Chapter 15

Assessing Head and Neck

Structure and Function #1

 The Head
o Cranium—8 bones
 Frontal (1)
 Parietal (2)
 Temporal (2)
 Occipital (1)
 Ethmoid (1)
 Sphenoid (1)

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Question #1
Is the following statement true or false?

The skull, which is the framework of a head, has two

subsections: the cranium and cervical vertebrae.

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Answer to Question #1
False.
The skull has two subsections: the cranium and the face.

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Structure and Function #2
 The Head
o Face—14 bones
 Maxilla (2)
 Zygomatic (2)
 Inferior conchae (2)
 Nasal (2)
 Lacrimal (2)
 Palatine (2)
 Vomer (1)
 Mandible (1)

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The Skull

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Question #2

Which bone belongs to the face?

A. Parietal
B. Temporal
C. Palatine
D. Sphenoid

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Answer to Question #2
C. Palatine.
Palatine is a facial bone that gives shape to the face.
Parietal, temporal, and sphenoid are bones of the cranium.

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Structure and Function #3

 The Neck
o Hyoid bone
o Several major blood vessels
o Larynx
o Trachea
o Thyroid gland

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Structures of the Neck

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Cervical Vertebrae

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Question #3
Tell whether the following statement is true or false.

The axis is the first of the seven cervical vertebrae.

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Answer to Question #3
False.
The axis is the second of the seven cervical vertebrae.

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Lymph Nodes

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Traumatic Brain Injury
 Presence of transportation accidents involving
automobiles, motorcycles, bicycles, and pedestrians
 Presence of violence, such as firearm assaults and child
abuse or self-inflicted wounds
 Falling
 Excessive alcohol ingestion
 Infants and elderly being cared for by caregivers

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Infant and Toddlers Risk Factors
 Environmental risks (for falls)
 Lack of parental knowledge of shaken baby syndrome
 Caregivers risk of shaken baby syndrome

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Children and Teens Risk Factors
 Knowledge and use of protective equipment in sports
and bicycle use
 Knowledge and use of safety practices when driving

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Adults and Older Adults Risk Factors
 Knowledge and use of safety practices when driving
 Impairment of physical or mental stability
 Potential for maltreatment or domestic violence

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Risk Reduction #1
 Buckling your child in the car using a child safety seat,
booster seat, or seat belt (according to the child’s height,
weight, and age). Know the stages:
o Birth through age 2
o Between ages 2 and 4/until 40 lb
o Between ages 4 and 8 or until 4’ 9” tall
o After age 8 and/or 4’ 9” tall
 Wearing a seat belt every time you drive or ride in a
motor vehicle

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Risk Reduction #2

 Never driving while under the influence of alcohol or drugs

 Wearing a helmet and making sure your children wear helmets
when:
o Riding a bike, motorcycle, snowmobile, scooter, or all-
terrain vehicle
o Playing a contact sport, such as football, ice hockey, or
boxing
o Using in-line skates or riding a skateboard
o Batting and running bases in baseball or softball
o Riding a horse
o Skiing or snowboarding

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Risk Reduction #3
 Making living areas safer for seniors, by:
o Removing tripping hazards such as throw rugs and
clutter in walkways
o Using nonslip mats in the bathtub and on shower
floors
o Installing grab bars next to the toilet and in the tub
or shower
o Installing handrails on both sides of stairways
o Improving lighting throughout the home

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Risk Reduction #4

 Maintaining a regular physical activity program, if your

doctor agrees, to improve lower body strength and
balance
 Making living areas safer for children, by:
o Installing window guards to keep young children from
falling out of open windows
o Using safety gates at the top and bottom of stairs
when young children are around
o Making sure that the surface on your child’s
playground is made of shock-absorbing material,
such as hardwood mulch or sand.

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 Health Assessment: Subjective Data
 Interview Approach (COLDSPA)
o History of current health problem, past health, family
o Lifestyle and health practices

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Headache Impact Test #1

 When you have headaches, how often is the pain

severe?
 How often do headaches limit your ability to do usual
daily activities including household work, work, school,
or social activities?
 When you have a headache, how often do you wish you
could lie down?
 In the past 4 weeks, how often have you felt too tired
to do work or daily activities because of your
headaches?

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Headache Impact Test #2

 In the past 4 weeks, how often have you felt fed up or

irritated because of your headaches?
 In the past 4 weeks, how often did headaches limit
your ability to concentrate on work or daily activities?

