2-6
Section II. PHYSICAL EXAMINATION
2-6. NOSE AND SINUSES
a. Physical examination of the nose and sinuses should begin with an overall observation for general deformity or irregularity. Watch the patient breathe through both the mouth and nose. Do the nostrils flare with inspiration? Is the sense of smell intact? The nasal passages should be clear and unobstructed, with no discharge present. Observe the nasal septum. It is normally straight and un-perforated, dividing the nasal cavity into two chambers of relatively equal size and shape. The mucous membranes should be pink.
b. Examine the sinuses for tenderness. Avoiding the eyes, use the fingertips to direct manual pressure upward over the frontal sinuses. With the thumbs, direct pressure upward over the lower edge of the maxillary bones to examine the maxillary sinuses.
