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