Hello, welcome to the clinic.
So today I'm going to be doing a detailed face and neck examination for you with magnification
and illumination.
I've also divided the face up into different zones as shown here
okay so starting in zone one the forehead left side
first going to apply some magnification
I'm going to be looking first for any lumps or bumps
Okay so I have a double source of magnification
This is the light source so left side of the forehead
just relax
okay no signs of any lumps or bumps
or naevi there, that's good
just arc round a little up to the scalp line
the skin looks healthy
let's come closer
let's go to zone three which is the right side of the forehead.
okay looking for the same thing lumps or bumps, any discoloration, for areas of elevation,
pigmentation
moles, tags, things like this
scalp line, looking fine
healthy on the right too, I'm going to just
have a feel of the forehead of each hand here
just checking for any ipsilateral sweating there
that's fine, let's just try a little sensation test on the forehead, close the eyes, there's
a soft and slightly sharp applicator.
Tell what do you feel
that's fine, just relax let's take some written notes there
okay let me have a little look at the nose and a little feel
just breathe through the nose please
just lean back for me I want to look inside the nostril slightly
okay and for the left
that's looking clear no signs of any polyps there
just a space between the eyes, that's fine
Let's have a look at the right ear, just turn slightly to the left please
I'm just going to look at all the different structures of the ear including behind the
ear
okay
I'm just going to have a little feel of the ear
and any pain or tenderness there?
okay just turn slightly to your right.
A look at the left ear
okay any problems with your hearing at all?
just a little bit of scarring just on the outer
part of the ear canal there
okay let me check for any lesions, going to have a feel of the ear
report any tenderness to me
okay I should have a little bit of a deeper look inside the ear canal with the otoscope
internally fine just the external changes there, thank you
just a little bit of scarring on the entrance to the ear canal on the left side.
Any accidents that you know about that led to this scarring?
okay I'll just take some notes
I'm going to focus on the orbits now the areas around the eyes, the skin, the eyelids, not
so much the the eyeballs themselves but just the skin
Looking again for lumps or bumps or anything sinister like carcinomas.
Okay just look straight towards me please, now look down this is for the right upper
lid
okay
so the skin region is clear there's no signs of xanthelasma
No evidence of milia.
Good, okay I'm just looking at the lashes
No evidence of madarosis there, just looking up for me please, let's have a look at the
lower lid now, no poliosis
lashes are pointing outwards nicely
Okay and looking more closely at the lid margins, just want to ensure share there's no signs
of carcinoma, which is very serious
Okay take a blink, nice movement of the lid there, good, no signs of chalazions, lumps
or bumps, just close the eyes, let me have a little feel of the lid
keep the eye closed let's try the lower lid
nice and flat there.
okay left eye now please or left orbital region
okay close the eye, let's look at the upper lid.
Look straight ahead, compare the two, no signs of any ptosis.
Looking up now, lower lid margin, no evidence of blepharospasm at the moment
Okay no xanthelasma which is a good sign
no milia, no obvious cysts manifesting there, close the eye, have a feel of the
upper lid there
and the lower
look at me straight ahead now
look up
equal looking apertures there, thank you, good looking orbital regions, no pathology
identified there
so right orbit no ptosis, no evidence of xanthelasma, milia or carcinomas
no trichiasis
okay just a little check of the cheek areas now, might have a little sensation test again,
right side
and left side
cheeks are fine, again just a sensation test so say if you feel the sharp or soft feeling.
Close the eyes please
that's fine you can relax now
onto the lower jaw
any pain on chewing?
no jaw pain? not more on one side?
okay lower jaw, just check the skin
okay open the mouth wide now please, and grit the teeth, and give me a smile, move the jaw
to the right, and to the left, good, relax, open the mouth wide again
okay and just clench the jaw please, excellent
okay it's just the neck region to go, let's take some notes there sensation test
around the cheeks was fine
okay let me have a gross look at your neck
the skin's looking fine, let me have a feel of the neck, tilt your head back just ever
so slightly
okay no problem swallowing food?
good
I'm just going to place my fingers just on the neck there, I just want you to swallow
for me, thank you.
have a look at that area in a little bit more detail closer up
marvellous thank you.
I think overall everything's coming back fine
just wrapping up the final notes with the neck there, just that slight scarring on the
left ear
other than that the face examination
has been fine, noo abnormalities detected
right so that's everything I'm going to let you go now thank you