RLE 12

• The head and neck contains the cranium, face, sensory organs, neck, thyroid gland, and lymph nodes.
• The history is critical in determining the focus of the physical examination.
• The nurse can utilize OLD CART mnemonic to ask follow-up questions in order to obtain a full description of the condition.
• If the patient noticed severe or frequent headaches, the nurse should ask about the onset, characteristics, location, associated manifestations, duration, and relieving/exacerbating factors.
• The nurse should note the quantity, distribution, texture, and pattern of hair loss on the scalp.
• Parkinson disease’s facial symptom is characterized as a mask-like face with decreased blinking and a characteristic stare.
• The session is concluded with the teacher directing the students to mark their place in the work tracker.
• The students will mark their place in the work tracker, which is a visual to help students track how much work they have accomplished and how much work there is left to do.
• The instructor will now rationalize the answers to the students and will encourage them to ask questions and to discuss among their classmates.
• The work tracker will be part of the student activity sheet.
• The nurse should note for scaliness, lymph nodes, nevi, or other lesions on the scalp.
• The nurse should note for any deformities, depressions, lumps, or tenderness on the skull.
• The nurse should note for facial expression and contours, asymmetry, involuntary movements, edema, and masses on the face.
• The nurse should note for the colour, pigmentation, texture, thickness, hair distribution, and any lesion on the neck.
• The nurse should feel in sequence for the following nodes: Preauricular, Posterior auricular, Occipital, Tonsillar, Submandibular, Submental, Superficial cervical, Posterior cervical, Deep cervical chain, Supraclavicular, and Superior cervical.
• A 43-year-old Asian female presenting for a routine check-up may be experiencing changes due to aging, have a brain tumor, hyperthyroidism, or hypothyroidism.
• During a physical examination of a patient, an enlarged tender tonsillar lymph node would prompt the nurse to assess for meningitis, look for involvement of other regions of the body, and look for a source such as infection in the area that it drains.
• A 72-year-old male arriving in the emergency department after falling down his front steps may have two soft lumps on the side of his head, which could be wens, pigmented nevi, signs of abuse, or edema from the fall.
• The thyroid gland is typically soft in a patient with Graves’ disease.
• Activities that aggravate a tension headache include listening to music, sex, driving, and watching a movie.
• The thyroid cartilage lies just below the mandible, has a curve on its inferior edge, is related to the cricoid cartilage, and has a notch on its superior edge.
• Associated manifestations of a headache caused by a traumatic head injury include attention span deficit, changes in taste, gait changes, seizures, and loss of speech.
• The nurse should inspect the trachea for any deviation from its usual midline position and feel for any deviation.
• The nurse should inspect the neck for thyroid gland and palpate the thyroid gland.
• For detailed information, images and explanation, please refer to pages 219 – 224 for the physical examination of the head and neck.