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