Upload
ballano-borinaga-gino-al
View
14
Download
0
Embed Size (px)
DESCRIPTION
assessent
Citation preview
Click to edit Master subtitle style
2/5/16
HEAD AND NECK ASSESSMENT
2/5/16
A. Structure & function
HEAD Cranium
Cranium houses & protects the brain and major sensory organs
Consist of 8 bones:1 frontal
2 temporal
2 parietal
1 occipital
1 ethmoid
1 sphenoid
2/5/16
1
211
12
3
5
4
7
6
10
9
8
13
2/5/16
FaceFacial bones (14 bones)All facial bones are immovable
except the mandible which has a free movement at the temporomandibular joint.
Consists of many muscles that produce facial movement & expression
Temporal artery
Parotid glands
Submandibular salivary glands
2/5/16
NECKCompose of muscles,
ligaments and the cervical vetebrae.
Contained within the neck are:
Hyoid bone
Several major blood vessels
The larynx
Trachea
Thyroid gland
2/5/16
Muscles and Cervical Vertebrae
Sternocleidomastoid rotates and flexes the head
Trapezius extends the head and moves the shoulders
2/5/16
Two major muscles also forms triangles that provide important landmarks for assessment;
Anterior triangle under the mandible
Posterior triangle between the trapezius and sternomastoid muscles.
C1 - C7 located in the posterior neck and support the cranium
2/5/16
Blood vessels
Internal jugular veins Carotid arteriesExternal jugular veins
2/5/16
Thyroid glandLargest endocrine gland
Produces thyroid hormones
Landmark structure for
accurate palpation:
Trachea
Cricoid cartilage
Thyroid cartilage (Adams apple)
larger, located just above the
cricoid cartilage.
Hyoid bone
Consist of 2 lateral lobes that curve posteriorly on both sides of the trachea & esophagus.
2/5/16
Lymph nodes of the head & neck
1
3
2
10
4
7
9
6
5
8
Click to edit Master subtitle style
2/5/16
Collecting subjective data
2/5/16
Health historyUse COLDSPA
Pain
Do you experience neck pain?
Do you experience headache? Describe.
Do you have any facial pain? Describe.
Do you have difficulty moving your head or neck?
Other symptomsHave you noticed any lumps or lesions on your
head or neck that do not heal or disappear? Describe their appearance and location.
2/5/16
Have you experienced any dizziness, lightheadedness, spinning sensation, or loss of consciousness? Describe.Have you noticed a change in the
texture of your skin, hair or nails.Have you noticed a change in your
energy level, sleep habits or emotional stability?
Have you experienced any palpitations, blurred vision or changes in bowel habits?
2/5/16
Past health history
Described any previous head or neck problems you have had? treatment?, Results?Have you ever undergone radiation therapy for problem in your neck region?
2/5/16
Family history
History of head and neck cancer in your family?History of migraine headaches in your family?
Click to edit Master subtitle style
2/5/16
Collecting objective data
2/5/16
Physical examination
Head and FaceInspection
1. Inspect the head. For size, shape & configuration.
Normal: Symmetrical, round & erect and in midline. No lesions visible.
Abn : Skull & facial bones are larger & thicker
2/5/16
2. Inspect for involuntary movement. Normal : Head is still and
upright Abn : Tremors, involuntary
nodding, head tilted to one side
2/5/16
3. Inspect the face. For symmetry, features, movement, expression & skin conditions Normal : Symmetric with a round and
oval, elongated or square appearance. No abnormal movements.
Abn : Asymmetry in front of the earlobes (parotid enlargement), Unusual or asymmetric orofacial movements, drooping on one side of the face, Mask-like face, Sunken face with depressed eyes and hallow cheeks, swollen face
2/5/16
1 2
2/5/16
Palpation1. Palpate the head. Palpate for
consistency. Normal : Hard and smooth without
lesions
Abn : Lesions or lumps on the head
2. Palpate temporal artery Normal : Elastic and non-tender
Abn : Hard, thick, and tender with inflammation
2/5/16
3. Palpate the Temporomandibular joint (TMJ) Normal : (-) swelling, tenderness, or
crepitation, mouth opens & closes fully, lower jaw moves laterally
Abn : Limited ROM, swelling, tenderness, or crepitation
2/5/16
NECK
InspectionInspect the neck.Normal : symmetric with head centered and
without bulging masses.
Abn : Swelling, enlarged masses, or nodules
Inspect movement of neck structuresNormal : thyroid & cricoid cartilage, and
thyroid gland move upward symmetrically.
Abn : Asymmetric and generalized enlargement
2/5/16
Inspect the cervical vertebrae. Normal : C7 or vertebrae prominence is
visible and palpable.
Abn : Prominence or swelling other than C7.
Inspect ROM.Normal : smooth and controlled with 45
degree flexion, 55 degree extension, 40 degree lateral abduction, 70 degree rotation.
Abn : Stiffness, rigidity. Limited ROM (inflammation, spasms, arthritis)
2/5/16
Neck Palpation
Palpate the tracheaNormal : midline
Abn : Pulled to one side
Palpate the thyroid gland. Normal : if palpable, smooth, firm,
nontender, nodule free. Right lobe 25% larger than left lobe
Abn : enlargement, (+) nodules
2/5/16
2/5/16
Lymph nodes of the head and neck Palpate the:
1. Preauricular nodes
2. Postauricular nodes
3. Occipital nodes
4. Palpate the tosillar nodes
2/5/16
5. Palpate the submandibular
6. Palpate the submental
7. Palpate the superficial cervical nodes
2/5/16
8. Palpate the posterior cervical nodes
9. Palpate the deep cervical chain nodes
10.Palpate the supraclavicular nodes
11. Infraclavicular nodes
2/5/16
Differentiating Lymph NodesCHARACTERISTICS NORMAL INFECTION MALIGNANCY
Size 1 cm Enlarged Enlarged
Shape Round Round Irregular
Consistency Soft to rubbery Boggy Hard
Delimitation Well defined Well defined Irregular borders
Mobility Mobile Mobile Immobile
Tenderness Nontender Tender Nontender
2/5/16
Normal : (-) swelling, tenderness, hardness, enlargementAbn : (+) swelling, tenderness, hardness,
enlargement, immobility.
2/5/16
Neck Auscultation
Auscultate the thyroid only if you find an enlarged thyroid gland.Normal : No sound
Abn : a soft, blowing, swishing sound (bruit) auscultated over thyroid lobes is often heard in hyperthyroidism.
Slide 1Slide 2Slide 3Slide 4Slide 5Slide 6Slide 7Slide 8Slide 9Slide 10Slide 11Slide 12Slide 13Slide 14Slide 15Slide 16Slide 17Slide 18Slide 19Slide 20Slide 21Slide 22Slide 23Slide 24Slide 25Slide 26Slide 27Slide 28Slide 29Slide 30Slide 31Slide 32