Assessing neck, thyroid, lymph nodes (EXAM 5)

Pt. experiencing neck pain or stifness may indicate 3

1. muscle strain or spasm

2. head injury

3. swollen lymph nodes

When gathering health hx on lymph nodes, what recent conditions should we ask about? (4)

1. colds

2. viruses

3. infections

4. exposure to radiation / chemicals

Lymph nodes may be enlarged due to what disease? (2)

1. cancer

2. HIV

For assessing neck, thyroid, and lymph nodes, we should have the pt. expose what areas of body?

neck and upper chest

Each side of neck is divided into 2 triangles by what muscle?

sternocleidomastoid

Where is the sternocleidomastoid muscle?

extends from behind ear down to clavicle

When obtaining thyroid hx, we should ask for changes in what? (3)

1. temp tolerance

2. mood swings

3. texture of skin, hair, nails

What could changes in temp tolerance, skin, hair, nails, and mood swings indicate?

thyroid disease

When gathering thyroid hx, we should ask if patient has what 2 conditions?

1. hypothyroidism

2. hyperthyroidi

When gathering thyroid hx, we should ask if pt. has any trouble?

swallowing

Where is the thyroid gland?

anterior lower neck, over to each side of trachea

What does the thyroid gland secrete?

a hormone that regulates metabolism

When inspecting a patients neck, we want to note overall

symmetry or scars

We check a pt.s neck ROM by having pt. (2)

1. move chin to chest, head back

2. move head so ears are moved toward shoulder on each side

When inspecting thyroid, look at lower area of neck for (4)

1. enlargement of thyroid gland

2. nodules

3. masses

4. areas of fullness

How can we get better visualization of our pt.s thyroid area?

hyperextend neck

WE should offer the pt. a sip of water while observing neck and have pt. 1._______ and watch for 2._______ movement of thyroid gland.

swallow, upward

Can the thyroid gland be visualized normally?

no

To palpate trachea, where should we place our hands?

either side of trachea below thyroid cartilage

When palpating patient’s thyroid gland, we have patient tilt head to right and swallow, while we ?

displace the left lobe and palpate right

How should the lobes of the thyroid feel?

smooth, rubbery, free of nodules

There are approx. how many lymph nodes?

100

What are the 2 purposes of the lymph nodes?

1. to filter lymphatic fluid

2. protect body from foreign antigens

Chains of lymph nodes extend from ?

lower half of head down into neck

What shape are lymph nodes, typically

oval / bean

What size and texture are the lymph nodes, usually

less than 2 cm and soft

What are lymph nodes usually embedded into?

connective tissue

Lymph nodes are palpated for enlargement due to (4)

1. inflammation

2. infection

3. cancer

4. some meds / vaccines

What position should pt. be in for palpating lymph nodes?

relaxed and bed neck slightly foward

What 5 things are we assessing about lymph nodes?

1. location

2. size

3. shape

4. consistency

5. tenderness

normal findings of lymph nodes in ALL ppl 2

1. not easily palpable

2. small, non-tender

Abnormal lymph node findings (3)

1. enlarged

2. palpable

3. tender

What can enlarged, palpable, and/or tender lymph nodes indicate? (2)

1. infection

2. tumors

2 expected age related findings in older adults for lymph nodes

1. diminished immune response

2. atrophy

5 expected age related changes of the Thyroid in older adults

1. diminished function

2. atrophy

3. not seen

4. nodules

5. irregular edges