Assessing Head and Neck

TOOLS USED: stethoscope to auscultate the neck

Inspection

Inspect the head

 Inspect the head for size, shape and configuration.
Normal findings

 Head is symmetric
 round
 in midline and appropriately related to body size
 no lesions
abnormal findings

 abnormally small head called microcephaly

 skull and facial bones are larger and thicker
 acorn-shaped, enlarged skull bones

 Inspect for involuntary movements.

Normal findings
 Head should be still and upright
abnormal findings

 Involuntary nodding movement

 Head tilted to one side that may indicate unilateral vision or hearing deficiency

 Inspect the face for symmetry, features, movement expression, and skin condition

Normal findings
 Face is asymmetric with round, oval, elongated appearance
 No abnormalities movement

abnormal findings

 Asymmetric orofacial movement

 Asymmetric anterior to earlobes occurs with parotid gland enlargement from an
abscess or tumor.

palpation
 Palpate the head
 Note for consistency
Normal findings

 Normally hard
 Smooth
Abnormal findings

 Lesions or lumps on head

 Palpate the temporal artery.

Normal findings
 Elastic
 Not tender
Abnormal findings

 Temporal artery is hard, thick, and tender with inflammation

 Inflammation of the temporal arteries may lead to blindness

 Palpate the temporomandibular joint.

Normal findings
 No swelling, tenderness, or crepitation movement
 Mouth opens and close fully
 Lower jaw moves laterally
Abnormal findings

 Limited range of motion, swelling, tenderness, or crepitation that may indicate TMJ
syndrome.

Percussion

 Percussion is not applicable in the assessment

Auscultation

 auscultation is not applicable in the assessment

Inspection
Inspect the Neck
  Observes the clients slightly extended neck for position, symmetry, and lumps or masses
Normal findings

 Neck is symmetric, with head centered

 No bulging masses

Abnormal findings

 Swelling
 Enlarged masses or nodules, it may indicate an enlarge thyroid gland
 Inflammation of lymph nodes, or a tumor

 Inspect movement of the neck structures.

Normal findings

 The thyroid cartilage and cricoid cartilage move upward

symmetrically as the client swallows.
Abnormal

 Asymmetric movement or generalized enlargement of the thyroid

gland

 Inspect the cervical vertebrae.

Normal findings

 C7 (vertebrae prominens) is usually visible and palpable

Abnormal

 Prominence or swellings other than the C7 vertebrae may

be abnormal.

 Inspect range of motion.

Normal findings

Normally neck movement should be smooth and controlled with 45-degree flexion,
55-degree extension, 40-degree lateral abduction, and 70-degree rotation.
Abnormal findings

 Muscle spasms, inflammation, or cervical arthritis may cause stiffness, rigidity, and
lim ited mobility of the neck,

 Palpate the trachea.

Normal findings

 Trachea is midline.
 Abnormal findings

 the affected side in cases of large atelectasis, fibrosis or pleural adhesions. The
trachea is pushed to the unaffected side in cases of a tumor, enlarged thyroid lobe,
pneumothorax, or with an aortic aneurysm.

Palpation
Palpate the Neck

 Palpate the thyroid gland.

Normal findings

 Landmarks are positioned midline.

 lobes are smooth, firm, and nontender.
Abnormal findings

 Landmarks deviate from midline or are obscured because of masses or abnormal

growths.
 enlarged, tender gland may result from thyroiditis.
 rapid enlargement of a single nodule suggests a malignancy

 Palpate the lymph nodes.

Normal findings

 no swelling or enlargement and no tenderness

 No hardness
Abnormal findings

 Swelling,
 tenderness,
 hardness,
 immobility,
 enlargement

Auscultation
Ausculate the neck
 Auscultate the thyroid only if you find an enlarged thyroid gland during inspection tion or
palpation.
Normal findings

 No bruits are auscultated.

Abnormal findings
  A soft, blowing, swishing sound auscultated over the thyroid lobes is often heard in
hyperthyroidism because of an increase in blood flow through the thyroid arteries.

Percussion

 Percussion is not applicable in the assessment