Head-To-Toe Assessment (B. Face)

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1.    Observe the face for shape.
2.    Inspect for Symmetry.

a.    Inspect for the palpebral fissure (distance between the eye lids); should be equal in both eyes.
b.    Ask the patient to smile, There should be bilateral Nasolabial fold (creases extending from the angle of the corner of the mouth). Slight asymmetry in the fold is normal.
c.   If both are met, then the Face is symmetrical

3. Test the functioning of Cranial Nerves that innervates the facial structures

a.    CN V (Trigeminal)

1.    Sensory Function
·    Ask the client to close the eyes.
·    Run cotton wisp over the fore head, check and jaw on both sides of the face.
·    Ask the client if he/she feel it, and where she feels it.
·    Check for corneal reflex using cotton wisp.
·    The normal response in blinking.

2.    Motor function
·    Ask the client to chew or clench the jaw.
·    The client should be able to clench or chew with strength and force.

b.    CN VII (Facial)

1.    Sensory function (This nerve innervate the anterior 2/3 of the tongue).
·    Place a sweet, sour, salty, or bitter substance near the tip of the tongue.
·    Normally, the client can identify the taste.

2.    Motor function
·    Ask the client to smile, frown, raise eye brow, close eye lids, whistle, or puff the cheeks.

Normal Findings:
·    Shape maybe oval or rounded.
·    Face is symmetrical.
·    No involuntary muscle movements.
·    Can move facial muscles at will.
·    Intact cranial nerve V and VII.

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