Head and Face INSPECTION Head: Size, Shape and Configuration: Upon inspection patients head is symmetric, round,

, erect and in midline. No lesions are visible. Head for involuntary movements: Upon inspection patients head is held still and up right. Face: symmetry, features, movement, expressions and skin condition: Upon inspection the face is symmetric with an elongated appearance. No abnormal movement. Neck: Upon inspection patients neck is symmetric with head centred without bulging masses Movement of the neck structures: Upon inspection the thyroid cartilage, criroid cartilage and thyroid gland move upward symmetrically as the patient swallows. Cervical vertebrae: Upon inspection C7 (vertebrae prominens) is visible and palpable. Range of motion of the neck: Upon inspection neck movement is smooth and controlled with 45 degree flexion, 55 degree extension, 40 degree lateral abduction and 70 degree rotation. PALPATION Head: palpate for consistency: Upon palpation patients head is hard and smooth without lesions. Temporal artery: Upon palpation the temporal artery is elastic and non-tender. Temporomandibular joint: Upon palpation there is no swelling, tenderness or crepitation with movement. Mouth opens and closes fully (3-6 cm between upper and lower teeth). Lower jaw moves laterally 1-2 cm in each direction. Trachea: Upon palpation patients trachea is located midline. Thyroid Gland: Upon palpation landmarks are position midline. Lymph nodes: preauricular nodes, postauricular nodes, occipital nodes, tonsillar nodes, submandibular nodes, submental nodes, superficial cervical nodes, posterior cervical

nodes, deep cervical chain nodes, supraclavicular nodes: Upon palpation there is no swelling or enlargement and non-tender. Eyes INSPECTION Visual Acuity: Patients distant visual acuity is normal 20/20 without corrective lenses. Perform the positions test assesses eye muscles strength and cranial nerve function: Upon assessment patients eye movement is smooth and symmetric throughout all six directions. Eyelids and eye lashes: Upon inspection the upper lid margin is between the upper margin of the iris and the margin of the pupil. The lower lid margin rests on the lower border of the iris. No white sclera is seen above or below the eye lids. Ability of eyelids to close: Upon assessment the patients upper and lower lids close easily and meet completely when close. Redness, swelling, discharge or lesion: Upon observation patients skin on both eyelids is without redness, swelling or lesion. Position and alignment of the eyeball in the eye socket: Upon observation patients eyeball are symmetrically aligned in sockets without protruding sinking. Sclera: Sclera appears white although blacks occasionally have a gray-blue color to the sclera. Moist and without lesions. Conjunctiva: Conjunctiva are both smooth, shiny and red. Without swelling and lesion and it is moist. Cornea: Corneal surface is moist, shiny and transparent without discharge or cloudiness.

Iris: Iris appears flat with a regular shape and even coloration. Pupil: Black in color appears round, regular, smooth border and of equal size in both eyes, normally about 3-7 mm in diameter.

Test for accommodation: PERRLA: Pupils are Equally Round Reacts to Light and responds to Accommodation.

Ears INSPECTION External Ear: Position, color, shape, size, any deformities, inflammation or lesions: Upon inspection the ear matches the rest of the patients skin and is positioned centrally and in proportion with the head. Cerumen is not moist and do not obscure the lymphatic membrane. There are no foreign bodies, redness, drainage, deformities, lesions or nodules. External Auditory Canal: Upon inspection patients auditory canal has small amount of odorless cerumen (ear wax). Voice Whisper Test: The patient was able to repeat words whispered from a distance of 2 feet. Romberg test: Upon performing Romberg test patient maintains position for 20 seconds with minimal swaying. PALPATION External Ear: Both ears are firm, not tender and without lumps or lesions. Auricle and Mastoid Process: Upon palpation the patients auricle, tragus and mastoid are not tender.

Nose INSPECTION: External Nose: Upon inspection and palpation, nasal color is the same as the rest of the face, nasal structure is smooth and symmetric and no tenderness. Check patency of air flow through the nostrils: Patient is able to sniff through each nostril while the other is occluded. Frontal Sinuses: Upon inspection there is no evidence of swelling around the eyes. Maxillary Sinuses: Upon inspection there is no evidence of swelling around the eyes and nose. PALPATION PERCUSSION Oral Cavity INSPECTION Lips: Upon inspection patients lips are smooth and moist without lesion and swelling. Gums: Upon inspection patients gum are pink, firm, moist, no retraction, no bleeding. The gum, margins at the teeth are tight and well defined. Frontal Sinus: Upon percussion the sound produce was flat. Maxillary Sinus: Upon percussion the sound produce was flat. External Nose: Upon palpation the external nose is non-tender. Sinuses: Frontal and Maxillary Sinuses: Upon palpation the sinuses are non-tender.

Teeth: Upon inspection the patients teeth are yellowish, straight and in proper alignment without decays.

Tongue: Upon inspection patients tongue is smooth, shiny, pink and with no lesion.

Hard and Soft Palate: Upon inspection patients hard palate is whitish with firm, transverse rugae (wrinkle like folds).

Tonsils: Upon inspection patients tonsils are present pink and symmetric. No exudate swelling or lesions are noted.