assessment head, neck and mouth in critical care assessment contain anatomy way of assess, normal finding and abnormal by Dr Rezq Mansour Alqetwi critical care nursing master
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Assessment head and neck(1).pdf
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
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
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
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.
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