HAS - Head and Neck

• Head and Neck assessment

  Focuses on the cranium, face, thyroid gland, and lymph nodes

  
• Sensory glands in the head and neck

  • Eyes
  • Ears
  • Nose
  • Mouth
• Things to remember during assessment

  • Positioning: Individual sits upright
  • Environment: Ensure good lighting, privacy, and hygiene
  • Initial Steps: Explain exam, obtain consent, obtain vital signs, ask about tenderness
• Levels of consciousness


  • Alert: Normal response
  • Confused: Disoriented
  • Lethargic: Drowsy
  • Obtunded: Slowly responding
  • Stuporous: Minimal response
  • Comatose/Unresponsive: No response
• Skull and scalp assessment

  • Notice asymmetries, deformities, lacerations, signs of trauma
  • Skull shape varies by age, gender, race
  • Malformations can be caused by congenital disorders, trauma, brain tumors, scalp swelling, hematoma, skin cancer, hydrocephalus
• Normal findings for head assessment

  Round, normal size, in proportion, smooth contour, normocephalic, head held still
• Abnormal head conditions


  • Microcephaly: Abnormally small head
  • Acromegaly: Larger, thicker skull and facial bones
  • Hydrocephalus: Abnormal increase in head size
  • Bulging fontanelle: Sign of intracranial pressure
  • Sunken fontanelle: Indicates dehydration
  • Involuntary head movements: Neurologic disorders
• Face assessment


  • Inspect for symmetry, features, movement, expression, skin condition
  • Palpate temporal artery, temporomandibular joint

  
• Temporal arteritis


  Inflammation of the temporal arteries that may lead to blindness
• F.A.S.T. method


  Used for face assessment
• Neck assessment


  • Inspect for position, symmetry, lumps/masses, jugular vein distension
  • Inspect cervical vertebrae and thyroid movement
  • Palpate trachea, thyroid gland, lymph nodes
  • Auscultate thyroid gland

  
• Goiter


  Swelling (hypertrophy) of the thyroid gland
• Jugular vein distension


  Indicator of excessive fluid volume, not decreased fluid volume
• Sites of lymph nodes


  • Pre-auricular
  • Post-auricular
  • Occipital
  • Tonsillar
  • Submandibular
  • Submental
  • Superficial cervical
  • Posterior cervical
  • Supraclavicular
  • Infraclavicular
  • Deep cervical
• The mandible is the only movable bone in the skull
• The temporomandibular joint (TMJ) connects the mandible to the temporal bones of the cranium
• The TMJ allows for opening, closing, and side-to-side movement of the jaw
• The TMJ allows for opening and closing movements of the mouth as well as side-to-side movements.
• The maxilla forms the upper jaw and supports the teeth.