Head and neck assessment

• Acromegaly is characterized by enlargement of the facial features (nose, ears) and the hands and feet.

  
• Cushing syndrome may present with a moon-shaped face with reddened cheeks and increased facial hair.

  
• Exophthalmos is seen in hyperthyroidism.

  
• A tightened, hard face with thinning facial skin is seen in scleroderma.

  
• Bell palsy usually begins suddenly and reaches a peak within 48 hours. Symptoms may include twitching, weakness, paralysis, drooping eyelid or corner of the mouth, drooling, dry eye, dry mouth, decreased ability to taste, eye tearing, and facial distortion. One-sided facial paralysis is characteristic

  
• Myxedema (severe hypothyroidism) is characterized by a dull, puffy face; edema around the eyes; and dry, course, and sparse hair.

  
• Clients with Parkinson disease have a mask-like facial appearance, along with a shuffling gait, rigid muscles, and diminished reflexes.

  
• SIMPLE GOITER

  • A simple (nontoxic) goiter is any enlargement of the thyroid gland not caused by inflammation or neoplasm.

  
• Cerebrovascular accident results in neurologic damage. The symptoms depend on what part of the brain was affected.

  
• Parotid gland


  The largest of the three main parts of salivary glands, located on either side of the face, just below and in front of the ears
• Sublingual gland


  Salivary gland on either side of the tongue
• Trachea


  The air passage extending from the throat and larynx to the main bronchi
• Hyoid bone


  A horse-shaped bone at the bone at the base of the tongue; the only bone in the body not directly attached to another bone
• Cricoid cartilage


  Ring-like cartilage forming the lower and back part of the larynx
• Thyroid gland


  The largest of the endocrine glands, situated in the front and sides of the neck just below the thyroid cartilage
• Cranial nerve XI (Accessory)


  Spinal accessory nerve-contraction of trapezius and sternocleidomastoid muscles
• Trapezius and sternocleidomastoid


  Paired muscles that allow movement and provide support to the neck and head
• Adam's apple


  The thyroid cartilage located just above the cricoid cartilage
• Vertebra prominens


  Cervical vertebra (C7) that can be easily palpated when the neck is flexed
• Assessing carotid arteries


  Assess each artery individually to prevent a reduction of the blood supply to the brain
• Sudden head and neck pain and stiffness with oral temperature of 37.7 C (100 F)

  Symptoms of meningeal irritation
• Sharp shooting facial pains lasting 10-20 seconds, occurring more frequently


  Symptoms of trigeminal neuralgia
• Severe recurring headache, lasting for several days, accompanied by nausea and vomiting

  Symptoms of a migraine headache
• Intense and stabbing headaches, often occurring in the late evening


  Symptoms of cluster headache
• Dull, aching, tight, and diffuse headaches lasting several days


  Symptoms of tension headaches
• Severe headache usually beginning in the morning, becoming worse when coughing, accompanied by dizziness


  Symptoms of a tumor-related headache
• Ask the client if touching the head is permissible before performing a head and neck assessment on an adult client who has immigrated to the US from Cambodia
• Larger and thicker skull and facial bones


  Symptoms of acromegaly
• Asymmetry in front of the client's ear lobes


  Symptoms of parotid gland enlargement
• Asking the client to swallow a small sip of water

  Allows the nurse to inspect movements of the client's thyroid gland
• Trachea pulled to the left side

  Refer the client to a physician for further evaluation
• Approach the client posteriorly when assessing the thyroid gland
• Instruct the client to sit in an upright position when assessing the lymph nodes
• Diffuse neck enlargement, perspiring, fidgety, "hungry all the time, but I have lost weight"


  Symptoms of a priority nursing diagnosis of health-seeking behaviors related to verbalization of wanting to stay healthy and concerns over weight loss
• Cranium


  Houses and protects the brain and major sensory organs
• Bones of the cranium

  • Frontal (1)
  • Parietal (2)
  • Temporal (2)
  • Occipital (1)
  • Ethmoid (1)
  • Sphenoid (1)
• Cranial bones in the adult

  Joined together by immovable sutures: the sagittal, coronal, squamosal, and lambdoid sutures
• Facial bones


  Give shape to the face
• Facial bones


  • Maxilla (2)
  • Zygomatic (cheek) (2)
  • Inferior conchae (2)
  • Nasal (2)
  • Lacrimal (2)
  • Palatine (2)
  • Vomer (1)
  • Mandible (jaw) (1)
• Mandible


  Has free movement (up, down, and sideways) at the temporomandibular joint (TMJ)