Health Assessment Lecture 4: Head and Neck

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Questions and Answers

Which quality of a headache is specifically associated with migraine headaches?

Pressure-like sensation

Throbbing (correct)

Bandlike tightness

Occipital pain

In assessing head injuries, which factor is least relevant to determine prior to the injury?

Location of impact

Wearing a helmet

Dizziness

History of illness (correct)

What sensation describes vertigo as opposed to general dizziness?

Spinning sensation (correct)

Feeling of falling

Swimming sensation

Feeling faint

Which of the following is not a common associated symptom of severe headaches?

Shortness of breath Signup and view all the answers

When palpating the skull, which characteristic is not normal?

Visibly asymmetric head shape Signup and view all the answers

Which factor is least likely to aggravate tension headaches?

Caffeine consumption Signup and view all the answers

Which condition is least likely to be associated with neck pain and limitations in motion?

Thyroid issues Signup and view all the answers

What type of headache is characterized by pain around the eye and cheek area?

Cluster headache Signup and view all the answers

What is the location of the submandibular lymph nodes?

Halfway between the tip and angle of the mandible Signup and view all the answers

Which of the following conditions would cause the trachea to shift toward the affected side?

Pleural adhesions Signup and view all the answers

During a thyroid examination, which finding suggests hyperthyroidism?

Auscultation reveals a bruit Signup and view all the answers

What is the correct approach to palpate the thyroid gland using the anterior method?

Using thumbs Signup and view all the answers

Which abnormal finding in the thyroid gland suggests potential malignancy?

Presence of nodules or lumps Signup and view all the answers

What is the main characteristic of the normal trachea?

Midline position with symmetric spaces Signup and view all the answers

How should the posterior approach to palpating the thyroid gland be performed?

One hand palpates while the other pushes the thyroid Signup and view all the answers

What physical characteristic would indicate an abnormal finding in the trachea?

Shifted position Signup and view all the answers

What is an abnormal finding when palpating the temporal artery?

Artery feels hardened and thick Signup and view all the answers

Which of the following could result in a flat affect when inspecting a patient's facial expression?

Depression Signup and view all the answers

How would you describe an abnormal finding during the palpation of the temporomandibular joint?

Crepitation and tenderness Signup and view all the answers

What characterizes normal facial symmetry when inspecting facial structures?

Erect head position centered midline Signup and view all the answers

Which condition could lead to enlarged lymph nodes, as observed during palpation?

Infection or neoplasm Signup and view all the answers

Which abnormal finding suggests a central brain lesion during a facial structure inspection?

Asymmetrical palpebral fissures Signup and view all the answers

What indicates a limitation in range of motion (ROM) in the cervical region?

Pain during movement Signup and view all the answers

Which of the following would indicate an appropriate finding of the salivary glands during palpation?

Soft, discrete, and movable Signup and view all the answers

Study Notes

Health Assessment - Lecture 4: Assessment of Head and Neck

Subjective Data:
- Headaches: Timing (onset, duration, frequency), Location (frontal, temporal, behind eyes, band-like, sinus, occipital), Type (tension - occipital, frontal, band-like tightness; migraines - supraorbital, frontotemporal; cluster - around eye, forehead, cheek), Quality (throbbing, pounding, shooting - migraines), Severity (mild, moderate, severe), Medications (contraceptives, bronchodilators, nitrates), Associated factors (nausea, vomiting, vision changes, neck pain, stomach problems), Aggravated and relieving factors, Effort to treat & coping strategies.
- Head Injury: Onset (setting - helmet/hard hat use, before injury - dizzy, lightheaded, seizure, after injury), Location (where head hit), Discharge (nose/mouth), History of illness, Associated symptoms, Effort to treat.
- Dizziness: Determine exact meaning (lightheadedness, swimming sensation, feeling of falling/spinning - vertigo).
- Neck Pain: Onset, Location, Associated symptoms, Precipitating factors.
- Lumps or swelling in neck: Any recent infection? Any tenderness? (acute infection), Difficulty swallowing (dysphagia), Smoker? (increased risk of respiratory & oral cancer), History of thyroid problems?
- Hx of head or neck surgery:

Inspection of Head and Face - Objective Data

Inspect and Palpate the Skull: Size and Shape (assess shape by palpating scalp):
- Head size/shape varies with ethnicity.
- Normocephalic (round, symmetrical, appropriately related to body size) - normal finding.
- Deformities (microcephaly - small head, macrocephaly - large head) - abnormal finding.
Inspect the Face:
- Facial expression (inspect face & noting facial expression):
  - Normal - appropriate to situation and behavior.
  - Abnormal - tense, rigid muscles (anxiety), flat affect (depression), excessive smiling (inappropriate).
- Facial Structures (Symmetric):
  - Eyebrows, palpebral fissures, nasolabial folds, & sides of the mouth.
  - Asymmetry - abnormal finding (central brain lesion or cranial nerve VII damage).
  - Exophthalmos, pigmentation, periorbital edema, involuntary movements/tics, or excessive blinking - abnormal finding.

Inspect & Palpate the Neck - Objective Data

Symmetry:
- Normal - centered, held erect, symmetrical accessory muscles.
- Abnormal - head tilt with muscle spasm, rigid head and neck (arthritic/arthritis).
Range of Motion (ROM):
- Normal - smooth and controlled motion.
- Abnormal - pain with any movement, limited movement (cervical arthritis, arthritic neck).
Test muscle strength and carotid artery pulsation.
Note enlargement of salivary and thyroid glands.
Lymph Nodes:
- Use gentle pressure, palpate with both hands.
- Note location, size, shape, mobility, consistency, tenderness.
- Normal - soft, discrete, non-tender, movable lymph nodes, non-palpable salivary glands.
- Abnormal (lymphadenopathy) - enlargement of lymph nodes > 1 cm (infection, allergy, or neoplasm).
- Different lymph node locations (preauricular, posterior auricular, occipital, submental, submandibular, jugulodigastric, superficial cervical, deep cervical, posterior cervical, supraclavicular).
Trachea:
- Normal- midline, symmetric spaces on both sides.
- Abnormal- shifted towards affected side (e.g., atelectasis, pleural adhesions, or fibrosis [indication of possible illness]); shifted to unaffected side (e.g., pneumothorax, aortic aneurysm, tumor, or unilateral thyroid lobe enlargement).
Thyroid Gland:
- Anterior or Posterior approach (palpate).
- Normal - not palpable.
- Abnormal - enlarged, auscultate for bruit (soft, pulsatile, blowing sound—heard best with stethoscope bell); enlarged lobes are easily palpated before swelling or tenderness, nodules/lumps.

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Description

This quiz focuses on the key elements of assessing head and neck conditions, including subjective data related to headaches, head injuries, and dizziness. It covers characteristics such as timing, location, type, quality, severity, and associated factors. Understanding these assessments is crucial for accurate diagnosis and treatment planning.