Examination of Ear

1. Greetings
2. Introduction
3. Permission
4. Explanation of Procedure
5. Exposure (scarf / glasses etc.)
6. Headlight focus
7. Before you start inspection, always ask, if there is pain somewhere!!!
8. Inspection of Pinna, Preauricular area, post auricular area
9. Palpation of pinna, tragus, mastoid region
(Keep light on patient’s face to assess tenderness)
10. Examination of ear canal without speculum
11. Examination of ear canal with speculum
12. Otoscopy
13. Valsalva
14. Voice test
15. Tuning fork test
16. Facial nerve examination
17. Nystagmus
18. Fistula test
19. Cerebellar function test
20. Romberg test (ask patient to remove shoes)
21. Gait
22. Make him sit and ask to wear shoes
23. Re-wrap the patient
24. Say Thanks to the patient
Examination of Nose
1. Greetings
2. Introduction
3. Permission
4. Explanation of Procedure
5. Exposure (scarf / glasses etc.)
6. Headlight focus
7. Before you start inspection, always ask, if there is pain somewhere!!!
8. Inspection of External nose, orbits and check
9. Palpation of Ext nose, frontal, ethmoid and maxillary sinuses
(Keep light on patient’s face to assess tenderness)
10. Use Probe / scale to check nasal deviation
11. Cold Spatula test to assess patency
12. Smell test
13. Elevate the tip of nose and check for vestibulitis / any sign of
inflammation
14. Anterior rhinoscopy
(Non-dominant hand, enter speculum separately in both nostrils, focus on
color mucosa, turbinates, septum)
15. Posterior rhinoscopy
16. Eye movement
17. Re-wrap the patient
18. Say Thanks to the patient
Examination of Oral cavity and throat:-

1. Greetings
2. Introduction
3. Permission
4. Explanation of Procedure
5. Exposure (scarf / glasses etc.)
6. Headlight focus
7. Before you start inspection, always ask, if there is pain somewhere!!!
8. Inspection of face (lips, cheek, neck)
9. Mouth opening ( sufficient or if reduced the measure inter-incisor distance)
10. Focus on hygiene (teeth staining, any pigmentation, missing teeth, bad
smell etc.)
11. Check both gingivolabial sulci
12. Stenson duct opening
13. Retract and assess buccal mucosa
14. Tongue’ movement (Cranial nerve XIIth)
15. Use salt or sugar or any liquid like roohafza to assess taste sensation
(chorda tympani)
16. Floor of mouth by elevating and then retracting tongue laterally
17. Look at hard palate mucosa
18. Soft palate movement
19. Ask him to say aah and look at soft palate to assess IXth and Xth nerves
(Use tongue depressor, to depress tongue, for better visualization of palate)
20. Look at posterior pharyngeal wall and tonsils
21. Indirect laryngoscopy
22. Bimanual palpation of submandibular gland
23. Neck node palpation
24. Re-wrap the patient
25. Say Thanks to the patient
Examination of neck:-

1. Greetings
2. Introduction
3. Permission
4. Explanation of Procedure
5. Exposure (scarf / glasses etc.)
6. Headlight focus
7. Before you start inspection, always ask, if there is pain somewhere!!!
8. Inspection of neck
9. Look
Swallowing (thyroid gland)
Tongue protrusion and look at neck for thyroglossal duct cyst
Cough or Valsalva by turning head on both sides (laryngocele)

10. Listen
Stridor (deep breathing)
Recurrent laryngeal nerve function/ hoarseness (Counting)
11. Palpate for laryngeal crepitus
12. Indirect laryngoscopy
13. Neck node palpation
14. Re-wrap the patient
15. Say Thanks to the patient
Examination of Larynx:-

1. Greetings
2. Introduction
3. Permission
4. Explanation of Procedure
5. Exposure (scarf / glasses etc)
6. Headlight focus
7. Before you start inspection, always ask, if there is pain somewhere!!!
8. Inspection of neck
9. Look
Cough or Valsalva by turning head on both sides (laryngocele)
10. Listen
Stridor (deep breathing)
Recurrent laryngeal nerve function/ hoarseness (Counting)
11. Palpate for laryngeal crepitus
12. Indirect laryngoscopy
13. Neck node palpation
14. Re-wrap the patient
15. Say Thanks to the patient