HEAD AND NECK ASSESSMENT

ANATOMY:
STRUCTURE AND FUNCTIONS
• HEAD
• CRANIUM
• FACE
• NECK
• MUSCLES
• CERVICAL VERTEBRAE
• TRACHEA
• ESOPHAGUS
• BLOOD VESSELS
• THYROID GLANDS
• LYMPH NODES
HEAD
DIVIDED INTO TWO (2) SUBSYSTEMS:
CRANIUM
• Protects the brain and the major
sensory organs of the head
• Composed of (8) bones: FRONTAL
(1), PARIETAL (2), TEMPORAL (2),
OCCIPITAL (1), ETHMOID (1),
SPHENOID (1)
Cranial bones are joined together by
(4) immovable sutures: SAGITTAL,
CORONAL, SQUAMOSAL, and
LAMBDOID
FACE
• Gives shape, expression, and
movement.
• Consists of (14) bones: MAXILLA(2),
ZYGOMATIC CHEEK(2), INFERIOR
CONCHAE (2), NASAL (2),
LACRIMAL (2), PALATINE (2),
VOMER (1), MANDIBLE aka JAW (1)
• ALL BONES ARE IMMOVABLE EXCEPT
FOR THE MANDIBLE
• Muscles that give expression and
movement.
• Salivary Glands
NECK
Muscles of the neck – allows
movement and provide support of
head and neck.
• Sternocleidomastoid muscle –
rotates and flexes
• Trapezius muscles- extends head and
move shoulders
• CN 11 – responsible for
movement
• Cervical Vertebrae- supports cranium
• C1-C7
• C7- prominent upon neck flexion
Trachea
• Airway
• Composed of C-shaped
cartilages – anatomical
landmarks for other anatomical
parts located on the neck.
• Cricoids cartilage – small bone
attached to and below the…
• Thyroid cartilage (Adam’s
apple)- connected to the
hyoid bone (where tongue is
attached)
Thyroid Glands
• Largest endocrine glands
• Produces thyroid hormones that
increased metabolic rate of most
body cells.
• Two lobes (curves posterior to
both sides of trachea and
esophagus)
• Isthmus – connects both lobes (lies
anterior to trachea).
• Covered by sternocleidomastoid
muscle.
Sternocleidomastoid muscle

Trapezius muscle
Lymph Nodes (10)
• Filters lymph – after collected by lymphatic vessels before it
returns to vascular system.
• Removes bacteria and tumor cells.
• Produces lymphocytes and antibodies that fight off foreign
substances (infection) that invades the body systems.
• Normally non-palpable (becomes palpable and inflamed with
infection).
Preauricular
Postauricular
Tonsillar
Occipital
Submandibular
Submental
Superficial cervical
Posterior cervical
Deep cervical
Supraclavicular
HEALTH ASSESSMENT
SUBJECTIVE DATA
• History taking (Review of System) – thorough to detect
cause of possible underlying systematic problems

• Evaluate ADLs that may affect the condition of client’s

HEAD and NECK
E.g. stress, tension, poor posture and lack of exercise
may be contributory factors for head and neck
discomforts
• Self-image may be influenced by client’s facial structures
SUBJECTIVE DATA
FOCUS QUESTIONS:
Lumps (onset, location, size, texture)?
Limited movement of the neck? Describe.
Facial pain/ neck pain/ headaches (COLDSPA)
 Prior neck injury (date, related to work, recreation, treatment)?
 Prior radiation therapy to head or neck?
Prior thyroid surgery?
Family History of head/ neck cancer, migraines?
Head and neck self-care: posture, use of helmet, seat belts,
tobacco products?
RISK FACTORS:
• HEAD INJURY
High-risk sports
Lack of protective devices
(eg. helmet, seatbelts)
• THYROID DISEASE
Radiation to upper body
Family history
• LYMPHATIC ENLARGEMENT
Immunosuppression
Chronic disease
Malnutrition
OBJECTIVE DATA
CLIENT PREPARATION
Instruct to remove any wig. Hat, ornaments, pins,
rubber bands, jewelry, and head or neck scarves.

Take care to consider cultural norms for touch when

assessing the head. Some cultures prohibit touching
the head or touching the feet before touching the
head.
CLIENT PREPARATION
• Position client in a sitting position: with back and shoulders
held back and straight. (Explain that they may need to keep
still in some areas of the examination or may be requested
to move and bend neck during palpation of neck muscles
and thyroid glands.

• To prevent anxiety assure client he/she will be informed of

assessment findings and what is performed during the
course of the assessment.
 EQUIPMENTS:
GLOVES
SMALL CUP OF WATER (thyroid exam)
STETHOSCOPE
INSPECTION OF THE HEAD

Shape and Symmetry

 Acromegaly
Hydrocephalus

Craniosynostosis
PALPATION OF THE HEAD

Contour Tenderness

Masses Depression
INSPECTION
INSPECTION
INSPECTION
Facial asymmetry, conditioned by right
orbital zygomatic and maxillomandibular
hypoplasia with occlusal cant and
deviated nose. Pre-and 2 years
postreconstructive facial appearance.
INSPECTION
Scleroderma Cachexia/Starvation
PALPATION
PALPATION
PALPATION
Anterior approach

Posterior approach
PALPATION
PEDIATRIC VARIATION
PEDIATRIC VARIATION
PEDIATRIC VARIATION
Bulging Fontanel VS Sunken Fontanel
END