Notes on Head and Neck Assessment

Understand the structures and functions of the head and neck.
Identify risk factors for head and neck disorders and methods to reduce these risks.
Conduct an accurate nursing history related to the head and neck.
Perform a physical assessment of the head and neck using appropriate techniques.
Differentiate normal from abnormal findings during head and neck assessments.
Recognize age-specific findings in head and neck assessments, particularly in older adults.

Cranium: Protects the brain and major sensory organs; consists of:
- Cranial bones: Frontal, parietal, occipital, temporal, ethmoid, sphenoid; joined by immovable sutures.
Face: Comprises 14 facial bones, including the temporal artery and parotid glands; facial symmetry reflects mood.
- Key features: Eyebrows, eyes, ears, nose, mouth, palpebral fissures, nasolabial folds.
Neck: Includes muscles (sternomastoid, trapezius), blood vessels (internal jugular veins, carotid arteries), the thyroid gland, trachea, and lymph nodes.

Key symptoms to inquire about:
- Headaches, neck pain, medications, and limited range of motion (ROM).
- Symptoms such as lumps, cough, difficulty swallowing, head injury, blurred vision, dizziness, skin changes, palpitations.
- Family history and lifestyle health practices.

Increased sensitivity to cold, constipation, depression, fatigue, heavier menstrual periods, pale/dry skin, thin hair/nails, weakness, unintentional weight gain.
Severe complications: Hoarseness, facial puffiness, thickened skin, eyebrow thinning.

Sudden weight loss without change in appetite, increased appetite, tachycardia, nervousness, heat sensitivity, fatigue, muscle weakness, goiter.

Risk includes age, transportation accidents, violence, falls, alcohol use. Client education on safety practices for all ages (e.g., seat belts, helmets) is vital.

Symptoms: Throbbing pain, sensitivity to light/noise, nausea/vomiting, can last up to 3 days.
Triggers: Stress, certain foods, alcohol.

Symptoms: Intense, localized, usually around the eye area; sudden onset, associated with autonomic features such as runny nose.

Symptoms: Dull, aching pressure often relieved by heat or massage; can last days, months, or years.

Evaluate size, shape, and consistency of the head.
- Normal: Normocephalic, upright, no involuntary movements.
- Abnormal: Microcephaly, acromegaly, visible pathological lumps.

Inspect for symmetry, movement, expression:
- Normal: Symmetric features without abnormal movements.
- Abnormal: Asymmetry suggesting conditions like CVA or Bell’s Palsy.

Inspect for symmetry, movement, lumps, and masses:
- Normal: Symmetric movement, midline trachea.
- Abnormal: Enlarged masses/nodules; stiff neck may indicate meningitis.

Techniques in palpation:
- Use slow, circular motions; compare bilaterally.
- Normal findings are round, discrete nodes <1 cm. Lymphadenopathy indicates potential infection or malignancy.

Preauricular, Postauricular, Occipital, Tonsillar, Submandibular, Submental, Superficial and Deep Cervical, Supraclavicular.

Acromegaly: Enlarged facial features due to excess growth hormone.
Cushing Syndrome: Moon face, hirsutism, issues with skin elasticity due to chronic steroid use.
Scleroderma: Hardening of skin, muscle atrophy; sign of connective tissue disease.

Bell’s Palsy vs. CVA:
- Bell’s Palsy: Lower motor neuron condition affecting one side of the face.
- CVA: Upper motor neuron condition impacting primarily lower facial muscles.

Review content on cranial/facial anatomy, lymph node locations, symptoms of thyroid disorders, and differences in headache types.
Understand normal vs. abnormal assessment findings and specific considerations for older adults.
Grasp techniques for palpating lymph nodes and interpreting findings accordingly.