Assessing The Head, Neck, And Regional Lymphatics

Front 1

How do you begin the assessment

Back 1

Inspect the hair,neck,cranium and face. Palpate the temporal artery,temporal-mandibular joint,maxillary. and frontal sinuses.Assess for function of cranial nerve#7.

Front 2

What is step #2

Back 2

Assess the eyes, start by testing the visual fields by confrontation, this evaluates cranial#2. Test extra ocular muscle function assessing for corneal light reflex in the same spot on both eyes. Also test extra ocular function by checking for parralleltracking when assessing the six cardinal positions of gaze. Extra ocular muscle function evaluates nerves #3,4, and 6.

Front 3

What is step #3

Back 3

Inspect external structures of the eye including eyebrows, eyelids, then inspect the normally clear conjunctivae and white sclera as well as each cornea and iris. Note pupil size, shape, and equality, then darken the room slightly and test the pupilary light reflex. Both pupils should react briskly. Then test for accommodation. After darkening the room a bit more, use an opthalomoscope to check the red reflex, then inspect the red reflexand ocular fundus including the optic disk, retinal vessels, general background and macula.

Front 4

What is step #4

Back 4

With normal room lighting, evaluate the ears. Start with external ears noting alignment, skin condition and auditory meatus. Next move the auricle and push on the tragus to test for tenderness. Using an otoscope, observe the auditory canal and inspect the tempanic membrane noting its normally pearl-gray color, position, landmarks and integrity.

Front 5

What is step#5

Back 5

To assess hearing begin with the voice test in which you ask the person to repeat each word after you whisper it. Do the Weber test(vibrating tuning fork) on the skull then perform the Rinne test (tuning fork against mastoid process to check bone conduction then hold tuning fork next to ear to check air conduction).

Front 6

What is step#6

Back 6

To assess the nose begin with inspection of the external nose for symmetry and lesions, then test patency of each nostril. Using a nasal speculum attached to an otoscope, inspect the nares, nasal mucosa, spetum and turbinates.

Front 7

What is step #7

Back 7

Focus on the mouth and throat. Using a pen light and tongue blade, inspect the mouth including the teeth, gums, tongue floor of mouth, buccal mucosa, palate, and uvula. If the tonsils are present grade them on a 1-4 point scale. To assess cranial nerves #9 and #10, note the position of the uvula as the person says AHHH. Test the gag reflex. To test cranial nerve #12 ask the person to stick out his tongue. If indicated, put on a glove and bi-manuelly palpate the mouth.

Front 8

What is step #8

Back 8

Examine the neck by inspecting it for symmetry, lumps, and pulsations. Next palpate the cervicle lymph nodes, pre-auricular lymph nodes, auricular, occipital, submental, submandibular, jugular digastric, and supraficial cervicle nodes. Then inspect and palpate the carotid pulse one side at a time. If indicated, auscultate for carotid bruits.

Front 9

What is step#9

Back 9

Next, palpate the trachea to determine if it is in the midline. Test range of motion in the neck by having the person titl his head forward and back, then turn his head to each side, then shrugg his shoulders. To assess muscle strength and cranial nerve#11 have the person repeat these actions against your resistance.

Front 10

What is step#10

Back 10

Give the person a glass of water and step behind him, taking a stethoscope, ruler and marking pen with you. As he takes sips of water, palpate his thyroid gland.

Front 11

Is there information missing on these assessment flash cards

Back 11

Yes. Will continue later.

Hint 11

Sounds, descriptions, etc...