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Head, Mouth, Nose, Throat, Neck and Regional Lymph Nodes: Kristin Clephane, MSN, RN, CPN
Head, Mouth, Nose, Throat, Neck and Regional Lymph Nodes: Kristin Clephane, MSN, RN, CPN
Nose, Throat,
Neck and
Regional Lymph
Nodes
Kristin Clephane, MSN, RN, CPN
The Head
Cranial Bones:
Facial Bone:
The Head
The Head
The
Neck
The Neck
Cricoid cartilage
Thyroid cartilage
Hyoid Bone
The Neck
Lymphatics
Lymph Nodes
Lymphatics
Drainage:
Developmental: Infants
and Children
Head is 90% its full size by age six, (then the rest of
the body catches up).
Developmental:
Preganancy
Aging Adult
History/Subjective
Assessment
History/Subjective
Assessment
Did mother use ETOH or street drugs? How much and how
often?
Delivery vaginal or C-section? Any problems?
Was babys growth normal?
Assessment/Objective Data
Assessment/Objective Data
Note symmetry
Assessment/Objective Data
Touch chin to chest, turn head left and right, touch ear to
each shoulder, extend head backwards (look up).
Test strength (Cranial nerve XI) by adding resistance to
persons attempt to shrug shoulders.
Look for enlargement of salivary glands, thyroid gland and
lymph nodes.
Assessment/Objective Data
LYMPH NODES
Assessment/Objective Data
Lymph Nodes
Assessment/ Objective
Data
Trachea
Should be midline.
Assessment/Objective Data
Thyroid gland
Posterior approach- move
behind the pt., Push with left
hand, palpate with right. (then
reverse)
Anterior approach- Push with
right thumb, palpate with left
thumb (then reverse). Ask pt to
swallow.
Thyroid assessment
Auscultate Listen for bruit
(this is abnormal).
Link: Bruits in thyroid
Slide 13-21
Questions?
The Nose
Nares- Nostrils
Nasal Cavity
The Sinuses
The Sinuses
Mouth
Mouth
Mouth
ThroAT
Aging Adult
Cross-Cultural
Health History/Subjective
Data
Nose:
Discharge
Frequent colds
Sinus pain
Trauma
Epistaxis
Allergies
Altered smell
Health History/Subjective
Data
Mouth
Sores/lesions
Sore throat
Bleeding gums
Toothache
Hoarseness
Dysphagia
Altered taste
Smoking/Alcohol
Self-Care behaviors (dentist, dentures)
Slide 16-36
Mouth infection
Mouth dryness
Sore throat
Tooth loss
Tooth eruption
Self-care
Taste, smell
Slide 16-37
Equipment
Penlight
Gloves
External nose
Nasal cavity
Slide 16-38
Sinus AreasPalpate
Slide 16-39
Slide 16-40
Objective Data/Physical
Exam
Objective DataPhysical
Exam
ThroatInspection
1+=Visible, 2+ halfway
between tonsillar pillars
and uvula, 3+ touching
the uvula, 4+ touching
each other.
Questions?