02.04 Head/Neck Assessment

In this video we’re going to look at the head and neck assessment. Now, this assessment is mostly inspection, with a little bit of palpation. The truth is that head and neck abnormalities are very rare, but when you DO find abnormalities, they can indicate some serious disease processes, so it’s very important.

First, you want to be sitting or standing where you can face your patient directly, head on. The big thing you’ll be assessing is symmetry, so you need to be able to see both sides of their head and neck.

Start with inspection of the head - you’re looking for symmetry side to side, looking at the general size and shape. A little bit of asymmetry is normal, but make note of any significant asymmetry, any abnormal features, or any abnormal movements.

You can also have the patient smile, frown, puff out their cheeks, and raise their eyebrows to look for any asymmetry of movement or weakness on one side, which would never be normal.

Then you’ll palpate the scalp from the back to the front - be gentle, you’re feeling for any significant abnormalities or any tenderness. It should be mostly smooth and nontender.

Next you’ll inspect the neck. Again, looking for asymmetry. The trachea should be midline and there shouldn’t be any swelling or masses that might indicate goiter.

You want to inspect range of motion by having the patient look left and right, putting their chin up and down to their chest, then each ear to their shoulder. This movement should be smooth and they shouldn’t have any pain.

Then you’re going to palpate - you want to start with the temporomandibular joint - or TMJ - and have the patient open and close their mouth a few times. There should be no clicking or tenderness.

Then you want to palpate the thyroid gland while the patient swallows. It should be midline and nontender, and should move up and down smoothly.

Then finally you’re going to palpate for any swollen lymph nodes. Check the lymph nodes in front of the ears, below the jaw, and above the clavicle. You shouldn’t feel any lymph nodes and they should be nontender. If they are palpable, that could indicate some sort of infection, or in severe cases it could mean they have some sort of malignancy like lymphoma.

Again, head and neck abnormalities are rare, but they could indicate some significant problems - make sure you check out your outline for more details.
Now, go out and be your best selves today. And, as always, happy nursing!