HEAD AND NECK

• Types of Headache

  • Sinus headache
  • Cluster Headache
  • Tension Headache
  • Migaraine Headache
  • Tumor-related headache
• Sinus headache


  Pressure like pain in one specific area of the face of head, eye ridge, below cheek, after cold, sipon
• Cluster Headache


  Stabbbing pain, Tearing eyelid drooping, runny nose, eye and orbit radiating to face and temporal, Ingestion of alcohol
• Tension Headache

  Dull, tight, diffuse, Frontal, temporal, occipital, Stress, anxiety, depression
• Migaraine Headache


  Nausea, vomiting, sensitivity to light, Eye, temple, cheeks, forehead, one side of face, prodromal stage, Vertigo, ingestion of alcohol, chees, chocolate
• Tumor-related headache


  Aching, nausea, vomiting, neurologic, Varies where the tumor is located, No prodromal, aggravated by coughing, sneezing, sudden movements of head
• Assessing of Head and Neck

  1. Prepare the client

  2. Wash Hands
• Inspect (Head)

  • Size shape and configuration
  • Involuntary movements
• Normal head


  • Round and is of normal size or head circumference
  • Normocephalic
  • In proportion w/ gross body structure
  • Frontal, parietal and occipital prominences
  • Smooth skull contour
• Deviation from normal head

  • Disproportionate
  • Asymmetric parietal and temporal prominences; with more prominent nose and forehead; longer mandible
  • Increased head circumference
  • Square – head (Mowat-wilson Syndrome) (Smith-magenis Syndrome)
  • Bulging / depressed bone (Plagiocephaly)
  • Abnormal increase in head size in young child: may indicate hydrocephalus
  • Inconsistently large head size in adolescent or adult: may indicate: acromegaly (Enlarged features), microcephaly (small features), Paget's disease- Acorn shaped skull
• Palpate (head)


  • Consistency, nodules, masses, depression
• Normal palpation of head

  • Smooth, uniform consistency; absence of nodules or masses
• Deviation from normal palpation of head

  • Sebaceous cysts
  • Local deformities from trauma
  • Masses
  • Nodules
• Inspect (Face)


  • Symmetry and facial movements
• Normal facial movements


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

  • Asymmetric facial movements
  • Drooping of lower eyelid and mouth (Bell's Palsy- face Paralysis) (CVA\Stroke- drooping weakness)
  • Involuntary facial movement
  • Moon face (reddened cheeks, Cushing syndrome)
  • Parkinson's disease (mask like face)
  • Parotitis- Parotid gland enlargement
• Assess Signs of Stroke FAST warning signs: Face drooping, Arm Weakness, Speech difficulty, Time to call 911
• Inspect (Facial features)

  • Symmetry
• Normal facial features


  • Symmetric facial features
  • Eye brow hair equally distributed
  • Palpebral fissures equal in size
• Deviation from normal facial features

  • Asymmetric features
  • Increased facial hair
  • Thinning of eyebrows
  • Exopthalmos
  • Moon face
• Inspect (eyes)

  • For edema and shallowness
• Normal eyes


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

  • Periorbital edema
  • Cachexa- Sunken eyes, cheeks and temples (indicative of dehydration, starvation, and illness)
• Palpate Temporal Artery

  • Elasticity and tenderness
• Normal temporal artery

  • Elastic
  • Non tender
• Deviation from normal temporal artery

  • Tenderness
• Palpate TemporoMandibular Joint

  • Range of motion
• Normal temporomandibular joint

  • No edema
  • Eyes not sunken
• Deviation from normal temporomandibular joint

  • Swelling
  • Tenderness
  • Crepitation
• Inspect (Neck)


  • From neutral position and hyperextended (use penlight)
• Normal neck

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

  • Enlargements
  • Lymphadenopathy, lymphoma, or other malignancy
  • Torticollis- deviation of neck to one side caused by spasmodic contraction of neck muscles
  • Enlarged, visible thyroid
  • Goiter or malignant mass
• Inspect for movement of structure (Neck)

  • Symmetry
• Normal neck movement

  • Moves symmetrical
• Deviation from normal neck movement

  • Moves asymmetrical
• Inspect for cervical vertebrae

  • Visibility and palpability
• Normal cervical vertebrae

  • C7 visible
  • Palpable
• Deviation from normal cervical vertebrae

  • Prominence
  • Swelling
• Inspect range of motion (neck)

  • Smoothness and limitations
• Normal neck range of motion

  • Movement is smooth