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Assessment of the Head, Neck, Lymphatic System

Assessment of the Head, Neck, Lymphatic System. ANATOMY: Head. Frontal Parietal Temporal Occipital Zygomatic Lacrimal Sphenoid Maxilla/Mandible. ANATOMY: Neck. Sternocleidomastroid Trapezius Trachea Thyroid gland Salivary glands: parotid, submandibular, sublingual

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Assessment of the Head, Neck, Lymphatic System

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  1. Assessment of the Head, Neck, Lymphatic System

  2. ANATOMY: Head • Frontal • Parietal • Temporal • Occipital • Zygomatic • Lacrimal • Sphenoid • Maxilla/Mandible

  3. ANATOMY: Neck • Sternocleidomastroid • Trapezius • Trachea • Thyroid gland • Salivary glands: parotid, submandibular, sublingual • Cervical lymph nodes

  4. ANATOMY: Lymph Nodes • preauricular • posterior auricular • occipital • submandibular • submental • jugulodigastric • superficial cervical / deep cervical • posterior cervical chain • supraclavicular

  5. Focused Health History • Present health/illness status • lifestyle, environment, nutrition • Past health history • surgery, chronic illness, HA • Family health history • malignancy, blood disorders, recent infections, TB, history of HA, thyroid problems

  6. Assessment: HEAD • Inspection • symmetry • size and shape • any unusual movements • Palpation of scalp • texture and distribution of hair • tenderness

  7. Assessment: FACE • Inspection • facial expression • color, condition of skin • CN VII • Palpation of temporal artery • Thickening, hardness, tenderness • Ausculate • TMJ • Open/close jaw: crepitus, pain

  8. Assessment: NECK • Inspection • symmetry: trachea centered • stability • Range of motion • R ear to R shoulder • L ear to L shoulder • Chin to sternum • hyperextend neck

  9. NECK • Lymph nodes: 10 set of nodes • pads of 2nd, 3rd, 4th fingers • palpate both sides except at carotid • location, size, shape, # of nodes, surface characteristics, consistency, tenderness, mobility/fixation, signs of inflammation

  10. NECK • Thyroid gland • Inspection • swallow • Palpation • lobes usually not palpable • anterior/posterior, swallow (rises) • Auscultation • bell to auscultate for bruit

  11. Anatomy: EYE • Conjunctiva • Sclera: outer white layer • Cornea: covers pupil/iris • Anterior chamber: aqueous humor • Lacrimal apparatus: produces tears • Iris: color of eye • Pupil: allows light to pass • Lens

  12. EYE • Vitreous body: fluid in post. champ. • Retina: inner coat of the eye • Optic nerve: light travels to visual cortex • Optic disc: nasal side of retina • Retinal vessels: 4 sets • Macula: central vision, darker orange • Fovea centralis: sharpest vision

  13. Assessment History: EYES • Present health/illness status • vision, last eye exam • difficulty with vision • Past health history • trauma, surgery, infections • Family health history • myopia, hyperopia, strabismus • cancer, color blindness, cataracts, glaucoma, DM, HTN

  14. EYES: Inspection • Measure visual acuity • snellen, rosenbaum • Assess visual fields: confrontation • EOM: 6 cardinal fields, corneal light reflex, cover/uncover test • External ocular structures: eyelids, eyelashes, conjunctiva, sclera, cornea, anterior chamber, lacrimal apparatus, iris, pupil

  15. Eye Variations • Nearsightedness (Myopia): cannot see objects far away • Farsightedness (Hyperopia): cannot see objects nearby • Presbyopia: become farsighted as age • Astigmatism: uneven curvature: blurred vision

  16. Eye Variations • Exophthalmos: protrusion of eyeball • Ptosis: drooping upper eyelid • Hordeolum: sty • Conjunctivitis: “pink eye” • Arcus senilis: white ring around cornea that is normal with age

  17. Anatomy: EARS • Auricle (pinna) • Helix (outer), antihelix (inner) • Tragus • Tympanic membrane • shiny, transparent, pearl gray • light reflex: R=5 o’clock, L=7 o’clock • Manubrium (handle) • Pars flaccida • Pars tensa

  18. Focused Health History • Present health/illness status • Earaches, infections, discharge, hearing loss, tinnitus, vertigo, self-care behaviors • Past health history • Injuries, surgeries, environmental noise • Family health history • Hearing loss

  19. Assessment: EARS • Inspection • Position, shape • Hearing acuity • Weber, Rinne, Whisper test • Palpation • Tragus • Otoscopic Exam • Auditory canal • Tympanic membrane • Landmarks

  20. Anatomy: NOSE • Inferior turbinate • Middle turbinate • Superior turbinate • Ala of nose • Frontal, ethmoid, sphenoid, maxillary sinuses

  21. Focused Health History • Present health/illness status • Discharge, sinus pain, epistaxis, altered smell • Past health history • Frequent colds, trauma, allergies • Family health history

  22. Assessment: Nose and Sinuses • Inspection • Visual, nasoscopic • Patency • Septum • Transillumination • Frontal, maxillary • Palpation • Sinuses: frontal and maxillary

  23. Anatomy: MOUTH • Stenson’s duct: upper 2nd molar, parotid gland • Wharton’s duct: under tongue, submandibular gland • Palatine arch: tonsils • Uvula: midline • Teeth: 32 • Tongue: frenulum

  24. Assessment: MOUTH • Inspection • lips, gums, teeth • buccal mucosa • sublingual areas • tongue • paratid duct opening • pharynx, tonsils • hard palate, soft palate, uvula • Palpation

  25. Focused Health History • Present health/illness status • Sores or lesions, sore throat, bleeding gums, toothache, hoarseness, • Past health history • Smoking, alcohol consumption, self-care habits: dental, dentures • Family health history • Cancer

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