HEENT check off

Question 1

Intro

Answer 1

1. Introduce self
2. Confirm patient ID
3. Inform pt about verbal description of exam
4. Perform hand hygiene

Question 2

Appearance

Answer 2

1. well-developed
2. well-nourished
3. neatly dressed + groomed

Question 3

Behavior

Answer 3

1. cooperative
2. no acute distress
3. normal affect
4. makes good eye contact
5. normal motor function

Question 4

Inspect Scalp + Hair

Answer 4

1. normocephalic
2. atraumatic
3. symmetrical
4. no lesions
5. hair is evenly distributed

Question 5

Palpate Skull

Answer 5

1. no lumps
2. no depressions
3. no tenderness

Question 6

CN 7 - Facial

Answer 6

1. raise eyebrows, frown, clench + show teeth, smile, puff out cheeks, close eyes tightly
2. cranial nerve 7 intact
3. face symmetrical

Question 7

Palpate Temporal Arteries

Answer 7

1. pulsations felt bilaterally

2. no tenderness

Question 8

CN 5 - Trigeminal

Answer 8

1. hands on cheeks/temples, clench + relax jaw, push mandible into hand
2. motor function intact bilaterally
3. three cotton wisps
4. sensory function intact bilaterally

Question 9

Inspect Eyebrow + Orbitals + Eyelids

Answer 9

1. eyebrows are evenly distributed
2. no orbital edema
3. no eyelid drooping
4. no erythema
5. no discharge

Question 10

Inspect Conjunctivae + Sclera

Answer 10

1. pulls down bilateral lower lids
2. conjunctiva is moist + pink
3. sclera is white
4. no edema

Question 11

Palpate Lacrimal Glands + Sac

Answer 11

1. no tenderness

2. no edema

Question 12

CN 2/3 - Optic/Oculomotor

Answer 12

1. focus on far point then on near point
2. pen light bilateral eyes x 4
3. swing test
4. corneas clear bilaterally
5. pupils 4mm, round, equal
6. pupils reactive to light with consensual constriction
7. no afferent pupillary defect

Question 13

CN 3/4/6 - Oculomotor/Trochlear/Abducens

Answer 13

1. follow pen without moving head six directions
2. conjugate gaze in all six directions
3. convergence when focused on near object
4. no nystagmus

Question 14

CN 2 Optic - Visual Acuity

Answer 14

1. both eyes
2. right eye
3. left eye

Question 15

CN 2 Optic - Visual Fields/Confrontation

Answer 15

1. stare at nose
2. both cover eyes on same side
3. when do fingers come into view x2 each side
4. no scotoma
5. no visual field deficits

Question 16

Ophthalmoscope exam

Answer 16

1. darkens room, rest if needed, super close
2. adjust scope light + focus
3. red reflex present
4. disc margins sharp, no bulging, cup present in center
5. no AV nicking or hemorrhages
6. no macular exudates
7. no retinal lesions

Question 17

Inspect/Palpate Pinna + Tragus + Mastoid

Answer 17

1. ears are symmetrical
2. no deformities
3. no lesions
4. no swelling
5. no bruising
6. no tenderness (palpate)

Question 18

TM + canals

Answer 18

1. canal patent
2. no cerumen
3. no erythema
4. no discharge
5. TM are pearly gray
6. light reflex present
7. no bulging
8. no perforations

Question 19

CN 8 - Acoustic

Answer 19

1. 2 ft behind, occlude opposite ear, whisper
2. repeated all words correctly
3. cranial nerve 8 intact

Question 20

Hearing Loss

Answer 20

1. weber on forehead
2. vibration heard equally, no unilateral hearing loss
3. rhinne on bilateral mastoids/ears
4. air conduction is greater than bone conduction
5. no conductive or sensorineural hearing loss

Question 21

Palpate Sinuses

Answer 21

1. frontal + maxillary
2. no tenderness
3. no crepitus

Question 22

Inspects Nose

Answer 22

slight asymmetry of nose noted

Question 23

Nare Patency

Answer 23

1. occlude nare and exhale

2. nares are patent bilaterally

Question 24

Inspect Nasal Mucosa + Septum

Answer 24

1. nasal mucosa + turbinates are pink + moist
2. no discharge
3. no lesions
4. no edema
5. no perforations
6. no hematoma

Question 25

Inspect Lips, Gingiva, Teeth

Answer 25

1. lips are pink, no cracks or lesions
2. gingiva is pink, no lesions
3. no cracked or missing teeth

Question 26

Inspect Tongue + Buccal Mucosa

Answer 26

1. tongue is pink/moist, no lesions
2. buccal mucosa is pink/ moist, no lesions
3. no dentures or piercings noted

Question 27

CN 12 - Hypoglossal

Answer 27

1. stick tongue out
2. midline + symmetrical
3. able to move up to nose and down to chin

Question 28

CN 10 - Vagus

Answer 28

1. have patient say ‘ah’
2. symmetrical rise of soft palate
3. uvula midline
4. pillars are symmetrical
5. tonsils are 1+ bilaterally, no exudates
6. no edema, erythema or lesions noted to palate + pharynx

Question 29

CN 9/10 - Glossopharyngeal + Vagus

Answer 29

1. symmetrical rise and fall of thyroid cartilage

Question 30

Inspect Neck

Answer 30

1. neck is symmetrical
2. no masses
3. slight jugular pulsations, no distention
4. no carotid pulsations

Question 31

Palpate Carotids

Answer 31

1. carotid arteries are 3+ and bounding

2. rhythm is regular

Question 32

Auscultate Carotids

Answer 32

1. bruits absent bilaterally

Question 33

Thyroid Gland

Answer 33

1. find cricoid with swallow
2. flex neck forward + to the side being examined
3. thyroid is smooth
4. no nodules
5. no tenderness

Question 34

Palpates Lymph Nodes

Answer 34

1. preauricular
2. postauricular
3. occipital
4. parotid
5. tonsillar
6. submandibular
7. submental
8. anterior cervical
9. posterior cervical
10. supraclavicular
11. infraclavicular
12. no nodes palpated
13. no tenderness

Question 35

CN 11 - Spinal Accessory

Answer 35

1. push head against hand
2. shrug shoulders against resistance
3. strength is 5/5 with all three movements