it is smooth and pinkish & whitish in colour
respectively.
Abnormal findings: Pallor , dryness, edema and yellowish
color may indicate jaundice.
Lacrimal Apparatus
jaundice

17. 7) Inspect the Cornea and Lens:
Assess the Cornea of each eye for opacity with help of
Ophthalmoscope.
Normally: clear and transparent.
Abnormal findings: Cataract & roughness or
irregularities.
8) Inspect the Iris and Pupils :
Note the color, Size, shape and symmetry.
Normally: iris is of blue, green, brown in color.
pupil is round & equal in size.
Abnormal findings: Miosis ( Pupil constricted ) &
Mydriasis ( Pupil dilated ). Decreased or as absent of
pupillary response indicate serious brain damage or
blindness.
Miosis
Mydriasis
Cataract

18. c) Test color vision
• Depending on patient's age and literacy level
Snellen chart, Snellen E chart or picture chart is
used.
• patient sit or stand 6m (20 feet) from the Chart.
Abnormal findings: myopia & hypermetropia
B) Distance vision test
• Patient differentiate pattern and color on
card or identify color on bars on Snellen
Eye Chart.
• Abnormal findings : Inability to dis
distinguish Colors.

19. Assessment
of Ear
Introduction
• Ear assessment
involves assessment
of the external the
ear, Auditory Canal
and checking hearing
ability.

20. Purpose
• It is done to Screen for ear problems such as hearing loss, ear pain,
discharge, Lumps or objects in the ear.
Equipments
• watch
• penlight
• Pen & record
form
• Tunning fork
• Otoscope

21. Steps for procedure

22. Inspect the external ear
• A) Check the placement, angle of attachment, shape,
size & symmetry.
• Normally : angle of placement is 10o
• The helix, antihelix, antitragus, tragus and lobules are present. The
ears are 4-10cm in length and symmetrical in shape & size.
• Abnormal Findings : Placement of Pinna may be higher or lower.
• Any Absence of landmarks may indicate hearing effect.
• Macrotia (Ear bigger than 10cm), and Microtia (less than 4cm) may
indicate genetic defect.
Microtia
Macrotia

23. • B) Observe Color of ear, any lesion or any drainage from
ear
• Normally : The Color of ear matches to skin tone.
• Hair may be Present on helix, antihelix in older individuals.
• Abnormal Findings: Redness may indicate inflammation or infection.
• Purulent or Bloody drainage or lesions are common location for skin cancer.
• Palpate the External structure of the Ear
• Note the consistency of the skin, the presence of lesions and any sign of
tenderness.
• Normally: Skin is soft, pliable and nontender, no nodules or lesions are and
present.
• Abnormal findings: Tenderness is often associated with infections.

24. Access the Auditory Canal
• Examine the external Auditory Canal by pulling and backward and
downward. Use Otoscope for examination.
• Normal findings: no pain while pulling ear.
• Abnormal finding: If any kind of pain in ear movement indicates
Otitis Externa .
• Absence of the Ear Canal is known Atresia.
• Inflammation of middle ear can be suggested by presence of
sticky Yellow discharge.
Otitis externa
Ear discharge
Atresia

25. Hearing tests
Gross
hearing test
Weber test Rinne
test
Romberg
test

26. Assessment of nose
& sinuses
• Assess the size, symmetry and for any deformity.
• Assess the internal and external structure of the
nose.
• Asses and palpate the sinus e.g. ethmoid sinus,
frontal sinus , etc.
Introduction

27. Position
s
• Sitting position
Equipments
• penlight
• Pen & record
form
• Otoscope
• Gloves

28. Steps for
procedure
• For nose
- Inspect the external nose
- Check of patency of nasal
passage
- Inspect the internal structure
• For sinuses
- Assess ethmoid, frontal &
maxillary sinuses
• Assessment for smell

29. Inspect external nose
• Note the size, position, and shape. Observe for
discharge.
• Normal findings:- The nose is in midline and
symmetrical. No nasal discharge & DNS.
• Abnormal findings: Asymmetry suggests congenital
deformity or trauma.
• clear drainage suggests allergy & bloody drainage
may result from trauma.
DNS

30. Check for patency of nasal passage
• Ask the patient to close his mouth and close one naris
and breath through the other naris.
Inspect the internal structure
• By use of nasal speculum check mucosa (pink &
moist), septum is intact and in midline.
• Abnormal findings: polyps (pale translucent mass) &
DNS.
Polyps

31. Assessment for sinuses
• Ethmoid sinus, frontal sinus, sphenoidal sinus and maxillary
sinus are majorly used for assessment of sinuses
Assessment for smell
• To check proper functioning of nose (olfactory
nerve) alcohol and ammonia swab is used.
Ethmoid sinus

32. Reference’s
• Fundamentals of Nursing
• Book Of TNAI (Trained
Nursing Association Of India)
• Google
• https://
www.ncbi.nlm.nih.gov/
books/NBK361
•
https://en.wikipedia.org/wiki/
Health_assessment
• https://www.freepik.co
m/vectors/medical
• https://iconscout.com/
illustration/doctor-
checking-to-heartrate-
monitor-4704802
Image’s

33. Thank you