Head, Face, Neck

What is the most common problem

Headaches

Headaches

-Early morning, during day, during night, gradual versus abrupt

-Duration: minutes, hours, weeks, days, relieved by medication or sleep

Character of headache

Throbbing, pounding, boring, shock like, dull

Visual prodromal event

Early on, distortion of size, shape, photophobia

Pattern of headaches

-Worse in morning or evening, worse or better as day progresses, occurs only during sleep

Associated symptoms

Nausea, vomiting, diarrhea, photophobia, visual disturbance, and difficulty falling asleep

Precipitating factors

Fever, fatigue, stress, food, additives, prolonged fasting, alcohol

Objective-physical exam

Inspect, palpate, examine exterior then interior

What are the different sized of the head

micro, macro, normo

Palpation of scalp

Texture and distribution of hair

-alopecia

-facial

-color

-tenderness

-swelling

Face

Asymmetry

-Dropping and drooling

Palpate the temporal artery

-Tenderness

-Auscultation-bell

-Edema

-Color

—> condition of skin

—> cyanosis

—> jaundice

Lesions

Sinuses

-Frontal

-Maxillary

—> transilluminate

—> palpation

Nose

size, shape, symmetry, drainage, internal mucosa, color differences, intactness, perforations of septum, polyps

Mouth

lesions, odor, ulcers, moisture, bleeding gums, tongue, palate, buccal mucosa, tonsils

Anatomy of the neck

-Trachea

-Thyroid gland

-Salivary glands

-Cervical lymph nodes

Neck exam

Evaluate ROM, sternocleiodmastoid, trapezius, scalene

Neck Assessment

Lymph nodes

-size

-shape

-consistency

-definition

-mobility

-tenderness

Preauricular

front of ear

Posterior auricular

behind ear

Occipital

back of head

Submandibular

under jaw bone

Submental

under chin

Tonsillar

under jawline

Superficial cervical/deep cervical

Along neck

Posterior cervical chain

behind ear of clavicle

Supreaclavicular

Above clavicle

Thyroid: Palpation

Pads of finers, cricoid cartilae, work laterally between the trachea and sternocleoidmastoid muscle to feel one thyroid lobe for masses, ask patient to swallow, feel for masses, repeat for the other lobe

Neck exam

The thyroid should be auscultated for bruits using the diaphtagm of your stethoscope/especially if gland is enlarged

-Carotids should be ausculated seperately using BELL portion of your stethoscope