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Equipment for Head and Neck
Examination

 Gloves
 Penlight or flashlight
 Small glass of water
 Stethoscope

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Physical Assessment: Head

 Inspect the size, shape, configuration

 Consistency
 Involuntary movement
 Palpate the head

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Physical Assessment: Face #1
 Inspect the face
o Symmetry
o Features
o Movement
o Expression
o Skin condition

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Physical Assessment: Face #2

 Palpate
o Temporal artery: tenderness and elasticity
o Temporomandibular joint (TMJ): range of motion
(ROM), swelling, tenderness, crepitation

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Physical Assessment: Neck #1
 Inspect movement of neck structures
o Cervical vertebrae
o Neck ROM

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Physical Assessment: Neck #2

 Palpate
o Trachea
o Thyroid gland
 Thyroid cartilage
 Cricoid cartilage
 Auscultate an enlarged thyroid gland

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Physical Assessment: Neck #3

 Palpate lymph nodes of head and neck

o Preauricular
o Postauricular
o Occipital
o Tonsillar
o Submandibular

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Physical Assessment: Neck #4

 Palpate lymph nodes of head and neck (cont.)

o Submental
o Superficial cervical
o Posterior cervical
o Deep cervical
o Supraclavicular

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Normal and Abnormal Findings
 Review and discuss findings of assessment of client’s
head and neck with peers.

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Altered Thyroid Function
 Increased sensitivity to cold
 Constipation
 Depression
 Fatigue
 Heavier menstrual periods
 Pale, dry skin
 Thin, brittle hair or nails
 Weakness
 Unintentional weight gain

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Hyperthyroidism #1
 Sudden weight loss, without changes in appetite and diet
 Increased appetite
 Rapid heartbeat (tachycardia) greater than 100 beats a
minute, irregular heartbeat (arrhythmia), or palpitations
 Nervousness, anxiety, and irritability
 Tremor in the hands and fingers
 Sweating

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Hyperthyroidism #2
 Changes in menstrual patterns
 Increased sensitivity to heat
 Changes in bowel patterns, more frequent bowel
movements
 Enlarged thyroid gland (goiter)
 Fatigue, insomnia
 Muscle weakness

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Types of Headaches
 Sinus
 Cluster
 Tension
 Migraine
 Tumor related

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Abnormal Findings of the Head and Neck
 Acromegaly
 Cushing syndrome
 Scleroderma
 Hypothyroidism
 Bell palsy

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Abnormal Findings of the Head and Neck
 Acromegaly

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Abnormal Findings of the Head and Neck
 Cushing syndrome

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Abnormal Findings of the Head and Neck
 Scleroderma

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Abnormal Findings of the Head and Neck
 Hypothyroidism

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Abnormal Findings of the Head and Neck
 Bell palsy

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Findings in Older Adults #1
 Older clients who have arthritis or osteoporosis may
experience neck pain and a decreased ROM.
 In older clients, facial wrinkles are prominent because
subcutaneous fat decreases with age. In addition, the
lower face may shrink and the mouth may be drawn
inward as a result of resorption of mandibular bone, also
an age-related process.
 The strength of the pulsation of the temporal artery may
be decreased in the older client.

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Findings in Older Adults #2

 In older clients, cervical curvature may increase because

of kyphosis of the spine. Moreover, fat may accumulate
around the cervical vertebrae (especially in women). This
is sometimes called a “dowager’s hump.”
 Older clients usually have somewhat decreased flexion,
extension, lateral bending, and rotation of the neck. This
is usually due to arthritis.
 If palpable, the older client’s thyroid may feel more
nodular or irregular because of fibrotic changes that
occur with aging; the thyroid may also be felt lower in
the neck because of age-related structural changes.

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Validating and Documenting Findings

 Health promotion diagnoses

 Risk diagnoses
 Actual diagnoses
 Collaborative problems
 Medical problems

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SOLVING FOR A CHILD’AGE
 BIRTHDATE : APRIL 22 2020 DATE: JUNE 30, 2022
6 30 2022
4 22 2020
____________________
2 8 2 = 2 YEARS, 2 MONTHS AND 8 DAYS

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SOLVING FOR EDC
LMP: MAY 15 2022 -3(MONTH) + 7 (DAYS) +1 YEAR
5 15 2022
-3 +7 +1
_____________________
2 22 2023 FEB 22, 2023

JANUARY TO MARCH EX: JANUARY 13, 2022

1(+12) 13 2022
-3 +7
_______________________
10 30 2022 = OCTOBER 30, 2022

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