Neck, Thyroid, Lymph Nodes Assessment

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Questions and Answers

What may indicate a change in thyroid function in older adults?

Mood swings and changes in skin texture (correct)

Thicker hair and nails

Improved temperature tolerance

Stable weight and energy levels

Which is a key technique for assessing the thyroid gland?

Imaging studies

Inspection and palpation (correct)

Auscultation

Blood testing only

Which of the following describes an abnormal finding when palpating lymph nodes?

Flat nodes that are soft and symmetrical

Tender, swollen nodes with recent infections

Firm, non-tender nodes that are mobile

Hard, fixed nodes with an irregular shape (correct)

Which method is NOT typically used when assessing the neck and lymph nodes?

Vocal cord examination Signup and view all the answers

Which of the following best describes the normal findings when palpating lymph nodes?

Small, non-tender nodes are typically normal. Signup and view all the answers

What is the correct sequence for palpating lymph nodes in the neck?

Occipital, Preauricular, Submandibular, Deep cervical chain. Signup and view all the answers

Which of the following characteristics may indicate abnormal findings in lymph nodes?

Nodes are easily palpable and tender. Signup and view all the answers

When examining lymph nodes, which technique is recommended for palpation?

Palpating in a gentle rotating motion. Signup and view all the answers

In older adults, what is a common finding related to lymph nodes?

Nodes may feel irregular and be palpable. Signup and view all the answers

What should a practitioner assess in lymph nodes during palpation?

Location, size, shape, consistency, and tenderness. Signup and view all the answers

Which lymph node is located at the angle of the mandible?

Submandibular lymph node. Signup and view all the answers

What is the normal palpation characteristic of the thyroid gland?

Smooth, rubbery, and free of nodules Signup and view all the answers

What should be done if an enlarged thyroid gland or nodules are detected during inspection?

Report findings to the healthcare provider Signup and view all the answers

What is the expected size of normal lymph nodes?

Less than 2 cm Signup and view all the answers

Which characteristic is typically absent in normal thyroid palpation?

Tenderness Signup and view all the answers

How should the fingers be positioned during thyroid gland palpation?

On either side of the trachea below the thyroid cartilage Signup and view all the answers

What is a common method for assessing lymph nodes?

Palpate one side at a time, using circular motions Signup and view all the answers

Lymph nodes are typically shaped like which of the following?

Oval or bean-shaped Signup and view all the answers

Study Notes

Lymph Nodes

Lymph nodes are a part of the lymphatic system.
Lymph nodes are located throughout the body.
Lymph nodes filter lymph fluid and protect the body from foreign antigens.
Lymph nodes vary in shape and size.

Palpation of Lymph Nodes

Palpation of lymph nodes is typically done by advanced practitioners.
Lymph nodes should be palpated in a sequence.
Lymph nodes are palpated using the pads of the index and middle fingers in a gentle rotating motion.
Lymph nodes are palpated on both sides of the body at the same time.
To palpate lymph nodes:
- Stand in facing or to the side of the patient.
- Have the patient relax and bend their neck slightly forward.

Sequence for Palpation of Lymph Nodes

Occipital: base of the skull
Postauricular: over the mastoid
Preauricular: in front of the ear
Retropharyngeal (tonsillar): at the angle of the mandible
Submandibular: along the base of the mandible
Submental: midline under the chin
Anterior cervical: along the sternocleidomastoid muscle
Posterior cervical: along the anterior edge of the trapezius
Deep cervical chain: deep in the sternocleidomastoid muscle
Supraclavicular: above the clavicle

What to Assess When Palpating the Lymph Nodes

Location
Size and shape
Consistency and tenderness

Normal Findings of Lymph Nodes

Lymph nodes are not typically easily palpable.
Nonpalpable lymph nodes are normal.
Small, non-tender lymph nodes are also common and normal.

Abnormal Findings of Lymph Nodes

Enlarged, palpable, or tender lymph nodes can be associated with infection and tumors.

Thyroid gland:
- Diminished thyroid function.
- Atrophy of the thyroid gland.
- Normally not visualized.
- Nodules may form and be palpable.
- May feel irregular.
Lymph nodes:
- Diminished immune response.
- Lymph node atrophy.
- Often not visualized.

Thyroid Gland

The thyroid gland lies in the anterior lower neck.
The thyroid gland is over and to each side of the trachea (two lobes).

Inspection of the Thyroid Gland

Inspect the lower area of the patient's neck to see if an enlargement of the thyroid gland is visible or if nodules, masses or areas of fullness are present at the base of the neck.
Have the patient hyperextend their neck for better visualization.
Offer the patient a sip of water and, while observing the neck, have the patient swallow.
Watch for upward movement of the thyroid gland.
Normally, the thyroid gland cannot be seen or felt.

Palpation of the Thyroid Gland

The thyroid gland is often palpated while standing behind the patient.
Place your fingers on either side of the trachea below the thyroid cartilage.
Ask the patient to tilt their head to the right and swallow.
As the patient swallows, displace the left lobe while palpating the right lobe.
Repeat to palpate the left lobe.

Thyroid Gland Palpation (Continued)

The thyroid gland can also be palpated from the front by placing fingers on either side of the trachea and gently pressing one side at a time.
The thyroid gland is normally NOT palpable.
If palpable, the lobes should feel smooth, rubbery, and free of nodules.
Shape / symmetry: normal: equal on both sides
Tenderness: should be absent
Size: Report to HCP if enlarged.
Nodules: Report to HCP if one or more nodules are palpable.

Health History: Neck

Pain or stiffness: May indicate muscle strain or spasm, head injury, swollen lymph nodes.
Patient report of neck lumps.

Health History: Lymph Nodes

Recent colds, viruses, infections, exposure to radiation or chemicals: may cause temporary or permanent lymph node enlargement.
Lymph nodes may also be enlarged with diseases such as cancer and HIV.

Health History: Thyroid

Change in temperature tolerance, mood swings, change in texture of skin, hair and nails: May indicate thyroid disease.
Does the patient have a history of hypothyroidism or hyperthyroidism?
Does the patient take any thyroid medications?
History of thyroid surgery?
Family history of thyroid disease?
Any difficulty swallowing?

Physical Assessment: Neck

Have the patient expose their neck and upper chest.
May be helpful to have the patient seated in a chair so the nurse can stand behind the patient as well as being face to face.
Physical assessment techniques:
- Inspection
- Palpation
Supplies needed: light source.

Neck Inspection

Each side of the neck is divided into two triangles by the sternocleidomastoid muscle extending from behind the ear down to the clavicle.
Note overall symmetry or scars.
Inspect for neck masses.
Check for mobility and range of motion.

Neck Physical Assessment

Have the patient expose the neck and upper chest.
May be helpful to have the patient seated in a chair so that the nurse can stand behind the patient.
It can be helpful to be face to face.

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Description

This quiz covers essential information about lymph nodes, their role in the lymphatic system, and techniques for palpation. It includes details about the location and sequence of lymph node palpation, which is critical for advanced practitioners. Test your knowledge on the subject to ensure effective practice.