Assessment of head and neck Prepared By Hamdia Mohammed

1. Assessment of head and neck Prepared By Hamdia Mohammed

2. 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.

3. structures Of Head and Neck: • Skull encloses brain • Face: eyes, ears, nose, mouth • Neck: spine, esophagus, trachea, thyroid, arteries, veins, lymph nodes

4. 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?

5. 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)

6. Headache :- • When occur; lasts how long; pattern? • Pain characteristics, intensity, aggravated by movement? • Other symptoms • How treated (what, effective, when)?

7. 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

8. Neck pain or stiffness • First 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?

9. Hoarseness or voice change • Affected by weather, associated with cold or sore throat? • What makes better; treating effective?

10. Normal position of the thyroid

11. 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.

12. 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.

13. 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)

14. 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

15. Mouth and Oropharynx con’t • Inspect tongue: movement, color, surface characteristics • Palpate tongue: texture • Inspect lateral surfaces of tongue: color, surface characteristics

16. 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

17. Gingivitis

18. Palpation of the thyroid • Best palpated with examiner behind • Have patient swallow • Palpate both lobes

19. Lymph Nodes • Anterior cervical chain • Located along the sternocleidomastoid muscle

20. Enlarged left lobe thyroid

21. Hypothyroid Cold intolerance Slow pulse Thin, dry hair & dry, puffy skin Fatigue Thick tongue Delayed relaxation of Achilles reflex Hyperthyroid Heat intolerance Rapid pulse Flushed, sweating Anxious Fine tremors Exaggerated reflexes Differentiate between Hypothyroid and Hyperthyroid through Signs & symptoms