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 approach Fingers 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