1. Neck Assessment Heather Nelson, RN

2. Neck Inspect for symmetry, masses, scars, gland or lymph node enlargement. Inspect for symmetry, masses, scars, gland or lymph node enlargement. Evaluate ROM by having patient flex, extend, rotate, and laterally turn the head and neck. Evaluate ROM by having patient flex, extend, rotate, and laterally turn the head and neck. Inspect the neck as the patient swallows, observing symmetry and alignment. Inspect the neck as the patient swallows, observing symmetry and alignment.

3. Head and Neck Lymph Nodes Inspect and palpate lymph nodes of the head and neck. Inspect and palpate lymph nodes of the head and neck.

4. Lymph Nodes The superficial lymph nodes are named by location and are easily palpable when enlarged. The superficial lymph nodes are named by location and are easily palpable when enlarged. Note the size and location of any palpable nodes and whether they were soft or hard, non-tender or tender, and mobile or fixed. Note the size and location of any palpable nodes and whether they were soft or hard, non-tender or tender, and mobile or fixed.

5. Lymph Nodes Systematically palpate with the pads of your index and middle fingers for the various lymph node groups. Systematically palpate with the pads of your index and middle fingers for the various lymph node groups.

6. Lymph Nodes Preauricular Preauricular In front of the ear In front of the ear Postauricular Postauricular Behind the ear Behind the ear Occipital Occipital At the base of the skull At the base of the skull Tonsillar Tonsillar At the angle of the jaw At the angle of the jaw Submandibular Submandibular Under the jaw on the side Under the jaw on the side Submental Submental Under the jaw in the midline Under the jaw in the midline Superficial (Anterior) Cervical Superficial (Anterior) Cervical Over and in front of the sternomastoid muscle Over and in front of the sternomastoid muscle Supraclavicular Supraclavicular In the angle of the sternomastoid and the clavicle In the angle of the sternomastoid and the clavicle

7. Thyroid Gland Evaluation Inspect neck anteriorly for visible thyroid tissue and asymmetry with swallowing. Inspect neck anteriorly for visible thyroid tissue and asymmetry with swallowing. Watch patient swallow when head is hyperextended. Note asymmetry and enlargement. Watch patient swallow when head is hyperextended. Note asymmetry and enlargement. Palpate using a gentle touch. Palpate using a gentle touch. Palpate for size, shape, configuration, tenderness, and presence of any nodules. Palpate for size, shape, configuration, tenderness, and presence of any nodules.