Question

2. Give the importance of head, face, neck, and regional lymphatic assessment. Provide significant findings in each body parts that needs to be address to the physician.

Answer 1

PHYSICAL ASSESSMENT is important to gather subjective and objective clinical information from the patient . It helps to reach at a correct diagnosis and formulate care plan.

HEAD ASSESSMENT

✓ head includes skull,scalp and hair.

✓ skull - look for size and shape of skull, frontal and occipital prominences,any tenderness on palpation, any growths.

✓ scalp - check the color of scalp, look for any infestation

✓ hair - assess color and distribution of hair, notice texture of hair , any bald spots if present are also noted.

✓ some significant findings -

• tenderness on palpation indicates injury.

•dandruff or lice may be present on scalp.

•alopecia( hair loss) may be present.

•abnormality in contour of skull may also be present.

FACE ASSESSMENT

✓ include area extending from forehead to chin.

✓ eyes - look for symmetry, color of conjunctiva and sclera, vision,gaze, corneal reflex, condition of eyelids,etc.

✓ nose - look for symmetry, condition of nares, any deviation in nasal septum, any nasal growth, any discharge.

✓ ears - any discharge, hearing, any tinnitus, condition of tympanic membrane , any growth in ear canal.

✓ lips - pallor, moistness,etc.

Tongue - color,coating,moistness,any growth

Assess buccal mucosa and palate.

Also check uvula.

✓ also assess condition and color of facial skin.

✓ some findings -

•trigeminal nerve abnormality - if patient is not able to clench his jaw.

• motor function abnormality - if patient finds it difficult to frown , smile ,etc.

•ptosis ( droopy eyelids)

•jaundice ( yellow discoloration of eyes)

• deviated nasal septum

• auditory defects.

NECK ASSESSMENT

✓ includes assessing structures in neck like trachea, thyroid , jugular vein, lymph nodes,etc.

✓ palpate the trachea to find its location.

Palpate jugular vein.

Check the range of motion of neck.

Check lymph nodes by palpation.

✓ some significant findings -

• dislocated trachea

•tender lymph nodes indicates regional infection.

•enlarged thyroid gland in goitre, carcinoma , etc.

•jugular venous distention.

REGIONAL LYMPH NODE ASSESSMENT

✓ they drain lymph from a particular location like cervical lymph nodes.

✓ check size, tenderness and consistency of lymph nodes by palpating them.

✓ also look for symmetry

✓some significant findings -

•they help to locate the source for example infraclavicular swollen lymph nodes indicate breast cancer.

• in malignancies - lymph nodes are firm and non tender

•also gets enlarged in systemic infections like HIV.

• cold nodes are present in tuberculosis.