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- 1. Head, mouth and Neck Assessment PREPARE BY. Rezq Mansour Supervised By Dr Supervised By Dr. Fawz Abu Algaith Supervised By Dr Supervised By Dr Supervised By Dr. Fawz Abu Algaith Supervised By Dr Republic of Yemen Ministry of Higher Education and Scientific Research Razi University Master Program
- 2. Summary: Assessment of Head, mouth & Neck Includes: • Head • Face • Oral cavity • Neck & lymph nodes • Trachea • Thyroid
- 3. Anatomy
- 4. THE HEAD A skull is a rigid bony box that protects the brain, sense organs and upper spinal cord It includes : The bones of the cranium The bones of the face
- 5. The skull bone include Six bones that form the skull and are fused together at sutures. The skull is covered by scalp tissue, which is
- 6. The skull face bones Frontal bone Parietal bone Occipital bone Temporal bone
- 7. Face bones : consists of 14 bones that protect facial structures, including : The eyes, ears,nose, and mouth. These structures are generally symmetric. Like the skull.
- 8. • • These bones are immobile and are fused at sutures, with the exception of the mandible. The mandible articulates with the temporal bone of the skull at the temporomandibular joint, allowing for
- 10. The examination divided to Subjective Data post history present history Objective Data Inspection palpation
- 11. Head examination Subjective Data-Head Headache (HA) Injury Dizziness/Syncope Hx. Head or Face Surgery
- 12. Objective Data-Head Inspection and palpation head and face size, shape, skin characteristics Tenderness
- 13. Normal finding Normocephalic , skull is symmetric, upright in a straight position Scalp is shiny, intact, without lesions or masses
- 14. Abnormal findings in Pediatric Hydrocephalus
- 15. Down Syndrome
- 17. MASSES HEMATOMAS
- 21. Mouth Anatomy • Hard and soft palates • Uvula • Tongue
- 22. Salivary glands • Parotid • Submandibular • Sublingual
- 24. Subjective Data- Oral cavity • Sores/lesions • Sore throat • Bleeding gums • Toothache • Dysphagia • Altered taste • Tobacco
- 25. Objective Data- Oral Cavity Exam • Inspect and palpate: • Client opens and closes jaw- feel TMJ (temporomandibular Joint) • Note condition of teeth, gums and mucosa • Parotid glands: if swelling • Lips: (lumps, lesion, …etc) • Open mouth, stick out tongue, move side to side (tests CN XII) • Say AAH …soft palate rises midline (tests CN X) • With tongue blade inspect cheeks and underside lips • With gloves and gauze- pull tongue L and R
- 26. Objective Data- Oral Cavity Exam • Inspect uvula, palate, tonsils • Uvula looks like hanging pendant if split in two- bifid • Palate: anterior hard palate, whitish while posterior soft palate pinkish • Tonsils- graded by enlargement: • 1+ visible • 2+ near uvula • 3+ touching uvula • 4+ touching together
- 30. THE NECK EXAMMENATION Structures of the neck include : Upper portion of the spine, Esophagus, Trachea, Thyroid gland, Arteries, Veins, and Lymph nodes.
- 31. Neck anatomy Structures of the neck include : Trachea, Thyroid gland,
- 33. Lymph nodes - Preauricular - Posterior auricular (mastoid) - Occipital - Submental -Submandibular
- 34. Subjective Data-Neck History of problems Neck pain Lumps Swelling Surgery Neck Examination
- 35. Objective Data-Neck Inspect- symmetry, midline, erect ,masses and enlargement Note enlargement of lymph nodes Test for ROM, (naturally decreases with age). Palpate- carotid pulse, lymph nodes & thyroid Auscultate carotid arteries.
- 36. Range Of Motion
- 37. •Normal findings –Full ROM (range of motion), pain free, symmetrical muscles, no masses •Abnormal findings –Limited ROM, pain, asymmetrical muscles, masses Neck Mass
- 38. Trachea
- 39. Trachea normally centered; (at the suprasternal notch)
- 40. Subjective Data- Trachea History of trachea problems? Tracheostomy
- 41. Objective Data-Trachea Palpate trachea for : Deviations Tenderness Masses The Mass push trachea away from affected area, whereas atelectasis causes pull toward affected area.
- 42. • The cartilages should be smooth, non tender and move easily under examiner’s fingers when the client swallow • Palpation done by placing the thumb and forefinger on each side of the trachea
- 44. Objective Data- Thyroid Inspect: note deviations or bulges As person extends neck slightly and swallows water, note upward, symmetrical movement of trachea and other cartilage
- 45. Palpating Thyroid Ask person to tilt head slightly to side and palpate lobes. Use fingers on opposite side to displace gland in lateral direction, ask person to swallow: isthmus rises
- 46. • • • Posterior approach Rest thumbs on back of person’s neck, Place fingers on cricoid cartilage. Displace gland & palpate isthmus as person swallows, thyroid rises Palpating Thyroid
- 47. Palpating Thyroid Anterior approach - Rest fingers around sternomastoid muscle - place thumbs on side of trachea. - Displace gland & palpate isthmus as person swallows, thyroid rises
- 48. Normal thyroid finding as: Thyroid palpated as symmetric, without enlargement. Symmetrical movement with swallowing. Texture consistent, with no masses, nodules or tenderness.
- 50. Enlarged gland
- 52. Lymph nodes
- 53. Lymph nodes - Preauricular - Posterior auricular (mastoid) - Occipital - Submental -Submandibular
- 54. • • • Examination of lymphatic System : Firstly inspection for Enlarged lymph nodes, Skin lesions And edema
- 55. Examination of lymphatic System : • Secondly palpating gently the lymph nodes areas using pads of " 2, 3, 4" fingers in gentle circular motion. • Press lightly and then increasing pressure gradually. • Move skin lightly over the under lying tissues & not moving the examining fingers over the skin. • Large nodes due to malignancy are generally not tender vary in size, hard, asymmetrical
- 56. Lymph Nodes •Normal findings –Unable to palpate or see nodes •Abnormal findings –Enlarged nodes –Able to palpate or see nodes –Tenderness –Firm, hard nodes
- 58. THANK YOU