HEALTH ASSESSMENT

• Normal findings for head assessment


  • Round and is of normal size or head circumference
  • Normocephalic
  • In proportion w/ gross body structure
  • Frontal, parietal and occipital prominences
  • Smooth skull contour
  • Smooth, uniform consistency; absence of nodules or masses
  • Symmetric facial movements
  • Symmetric facial features
  • No edema
  • Eyes not sunken
  • No edema
  • Eyes not sunken
• Deviations from normal head assessment

  • Disproportionate
  • Asymmetric parietal and temporal prominences; with more prominent nose and forehead; longer mandible
  • Increased head circumference
  • Square – head
  • Bulging / depressed bone
  • Abnormal increase in head size in young child: may indicate hydrocephalus
  • Inconsistently large head size in adolescent or adult: may indicate acromegaly
  • Sebaceous cysts
  • Local deformities from trauma
  • Masses
  • Nodules
  • Asymmetric facial movements
  • Drooping of lower eyelid and mouth
  • Involuntary facial movement
  • Increased facial hair; thinning of eyebrows; exopthalmos; moon face
  • Periorbital edema
  • Sunken eyes, cheeks and temples (indicative of dehydration, starvation, and illness)
  • Abnormal
  • Swelling
  • Tenderness
  • Crepitation
• Assessment of the Neck

  • Inspecting the neck from the neutral position
  • Inspecting the neck when hyperextended
  • Use light palpation and check for masses or areas of tenderness
• Normal findings for neck assessment

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

  • Enlargements
  • Lymphadenopathy, lymphoma, or other malignancy
  • Torticollis
  • Enlarged, visible thyroid
  • Goiter or malignant mass
  • Masses: Lymphadenopathy, malignancies, thyroid masses
• Cervical Lymph Nodes


  • Occipital nodes
  • Post - auricular nodes
  • Pre - auricular nodes
  • Tonsillar nodes
  • Submandibular nodes
  • Submental nodes
  • Superficial cervical nodes
  • Posterior cervical nodes
  • Deep cervical nodes
  • Supraclavicular nodes
  • Infraclavicular nodes
• Normal findings for lymph node palpation


  • Lymph nodes normally not palpable especially the deep and clavicular nodes
  • If a node is palpable, normal characteristics include small, 1 cm, mobile, soft, nontender, and usually superficial
• Deviations from normal lymph node palpation

  Palpable nodes (1 cm or greater): Malignancy, inflammatory, or infectious process of glands or area they drain
• Palpating the Thyroid


  • Locate the thyroid isthmus below the cricoid cartilage
  • Anterior approach
  • Posterior approach
• Normal findings for thyroid palpation


  Generally nonpalpable. If some tissue is palpable , consistency is firm, smooth, and meaty, with no nodularity, enlargement, or tenderness
• Deviations from normal 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
• Normal findings for thyroid auscultation


  No sounds detected
• Deviations from normal thyroid auscultation


  Increased vascularity of hyperthyroidism