Head-To-Toe Assessment (M. Nose and Paranasal Sinuses)

The external portion of the nose is inspected for the following:

1.     Placement and symmetry.
2.    Patency of nares (done by occluding nosetril one at a time, and noting for difficulty in breathing)
3.    Flaring of alaenasi
4.    Discharge

The external nares are palpated for:

1.    Displacement of bone and cartilage.
2.    For tenderness and masses

The internal nares are inspected by heperextending the neck of the client, the ulnar aspect of the examiner’s hard over the fore head of the client, and using the thumb to push the tip of the nose upward while shining a light into the naris.

Inspect for the following:

1.     Position of the septum.
2.    Check septum for perforation. (can also be checked by directing the lighted penlight on the side of the nose, illumination at the other side suggests perforation).
3.    The nasal mucosa (turbinates) for swelling, exudates and change in color.
Paranasal Sinuses

Examination of the paranasal sinuses is indirectly. Information about their condition is gained by inspection and palpation of the overlying tissues. Only frontal and maxillary sinuses are accessible for examination.

By palpating both cheeks simultaneously, one can determine tenderness of the maxillary sinusitis, and pressing the thumb just below the eyebrows, we can determine tenderness of the frontal sinuses.

Normal Findings:

1.    Nose in the midline
2.    No Discharges.
3.    No flaring alae nasi.
4.    Both nares are patent.
5.    No bone and cartilage deviation noted on palpation.
6.    No tenderness noted on palpation.
7.    Nasal septum in the mid line and not perforated.
8.    The nasal mucosa is pinkish to red in color. (Increased redness turbinates are typical of allergy).
9.    No tenderness noted on palpation of the paranasal sinuses.

Complete Head to Toe Assessment with Videos

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