Chapter 11 Head Neck and Regional Lymphatics Copyright

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Chapter 11 Head, Neck, and Regional Lymphatics Copyright 2002, Delmar, A division of Thomson

Chapter 11 Head, Neck, and Regional Lymphatics Copyright 2002, Delmar, A division of Thomson Learning

Competencies l l l Identify the anatomic structures of the head and neck. Identify

Competencies l l l Identify the anatomic structures of the head and neck. Identify the lymph nodes of the head and neck. Describe the system-specific health history for the head and neck. (continues) Copyright 2002, Delmar, A division of Thomson Learning

Competencies l l Demonstrate the physical assessment of the head and neck. Describe normal

Competencies l l Demonstrate the physical assessment of the head and neck. Describe normal findings in the physical assessment of the head and neck. List common abnormalities found in physical assessment of the head and neck. Explain pathophysiology of common abnormalities found in physical assessment of the head and neck. Copyright 2002, Delmar, A division of Thomson Learning

Anatomy and Physiology l l l Skull Face Neck Thyroid Lymphatics Blood supply Copyright

Anatomy and Physiology l l l Skull Face Neck Thyroid Lymphatics Blood supply Copyright 2002, Delmar, A division of Thomson Learning

Health History l l Determine presence/absence of age- and gender-specific diseases of the head

Health History l l Determine presence/absence of age- and gender-specific diseases of the head and neck Common chief complaints £ £ £ Neck pain or stiff neck Hoarseness Neck mass Headache Head injury Copyright 2002, Delmar, A division of Thomson Learning

Evaluating Chief Complaint l Determine the following characteristics Quality £ Associated manifestations £ Aggravating

Evaluating Chief Complaint l Determine the following characteristics Quality £ Associated manifestations £ Aggravating factors £ Alleviating factors £ Setting £ Timing £ Copyright 2002, Delmar, A division of Thomson Learning

Past Health History l l l Medical conditions Surgeries Medications Communicable diseases Injuries or

Past Health History l l l Medical conditions Surgeries Medications Communicable diseases Injuries or accidents Special needs Copyright 2002, Delmar, A division of Thomson Learning

Family Health History l Determine if family history of Thyroid disease £ Headache £

Family Health History l Determine if family history of Thyroid disease £ Headache £ Copyright 2002, Delmar, A division of Thomson Learning

Social History l l Alcohol use Work environment Home environment Stress Copyright 2002, Delmar,

Social History l l Alcohol use Work environment Home environment Stress Copyright 2002, Delmar, A division of Thomson Learning

Health Maintenance Activities l l l Sleep Diet Use of safety devices Copyright 2002,

Health Maintenance Activities l l l Sleep Diet Use of safety devices Copyright 2002, Delmar, A division of Thomson Learning

General Approach to Head and Neck Assessment l l Greet patient, explain assessment techniques

General Approach to Head and Neck Assessment l l Greet patient, explain assessment techniques Environment £ £ £ l l Quiet Warm Private Adequate lighting Upright sitting position Compare right and left sides Systematic approach Copyright 2002, Delmar, A division of Thomson Learning

Assessment of the Head l Inspection Shape £ Symmetry £ l Palpation Contour £

Assessment of the Head l Inspection Shape £ Symmetry £ l Palpation Contour £ Masses £ Depression £ Tenderness £ Copyright 2002, Delmar, A division of Thomson Learning

Inspection and Palpation of the Scalp l Inspect £ l Normal findings £ l

Inspection and Palpation of the Scalp l Inspect £ l Normal findings £ l Lesions or masses Scalp is shiny, intact, without lesions or masses Abnormal findings £ Bleeding, lesions, masses, hematomas Copyright 2002, Delmar, A division of Thomson Learning

Assessment of the Face l Inspection Shape £ Symmetry £ (continues) Copyright 2002, Delmar,

Assessment of the Face l Inspection Shape £ Symmetry £ (continues) Copyright 2002, Delmar, A division of Thomson Learning

Assessment of the Face l Normal findings Symmetrical features £ Palpebral fissures equal £

Assessment of the Face l Normal findings Symmetrical features £ Palpebral fissures equal £ Nasolabial folds present bilaterally £ Shape can be oval, round, or slightly square £ (continues) Copyright 2002, Delmar, A division of Thomson Learning

Assessment of the Face l Abnormal findings £ £ Deformed or absent structures Asymmetry

Assessment of the Face l Abnormal findings £ £ Deformed or absent structures Asymmetry More or less pronounced facial features Diseases which may alter facial features: Bell’s palsy, Down syndrome, Graves’ disease, Myxedema, Cachexia, Cushing’s syndrome Copyright 2002, Delmar, A division of Thomson Learning

Mandible l l Palpate and auscultate the temporomandibular joint when the client opens and

Mandible l l Palpate and auscultate the temporomandibular joint when the client opens and closes the mouth Normal findings £ l No discomfort, joint articulates smoothly without clicking or crepitus Abnormal findings £ Pain, tenderness, crepitus, clicking, or snapping sound Copyright 2002, Delmar, A division of Thomson Learning

Neck l l l Inspection Palpation Normal findings £ l Full ROM, pain free,

Neck l l l Inspection Palpation Normal findings £ l Full ROM, pain free, symmetrical muscles, no masses Abnormal findings £ Limited ROM, pain, asymmetrical muscles, masses Copyright 2002, Delmar, A division of Thomson Learning

Thyroid Gland l l l Inspection Palpation Auscultation (continues) Copyright 2002, Delmar, A division

Thyroid Gland l l l Inspection Palpation Auscultation (continues) Copyright 2002, Delmar, A division of Thomson Learning

Thyroid Gland l Normal findings Symmetrical movement with swallowing £ Adam’s apple more pronounced

Thyroid Gland l Normal findings Symmetrical movement with swallowing £ Adam’s apple more pronounced in males £ No masses, tenderness, or enlargement £ Absent bruit £ (continues) Copyright 2002, Delmar, A division of Thomson Learning

Thyroid Gland l Abnormal findings Mass £ Enlarged gland £ Goiter £ Asymmetrical enlargement

Thyroid Gland l Abnormal findings Mass £ Enlarged gland £ Goiter £ Asymmetrical enlargement £ Presence of a nodule or bruit £ Copyright 2002, Delmar, A division of Thomson Learning

Lymph Nodes l l Inspection Palpation (continues) Copyright 2002, Delmar, A division of Thomson

Lymph Nodes l l Inspection Palpation (continues) Copyright 2002, Delmar, A division of Thomson Learning

Lymph Nodes l Location £ £ £ £ Preauricular Postauricular Occipital Submental Submandibular Anterior

Lymph Nodes l Location £ £ £ £ Preauricular Postauricular Occipital Submental Submandibular Anterior and posterior cervical chains Tonsilar Supraclavicular (continues) Copyright 2002, Delmar, A division of Thomson Learning

Lymph Nodes l Normal findings £ l Unable to palpate or see nodes Abnormal

Lymph Nodes l Normal findings £ l Unable to palpate or see nodes Abnormal findings Enlarged nodes £ Able to palpate or see nodes £ Tenderness £ Firm, hard nodes £ Copyright 2002, Delmar, A division of Thomson Learning

Gerontological Variations l l l Appearance and function of head and neck may be

Gerontological Variations l l l Appearance and function of head and neck may be altered Buffalo hump Kyphotic posture Limited ROM Dizziness Copyright 2002, Delmar, A division of Thomson Learning