Head, Face, and Neck,
Including Regional Lymphatics
Health Assessment Across the
Lifespan
NRS 102
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics

Structure and Function

Subjective Data—Health History Questions

Objective Data—Physical Exam

Abnormal Findings
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-2
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Structure and Function
Head

Cranial bones

Sutures

Facial bones

Facial muscles

Salivary glands
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-3
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Structure and Function
(cont.)
Neck

Neck
muscles

Anterior and
posterior triangles

Thyroid gland
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-4
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Structure and Function
(cont.)
Lymphatics

Preauricular

Posterior auricular
(mastoid)

Occipital

Submental

Submandibular
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-5
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Structure and Function
(cont.)
Lymphatics (cont.)

Jugulodigastric

Superficial cervical

Deep cervical

Posterior cervical

Supraclavicular
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-6
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Structure and Function
(cont.)
Developmental care

Infants and children

Fontanels

Head growth

Lymphatic system

Pregnant female

Aging adult
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-7
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Subjective Data—
Health History Questions

Headache

Head injury

Dizziness

Neck pain or limitation of motion

Lumps or swelling

History of head or neck surgery
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-8
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Subjective Data—
Health History Questions
(cont.)
Additional history for infants and children

Maternal alcohol or drug use

Type of delivery

Growth pattern
Additional history for aging adult

Dizziness

Neck pain
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-9
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Objective Data—
Physical Exam
Head–Inspect and palpate the skull

Size and shape

Temporal area
Head–Inspect the face

Facial structures
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-10
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Objective Data—Physical Exam
(cont.)
Neck–Inspect and palpate

Symmetry

Range of motion

Lymph nodes
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-11
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Objective Data—Physical Exam
(cont.)
Neck–Inspect and palpate
(cont.)

Trachea

Thyroid gland

Posterior approach

Anterior approach

Auscultate
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-12
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Objective Data—Physical Exam
(cont.)
Developmental care

Infants and children

Skull

Face

Neck

Special procedures

Pregnant female

Aging adult
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-13
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Sample Charting
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-14
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Sample Charting
(cont.)
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-15
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Sample Charting
(cont.)
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-16
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Abnormal Findings
Abnormalities in Head Size
and Contour

Hydrocephalus

Paget’s disease of bone (osteitis deformans)

Acromegaly
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-17
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Abnormal Findings
(cont.)
Swellings of the Head and Neck

Torticollis (wryneck)

Thyroid—multiple nodules

Thyroid—single nodule

Pilar cyst (wen)

Parotid gland enlargement
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-18
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Abnormal Findings
(cont.)
Pediatric Facial Abnormalities

Fetal alcohol syndrome

Congenital
hypothyroidism

Down syndrome

Atopic (allergic)
facies

Allergic salute
and crease
© Pat Thomas, 2006.
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-19
Chapter 13: Head, Face, and Neck, Including Regional Lymphatics
Abnormal Findings
(cont.)
Abnormal Facial Appearances
With Chronic Illnesses

Parkinson’s syndrome

Cushing’s syndrome

Graves’ disease

Hyperthyroidism

Myxedema (hypothyroidism)

Bell’s palsy

Brain attack or cerebrovascular accident

Cachectic appearance

Scleroderma
Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.
Slide 13-20