Unit 5A.9: NECK Assessment | Eyes, Ears, Nose & Sinuses, Mouth & Pharynx, Neck

1. Inspect the neck

2. Inspect Range of Motion

3. Palpate the trachea

4. Palpate the thyroid gland

5. Palpate lymph nodes

5 Steps of the Neck Assessment

Postauricular

Identify the lymph node

(1)

Occipital

Identify the lymph node

(2)

Superficial Cervical

Identify the lymph node

(3)

Posterior Cervical

Identify the lymph node

(4)

Deep Cervical

Identify the lymph node

(5)

Supraclavicular

Identify the lymph node

(6)

Preauricular

Identify the lymph node

(7)

Parotid

Identify the lymph node

(8)

Tonsillar

Identify the lymph node

(9)

Submental

Identify the lymph node

(10)

Submandibular

Identify the lymph node

(11)

Anterior Cervical

Identify the lymph node

(12)

• Symmetric

• Head centered

• Without bulging masses

Normal findings when inspecting the neck

Swelling, enlarged masses or nodules — may indicate an enlarged thyroid gland, inflammation of lymph nodes, or tumor

Abnormal findings when inspecting the neck

• 45 degree flexion

• 55 degree extension

• 40 degree lateral abduction

• 70 degree rotation

Normal findings when inspecting range of motion

• Muscle spasms

• Inflammation

• Cervical arthritis

Abnormal findings when inspecting range of motion

What may cause stiffness, rigidity, and limited neck mobility?

Meningitis

Abnormal findings when inspecting range of motion

What is stiff neck often a late symptom of?

Trachea is midline

Normal findings when palpating the trachea

• Large atelectasis (lung collapse)

• Fibrosis

• Pleural adhesions

Abnormal findings when palpating the trachea

When is the trachea pulled to the affected side?

• Tumor

• Enlarged thyroid lobe

• Pneumothorax

• Aortic Aneurysm

Abnormal findings when palpating the trachea

When is the trachea pushed to the unaffected side?

No

Normal findings when palpating the thyroid gland

Is the thyroid gland usually palpable in clients that are extremely thin with a long neck?

Isthmus

Normal findings when palpating the thyroid gland

What is usually palpated in the midline of clients that are extremely thin with a long neck?

Right lobe 25% larger than left lobe

Normal findings when palpating the thyroid gland

If the thyroid can be palpated, what are the lobes usually in clients that are extremely thin with a long neck?

• Thyroid feels more nodular or irregular due to fibrotic changes that occur with aging.

• Thyroid felt lower in the neck due to age related structural changes.

Normal findings when palpating the thyroid gland

If the thyroid can be palpated, what does the thyroid of an older client feel like? And due to what?

Diffuse enlargement like

• Hyperthyroidism

• Graves’ Disease

• Endemic Goiter

Abnormal findings when palpating the thyroid gland

In cases of what may the thyroid gland be palpated?

Thyroiditis

Abnormal findings when palpating the thyroid gland

What may an enlarged, tender gland result from?

Metabolic Processes

Abnormal findings when palpating the thyroid gland

Where may multiple nodules of the thyroid gland be seen?