Head & Neck
History Headache Head injury Dizziness Neck pain Lumps or swelling Head or neck surgery
The Head
Position Midline without movements
Size and shape Palpate temporal artery Palpate TMJ Inspect the face
Expression, symmetric
The Neck
Inspect & palpate for symmetry Observe for proper ROM Palpate 10 groups of lymph nodes Trachea – straight, have swallow Thyroid gland
Posterior & anterior approachFingers vs thumbs
Lymph Nodes
Palpate lymph nodes with tips of fingers in a circular motion
Lymph nodes
of Head & Neck Palpate
Submandibular
& cervical nodes with chin down
Characteristics for Swollen Lymph Nodes
Location – name Size Consistency – firm/soft Symmetrical Fixed or Mobil Tenderness Redness Heat Increased Vascularity Surface area over lymph node
Shotty Nodes
Common in children, indicative of a past infection. May see swelling for 2-3 months. < 1cm in size Mobil Nontender Without redness Without heat Firm
Lymph Nodes Indicative of Present Infection
> 1cm in size Soft Tender Warm Red
Common Neck Abnormalities
Lymphadenopathy Associated with throat infection, ulcers
Nontender Cervical Lymphadenopathy Consider Hodgkins Disease
Supraclavicular Lymphadenopathy Consider TB
Left Supraclavicular Lymphadenopathy (Biroches) Consider Metastatic CA, Primary site:
abdomen, esophagus or lungs Small Diffuse Goiter
Seen with early menstruation, pregnancy, hyper, hypothyroidism. Usually < 40 years of age
Large Diffuse Goiter
Seen with hyper, hypothyroidism A unilateral enlarged thyroid associated
with malignancy Multiple thyroid nodules associated with CA– Thyroid adenoma