head and neck

• The framework of the head is the SKULL
• The skull has two subsections:

  • Cranium
  • Face
• The cranium houses and protects the brain and major sensory organs
• The cranium consists of eight bones:

  • Frontal
  • Parietal
  • Occipital
  • Ethmoid
  • Temporal
  • Sphenoid
• The face gives shape to the face
• The face consists of fourteen bones:

  • Maxilla
  • Zygomatic (cheek)
  • Inferior conchae
  • Nasal
  • Lacrimal
  • Palatine
  • Vomer
  • Mandible (jaw) - TMJ
• The neck is composed of muscles, ligaments, and cervical vertebrae
• The neck includes:

  • Hyoid bone
  • Blood vessels
  • Larynx
  • Trachea
  • Thyroid gland
• Lymph nodes have a filtering function for lymph and produce lymphocytes and antibodies
• Lymph nodes are less than 1 cm long and buried deep in connective tissues
• Collecting Subjective Data involves interviewing for nursing health history
• History of Present Health Condition includes assessing pain using COLDSPA:

  • Character
  • Onset
  • Location
  • Duration
  • Severity
  • Pattern
  • Associated Factors
• Other symptoms to assess:

  • Headache
  • Facial Pain
  • Trigeminal neuralgia (fifth cranial nerve)
  • Movement of head/neck
  • Lumps or lesions
  • Cough, dysphagia
  • Lightheadedness, dizziness, spinning sensation, blurred vision, LOC
• Past Health History includes:

  • Head or Neck Problem (trauma, injury or fall)
  • Thyroid cancer, nodules or thyroid-related medical issues
  • Radiation Therapy for a neck or chest problem
• Family History and Lifestyle and Health Practices are also important to assess
• Collecting Objective Data involves preparing the client and equipment
• Inspection and Palpation of the head and neck are key steps
• Inspection and Palpation of the head includes assessing size, shape, configuration, and involuntary movement
• Abnormal findings may include:

  • Microcephaly
  • Acromegaly
  • Acron-shaped, enlarged skull bones (Paget Disease)
• Palpation of the head should feel hard, smooth, and without lesions
• Inspection and Palpation of the face involves assessing symmetry, features, movement, expression, and skin condition
• Abnormal findings may include:

  • Bell palsy
  • Pale, swollen face (Nephrotic Syndrome)
  • Mask-like face (Parkinson Disease)
• Palpation of the temporal artery should feel elastic and non-tender
• Abnormal findings may indicate temporal arteritis (blindness)
• Palpation of the temporomandibular joint should have no swelling, tenderness, or crepitus
• Abnormal findings may include limited motion, swelling, tenderness, or crepitation (TMJ syndrome)
• Inspection of the neck involves observing position, symmetry, and lumps/masses
• Abnormal findings may include swelling or nodules/masses
• Range of Motion (ROM) assessment includes neck movements like flexion, extension, lateral abduction, and rotation
• Abnormal findings may include muscle spasms, inflammation, or cervical arthritis
• Palpation of the trachea and thyroid gland are important steps
• Abnormal findings in the thyroid gland may include deviations from midline, diffuse enlargement, palpable gland, nodules, or tenderness
• Auscultation of the thyroid gland should be done if an enlarged thyroid is found
• Palpation of lymph nodes is also part of the assessment
• Preauricular, postauricular, and occipital nodes should be palpated
• Types and Characteristics of Headaches include:

  • Sinus Headache
  • Cluster Headache
  • Tension Headache
  • Migraine Headache
  • Tumor-related Headache
• Abnormalities of the Head and Neck may include:

  • Acromegaly
  • Cushing Syndrome
  • Scleroderma
  • Hyperthyroidism
  • Parkinsons Disease
  • Simple Golter
  • Cerebrovascular Accident
  • Bell Palsy
  • Hypothyroidism (Myxedema)