Health Assessment

• Normal head


  • Round and of normal size or head circumference
  • Normocephalic
  • In proportion with gross body structure
  • Frontal, parietal, and occipital prominences; smooths skull contour
• Deviations from normal head

  • Disproportionate
  • Asymmetric parietal and temporal prominences; with more prominent nose and forehead; longer mandible
  • Increased head circumference
  • Square-head
• Abnormal increase head size in young child

  May indicate HYDROCEPHALUS
• Inconsistently large head size in adolescent or adult

  May indicate ACROMEGALY
• Normal palpation of head


  • Smooth, uniform consistence; absence of nodules and masses
• Deviations from normal palpation of head include sebaceous cysts, local deformities from trauma, masses, and nodules
• Normal facial movements


  • Raise or lower both eyebrows
  • Blink both eyes
  • Close both eyes tightly
  • Smile and show the teeth
  • Frown
  • Puff the cheeks
• Deviations from normal facial movements

  • Asymmetric facial movements
  • Drooping of lower eyelid and mouth
  • Involuntary facial movement
• Recognize the signs of stroke and act F.A.S.T: Face drooping, Arm weakness, Speech difficulties, Time to call: time loss is brain loss
• Normal facial features


  • Symmetric facial features
  • Eyebrow hair equally distributed
  • Palpebral fissures equal in size
• Deviations from normal facial features

  • Asymmetric features
  • Increased facial hair
  • Exophthalmos; moon
• Normal eyes


  • No edema
  • Eyes not sunken
• Deviations from normal eyes


  • Periorbital edema
  • Sunken eyes, cheeks and temples
• Abnormal, swelling, tenderness, crepitation in the temporomandibular joint range of motion (TMJ ROM)
• What's behind your neck
• Anatomy of the thyroid and parathyroid gland
• Parathyroid increases blood calcium levels
• Lymph nodes
• Muscles of the neck
• Normal neck inspection


  • Neck erect, midline, no lumps, bulges or masses
  • Thyroid not visible, no masses, swelling, or hypertrophy in mid to lower half of anterior neck
• Deviations from normal neck inspection

  • Lymphadenopathy, lymphoma, or other malignancy
  • Congenital torticollis (deviation of neck to one side caused by spasmodic contraction of neck muscles)
  • Goiter or malignant mass (enlarged visible thyroid)
• Normal palpation of neck


  • Supple, non-tenderness, no masses
• Abnormal palpation of neck

  • Masses, lymphadenopathy, malignancies, thyroid masses
• Cervical lymph nodes to palpate

  • Occipital
  • Post-auricular
  • Pre-auricular
  • Tonsillar
  • Submandibular
  • Superficial cervical
  • Posterior cervical
  • Deep cervical
  • Supraclavicular
  • Infraclavicular
• Normal lymph nodes


  • Normally not palpable, especially the deep clavicular nodes
  • If palpable, small (1cm), mobile, soft, non-tender, and usually superficial
• Abnormal lymph nodes


  • Palpable nodes (1cm or greater); malignancy, inflammatory or infectious process of glands or area they drain
• Palpating the thyroid


  1. Locate the thyroid isthmus below the cricoid cartilage

  2. Anterior approach: Slide fingers to the right, gently displace trachea to right, and palpate gland as patient swallows. Slide fingers to the left, gently displace trachea to left, and palpate gland as patient swallows.

  3. Posterior approach: Have patient tilt head to right, and then gently displace trachea to right, slide fingers to right, and palpate right thyroid lobe as patient swallows. Repeat with head tilted left to palpate left lobe.
• Normal thyroid palpation


  • Generally non-palpable. If some tissue is palpable, consistency is firm, smooth, and meaty with no nodularity, enlargement, or tenderness
• Abnormal thyroid palpation


  • Enlarged thyroid
  • Nodular thyroid tissue
  • Tender thyroid
• Auscultation of the thyroid

  If thyroid gland is palpable, have patient hold breath and then listen over the thyroid gland with the bell portion of the stethoscope for bruits
• The choroid maintains blood supply to the eye
• The vitreous placement of the retina and the eyeballs spherical shape