This document provides instructions for inspecting and examining the ears, nose, throat, mouth, and sinuses. It describes examining the external ears for drainage, nodules, lesions, and tenderness. It recommends performing an otoscopic examination to look inside the ears. For the nose, it instructs to inspect nasal symmetry and mucosa, and palpate for pain or swelling. Sinuses should be inspected, palpated, and percussed. The mouth and throat should be inspected using a tongue blade and light, noting the lips, gums, teeth, tongue, uvula, and palate. Palpation can check for lumps or lesions.

1. PARUL INSTITUTE OF
NURSING

2.  Health care personnel primarily use
inspection and palpation to assess the ears,
nose, and throat.
 If appropriate, you’ll also perform an
Otoscopic examination.

3. INSPECTION &
PALPATION OFTHE
EAR

4. Examine ear color and size.The ears should be
similarly shaped, colored the same as the face,
sized in proportion to the head, and
symmetrically placed.
Look for drainage, nodules, and lesions.
Cerumen is usually present and varies from
gray-yellow to light brown and black.

5.  Palpate the external ear, including the Pinna
and the tragus, and the mastoid process to
discover areas of tenderness, swelling,
nodules, or lesions.
 Then gently pull the helix of the ear backward
to determine whether the patient feels pain
or tenderness.

6. OTOSCOPIC
EXAMINATION

7.  Otoscopy is an examination that involves
looking into the ear with an instrument called
an otoscope (Auriscope).

8. ASSESSMENT OF
NOSE

9.  To assess nasal symmetry, ask the patient to
tilt his head back; then observe the position
of the nasal septum.
 Use a nasal speculum to inspect the inferior
and middle turbinates, the nasal septum, and
the nasal mucosa.
 Note the color of the mucosa, evidence of
bleeding, and the color and character of
drainage.

10.  Next, palpate the nose, checking for painful
or tender areas, swelling, and deformities.
 Evaluate nostril patency by gently occluding
one nostril with your finger and having the
patient exhale through the other.

11. ASSESSMENT OF
SINUSES

12. To assess the Paranasal sinuses, inspect, palpate, and percuss
the frontal and maxillary sinuses.
To assess the frontal and maxillary sinuses, first inspect the
external skin surfaces above and to the side of the nose for
inflammation or edema.Then palpate and percuss the sinuses.
If the nose and sinuses require more extensive assessment, use
the techniques of direct inspection and transillumination

13. ASSESSMENT
OF MOUTH &
THROAT

14.  Use inspection and palpation to assess the
mouth and throat.
 First, inspect the patient’s lips. They should be
pink, moist, symmetrical, and without lesions.
 Use a tongue blade and a bright light to inspect
the oral mucosa.
 Have the patient open his mouth; then place the
tongue blade on top of his tongue.
 The oral mucosa should be pink, smooth, moist,
and free from lesions and unusual odors.

15.  Next, observe the gums (gingivae). They
should be pink and moist and should have
clearly defined margins at each tooth. Inspect
the teeth, noting their number and condition
and whether any are missing or crowded.
 Next, inspect the tongue. It should be mid
line, moist, pink, and free from lesions. It
should move easily in all directions, and it
should lie straight to the front at rest

16.  Inspect the back of the throat (oropharynx) by
asking the patient to open his mouth while
shine the penlight on the uvula and palate.
 Finally, wearing clean gloves, palpate the lips,
tongue, and oropharynx. Note lumps, lesions,
ulcers, or edema of the lips or tongue. Assess the
patient’s gag reflex by gently touching the back
of the pharynx with a cotton-tipped applicator or
the tongue blade. This should produce a bilateral
response.