Advanced Health Assessment - Practice Material

Use of appropriate equipment is required for skills videos. Submissions without required equipment will receive zero points and students will forfeit their attempt. Pre-procedure requirements (5 points) __/ 1 point: Washes hands. __/ 1 point: Introduces self to patient. __/ 1 point: Identifies the patient using two identifiers. __/ 1 point: Provides privacy & appropriate environment. __/ 1 point: Professional demeanor and appearance. Head and Neck Exam Head (4 points) __/2 points: Inspect general size and contour of the skull, noting deformities, depressions, lumps, or tenderness. __/2 points: Inspect the face, noting expression, contour, symmetry, involuntary movements, edema, and masses. Eyes (30 points) __/2 points: Inspect eyelids, eyelashes, palpebral fissures, and alignment of eyebrows. __/2 points: Inspect lacrimal apparatus, conjunctiva, and sclera, noting color, swelling, discharge, vascularity, or nodules. __/2 points: Inspect cornea, lens, and pupils, noting opacities, size, shape, and symmetry. __/4 points: Assess visual acuity (CN II). Use a Snellen or Rosenbaum eye chart; ask the patient to cover one eye and read smallest line possible. __/2 points: Assess pupillary response to light (direct and consensual). __/2 points: Assess pupillary response to accommodation. __/4 points: Assess visual fields by confrontation (CN II). __/4 points: Assess extraocular movements (CN III, IV, VI), including convergence, noting nystagmus, and lid lag. __/8 points: Perform ophthalmoscopic exam, adjusting light, positioning the patient, and holding the ophthalmoscope correctly to identify red reflex, optic disc, retina, fovea, and macula. Ears (22 points) __/4 points: Inspect the auricles and surrounding tissue for symmetry, deformities, lumps, and lesions. __/4 points: Inspect the ear canal, noting discharge, foreign bodies, redness, swelling, and cerumen. __/8 points: Perform otoscopic exam, correctly positioning patient, auricle, and scope. __/2 points: Test auditory acuity using whisper test (CN VIII). (Stand 1 to 2 feet behind patient and ask them to occlude one ear. You whisper a twosyllable word in the other ear. Ask patient to repeat word back.) __/2 points: Test for lateralization of sound using the Weber test. [Only on HEENT Skills Exam; do not conduct on Head-to-Toe Exam.] __/2 points: Compare air conduction and bone conduction of sound using the Rinne test. [Only on HEENT Skills Exam; do not conduct on Head-toToe Exam.] Nose (12 points) __/2 points: Inspect for asymmetry, lesions, and deformity. __/2 points: Palpate nares to assess for nasal obstruction. __/2 points: Inspect the nares with the otoscope, noting color, swelling, bleeding, exudate, ulcers, or polyps of nasal mucosa and deviation, inflammation, or perforation of the septum. __/4 points: Palpate frontal and maxillary sinuses for tenderness. __/2 points: Test for olfactory function (CN I). Mouth (6 points) __/1 point: Inspect the lips, noting color, moisture, lumps, ulcers, cracking, or scaliness. __/1 point: Inspect the oral mucosa, noting color, areas of pigmentation, ulcers, white patches, and nodules. __/1 point: Inspect the gums and teeth, noting color, swelling, ulceration, bleeding, retraction, abnormal position, or looseness. __/1 point: Inspect the tongue and floor of the mouth, noting color and texture. __/2 points: Inspect the posterior pharynx, soft palate, anterior and posterior pillars, uvula, and tonsils, noting rise and fall of the soft palate (CN X), color, symmetry, swelling, ulceration, or exudate. Neck (26 points) __/2 points: Inspect the neck, noting symmetry, masses, scars, enlargement of glands, or visible lymph nodes. Palpate lymph nodes, noting size, shape, mobility, consistency, and any tenderness: __/2 points: Pre-auricular (front of ear) __/2 points: Posterior auricular (superficial to the mastoid process) __/2 points: Occipital (posterior base of skull) __/2 points: Tonsillar (angle of the mandible) __/2 points: Submandibular (midway between angle and tip of the mandible) __/2 points: Submental (midline behind the tip of the mandible) __/2 points: Superficial cervical (superficial to the sternocleidomastoid) __/2 points: Posterior cervical (along anterior edge of the trapezius) __/2 points: Deep cervical chain (deep to the sternocleidomastoid) __/2 points: Supraclavicular (deep in the angle formed by the clavicle and sternocleidomastoid) __/2 points: Inspect and palpate trachea for deviation. __/2 points: Inspect and palpate the thyroid gland at rest and with swallowing, noting symmetry, size, consistency, and tenderness. _____/ 105 points