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Chapter 11
Head, Neck, and
Regional Lymphatics
Copyright 2002, Delmar, A division of Thomson Learning
Competencies
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Identify the anatomic structures of
the head and neck.
Identify the lymph nodes of the
head and neck.
Describe the system-specific
health history for the head and
neck.
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Competencies
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Demonstrate the physical assessment of the
head and neck.
Describe normal findings in the physical
assessment of the head and neck.
List common abnormalities found in
physical assessment of the head and neck.
Explain pathophysiology of common
abnormalities found in physical assessment
of the head and neck.
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Anatomy and
Physiology
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Skull
Face
Neck
Thyroid
Lymphatics
Blood supply
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Health History
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Determine presence/absence of
age- and gender-specific
diseases of the head and neck
Common chief complaints
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Neck pain or stiff neck
Hoarseness
Neck mass
Headache
Head injury
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Evaluating Chief
Complaint
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Determine the following
characteristics
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Quality
Associated manifestations
Aggravating factors
Alleviating factors
Setting
Timing
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Past Health History
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Medical conditions
Surgeries
Medications
Communicable diseases
Injuries or accidents
Special needs
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Family Health History
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Determine if family history of
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Thyroid disease
Headache
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Social History
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Alcohol use
Work environment
Home environment
Stress
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Health Maintenance
Activities
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Sleep
Diet
Use of safety devices
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General Approach to
Head
and Neck Assessment
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Greet patient, explain assessment
techniques
Environment
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Quiet
Warm
Private
Adequate lighting
Upright sitting position
Compare right and left sides
Systematic approach
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Assessment of the
Head
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Inspection
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Shape
Symmetry
Palpation
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Contour
Masses
Depression
Tenderness
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Inspection and
Palpation
of the Scalp
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Inspect
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Normal findings
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Lesions or masses
Scalp is shiny, intact, without lesions
or
masses
Abnormal findings
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Bleeding, lesions, masses, hematomas
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Assessment of the Face
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Inspection
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Shape
Symmetry
(continues)
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Assessment of the Face
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Normal findings
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Symmetrical features
Palpebral fissures equal
Nasolabial folds present bilaterally
Shape can be oval, round, or slightly
square
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Assessment of the Face
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Abnormal findings
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Deformed or absent structures
Asymmetry
More or less pronounced facial features
Diseases which may alter facial features:
Bell’s palsy, Down syndrome, Graves’
disease, Myxedema, Cachexia, Cushing’s
syndrome
Copyright 2002, Delmar, A division of Thomson Learning
Mandible
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Palpate and auscultate the temporomandibular joint when the client
opens and closes the mouth
Normal findings
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No discomfort, joint articulates smoothly
without clicking or crepitus
Abnormal findings
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Pain, tenderness, crepitus, clicking, or
snapping sound
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Neck
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Inspection
Palpation
Normal findings
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Full ROM, pain free, symmetrical
muscles, no masses
Abnormal findings
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Limited ROM, pain, asymmetrical
muscles, masses
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Thyroid Gland
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Inspection
Palpation
Auscultation
(continues)
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Thyroid Gland
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Normal findings
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Symmetrical movement with
swallowing
Adam’s apple more pronounced in
males
No masses, tenderness, or enlargement
Absent bruit
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Thyroid Gland
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Abnormal findings
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Mass
Enlarged gland
Goiter
Asymmetrical enlargement
Presence of a nodule or bruit
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Lymph Nodes
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Inspection
Palpation
(continues)
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Lymph Nodes
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Location
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Preauricular
Postauricular
Occipital
Submental
Submandibular
Anterior and posterior cervical chains
Tonsilar
Supraclavicular
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Lymph Nodes
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Normal findings
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Unable to palpate or see nodes
Abnormal findings
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Enlarged nodes
Able to palpate or see nodes
Tenderness
Firm, hard nodes
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Gerontological
Variations
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Appearance and function of head
and neck may be altered
Buffalo hump
Kyphotic posture
Limited ROM
Dizziness
Copyright 2002, Delmar, A division of Thomson Learning