1. Head, Face, and Neck, Including Regional Lymphatics
Health Assessment Across the Lifespan
NRS 102

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
Superficial cervical
Deep cervical
Posterior cervical
Supraclavicular

7. Structure and Function (cont.)
Developmental care
Infants and children
Fontanels
Head growth
Lymphatic system
Pregnant female
Aging adult

8. Subjective Data— Health History Questions
Headache
Head injury
Dizziness
Neck pain or limitation of motion
Lumps or swelling
History of head or neck surgery
Headache: Unusually frequent, severe? Onset? Had this type before? Location? Character? Mild, moderate, severe? Course and duration? Precipitating factors? Associated factors? Other illnesses? Taking meds? What makes it worse? Treatment? Coping strategies?
Head injury: Onset? Setting? How were you just before injury? History of illness (heart trouble, diabetes, epilepsy)? Location? Duration? Associated symptoms? Pattern? Effort to treat?
Dizziness: Determine what patient means by dizziness. Onset? Associated factors?
Neck pain: Onset? Location? Associated symptoms? Precipitating factors? Related to stress? Coping strategies?
Lumps or swelling: Recent infection, tenderness? Duration? Change in size? History of irradiation of head, neck, upper chest? Difficulty swallowing? Do you smoke? Do you drink alcohol? Thyroid problems?
History of head or neck surgery: Ever had surgery of head or neck? Why? When? How do you feel about the results?

9. 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
Infants and children: Maternal use of alcohol or drugs during pregnancy? Type of delivery? Was baby’s growth normal?
Aging adult: Dizziness affect daily activities? Neck pain affect daily activities?

10. Objective Data— Physical Exam
Head–Inspect and palpate the skull
Size and shape
Temporal area
Head–Inspect the face
Facial structures

11. Objective Data—Physical Exam (cont.)
Neck–Inspect and palpate
Symmetry
Range of motion
Lymph nodes

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

13. Objective Data—Physical Exam (cont.)
Developmental care
Infants and children
Skull
Face
Neck
Special procedures
Pregnant female
Aging adult

14. Sample Charting

15. Sample Charting (cont.)

16. Sample Charting (cont.)

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

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

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

20. Abnormal Findings (cont
Abnormal Findings (cont.) 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