Head and Neck

• Republic of the Philippines
• Nursing Assessment of Physical Systems

  HEAD and NECK
• Head and neck assessment

  • Focuses on the cranium, face, thyroid gland, and lymph nodes contained within the head and neck
• Normocephalic


  Normal head size
• Cranium bones


  • Frontal (1 bone)
  • Parietal (2 bones)
  • Temporal (2 bones)
  • Occipital (1 bone)
  • Ethmoid (1 bone)
  • Sphenoid (1 bone)
• Face bones


  • Maxilla (2 bones)
  • Zygomatic (cheek) (2 bones)
  • Inferior chonchae (2 bones)
  • Nasal (2 bones)
  • Lacrimal (2 bones)
  • Palatine (2 bones)
  • Vomer (1 bone)
  • Mandible (jaw) (1 bone)
• Infants


  • Fontanels ("soft spots") – anterior and posterior fontanels
  • Voluntary head control should be present by about 6 months of age
• Neck muscles and cervical vertebrae

  • Sternocleidomastoid muscle – rotates and flexes the head
  • Trapezius muscle – extends the head and move the shoulders
  • 11th cranial nerve (spinal accessory nerve) – responsible for muscle movements that permits shrugging of the shoulders
  • Cervical vertebrae – C1(atlas), C2 (axis) up to C7
• Neck blood vessels


  • Internal and/or external jugular vein
  • Carotid arteries
• Nursing consideration


  Avoid bilaterally compressing the carotid arteries when assessing the neck as it might reduce blood supply to the brain
• Thyroid gland


  Largest endocrine gland producing thyroid hormones (T3, T4 and Thyrocalcitonin) that increase metabolic rate of most body cells
• Thyroid gland palpation


  • Points of reference - the trachea, cricoid cartilage and the thyroid cartilage ("Adam's apple" for male clients)
• Common thyroid disorders


  • Hypothyroidism
  • Hyperthyroidism (thyrotoxicosis)
• Lymph nodes


  They filter lymph - a clear substance composed mostly of excess tissue fluid which may or may not contain bacteria or tumor cells; they also produce lymphocytes and antibodies as defense against foreign microbes of substances
• Lymph nodes


  • Normally not palpable but may become overwhelmed with filtrates or microbes leading to painful swelling on palpation
• Types of lymph nodes

  • Preauricular
  • Postauricular
  • Tonsillar
  • Occipital
  • Submandibular
  • Submental
  • Superficial cervical
  • Posterior cervical
  • Deep cervical
  • Supraclavicular
• T3


  Stimulates the nervous system resulting in increased wakefulness, alertness, and responsiveness to external stimuli. Active, can impact your cells and your metabolism.
• T4


  Increases numerous enzymes that produce energy for the body. Inactive, it doesn't affect your body's cells. Converts into T3.
• Thyrocalcitonin


  Also called calcitonin, lowers the levels of calcium and phosphate in the blood and promotes the formation of bone.