1. Head, Face, and Neck, Including Regional Lymphatics
Chapter 13

2. Structure and Function
Subjective Data—Health History Questions
Objective Data—Physical Exam
Abnormal Findings

3. Structure and Function
Head
Cranial bones
Sutures
Facial bones
Facial muscles
Salivary glands

4. Structure and Function (cont.)
Neck
Neck muscles
Anterior and posterior triangles
Thyroid gland

5. Structure and Function (cont.)
Lymphatics
Preauricular
Posterior auricular (mastoid)
Occipital
Submental
Submandibular

6. Structure and Function (cont.)
Lymphatics (cont.)
Jugulodigastric (tonsilar)
Superficial cervical
Deep cervical
Posterior cervical
Supraclavicular (may be assessed with breast exam)

7. Structure and Function (cont.)
Developmental care
Infants and children
Fontanels
Head growth
Lymphatic system
Pregnant female- thyroid enlargement
Aging adult-more prominent nose, orbits

9. Subjective Data— Health History Questions
Headache
Head injury
Dizziness
Neck pain or limitation of motion
Lumps or swelling
History of head or neck surgery

10. Subjective Data— Health History Questions (cont.)
Additional history for infants and children
Maternal alcohol or drug use
Type of delivery
Growth pattern
Additional history for aging adult
Dizziness
Neck pain

11. Objective Data— Physical Exam
Head–Inspect and palpate the
Skull
Size and shape (normocephalic)
Temporal area-TMJ
Head–Inspect the face
Facial structures- symmetry

12. Objective Data—Physical Exam (cont.)
Neck–Inspect and palpate
Symmetry
Trachea position
Range of motion
Lymph nodes
Muscle strength
SCM, Trapezius

13. Objective Data—Physical Exam (cont.)
Neck–Inspect and palpate (cont.)
Thyroid gland
Posterior approach
Anterior approach
Auscultate

14. Objective Data—Physical Exam (cont.)
Developmental care
Infants and children
Skull- head circumference
Special procedures
Pregnant female
Aging adult

15. Abnormal Findings Abnormalities in Head Size and Contour
Hydrocephalus
Paget’s disease of bone (osteitis deformans)
Acromegaly

16. Abnormal Findings (cont.) Swellings of the Head and Neck
Torticollis (wryneck)
Thyroid—multiple nodules
Thyroid—single nodule
Pilar cyst (wen)
Parotid gland enlargement

17. Abnormal Findings (cont.) Pediatric Facial Abnormalities
Fetal alcohol syndrome
Congenital hypothyroidism
Down syndrome
Atopic (allergic) facies
Allergic salute and crease
© Pat Thomas, 2006.

18. Abnormal Facial Appearances With Chronic Illnesses
Parkinson’s syndrome
Cushing’s syndrome
Graves’ disease
Hyperthyroidism
Myxedema (hypothyroidism)
Bell’s palsy
Brain attack or cerebrovascular accident
Cachectic appearance
Scleroderma