LEARNING OBJECTIVES
At the end of this lecture each student e should be able to:
1 -list structures of head & neck
2 -Identify the health history for head & neck.
3 -Explain examination techniques for head & neck .
structures Of Head and Neck:Skull encloses brain
Face: eyes, ears, nose, mouth
Neck: spine, esophagus, trachea, thyroid, arteries, veins, lymph nodes
Health History Of Head And Neck
Present health status: changes, chronic disease, medications
(what/when), last eye exam; glasses or contacts?
Past medical history: surgery, headaches (type), problems now?
Family history: thyroid disease, DM, rheumatoid arthritis,
high blood pressure, migraines?
Health History: Head and Neck Problem-Based History
Headache:- How long or often; gradual or sudden onset?Where occur; single area or generalized pain;
when?Patterns, describe pain, intensity, other
symptoms (always/sometimes)
Headache :-
When occur; lasts how long; pattern?Pain characteristics, intensity, aggravated
by movement?Other symptomsHow treated (what, effective, when)?
HEALTH HISTORY: HEAD AND NECK PROBLEM-BASED HISTORY
Dizziness Describe sensation; first begin, how
often, how long What do when occurs, makes worse
or better, how treated
Neck pain or stiffnessFirst noticed, constant or come and go, how
long, cause?What part of neck painful, radiate, numbness
or tingling, intensity?Limited neck motion, movement affects pain,
keep from sleeping or working?What makes worse or better, how treated?Other symptoms: been ill, fever, rash,
headache?
Hoarseness or voice changeAffected by weather, associated with
cold or sore throat?What makes better; treating
effective?
NORMAL POSITION OF THE THYROID
Examination techniques of head & neck.
Inspect the skull for size, shape, and symmetry.
Palpate the skull for nodules or masses and depressions.
Use a gentle rotating motion with the fingertips. Begin at the front and palpate down the midline, then palpate each side of the head.
Examination techniques of head & neck.
Inspect the facial features.
Inspect the eyes for edema and hollowness. Note symmetry of facial movements.
Ask the client to elevate the eyebrows, frown, or lower the eyebrows, close the eyes tightly, puff the cheeks, and smile and show teeth.
Examination Overview: Nose and Paranasal Sinuses
Inspect and palpate nose: appearance, symmetry, discharge, tenderness
Assess nose for patency Inspect internal nasal cavity (mucosa,,
septum) Palpate frontal and maxillary sinuses
(tenderness)
Mouth and Oropharynx
Inspect lips: color, symmetry, moisture, texture
Inspect and palpate teeth: condition, color, surface characteristics, stability, alignment
Inspect and palpate inner lips and gingiva: integrity, tenderness, color, moisture
Inspect buccal mucosa, anterior and posterior pillars: color surface characteristics
Mouth and Oropharynx con’t
Inspect tongue: movement, color, surface characteristics
Palpate tongue: texture
Inspect lateral surfaces of tongue: color, surface characteristics
Mouth and Oropharynx con’t
Inspect palate and uvula: texture, color, surface characteristics
Inspect soft palate: movement
Inspect posterior wall of pharynx and tonsils: color, surface characteristics
GINGIVITIS
PALPATION OF THE THYROID
Best palpated with examiner behind
Have patient swallow
Palpate both lobes
LYMPH NODES
Anterior cervical chain
Located along the sternocleidomastoid muscle
ENLARGED LEFT LOBE THYROID
DIFFERENTIATE BETWEEN HYPOTHYROID AND HYPERTHYROID THROUGH SIGNS & SYMPTOMS
Hypothyroid1. Cold intolerance2. Slow pulse3. Thin, dry hair &
dry, puffy skin4. Fatigue5. Thick tongue6. Delayed relaxation
of Achilles reflex
Hyperthyroid1. Heat intolerance2. Rapid pulse3. Flushed, sweating4. Anxious5. Fine tremors6. Exaggerated
reflexes