Assessing The Neck

ASSESSING THE NECK Anatomy of the neck

Examination includes the muscles, lymph nodes, trachea, thyroid gland, carotid arteries and jugular veins. • Anterior Triangle – Medial Border of Sternocleidomastoid Muscle and Mastoid • Posterior Triangle – Formed by Trapezius and Sternocleidomastoid (SCM) Muscles and Clavicle.

Includes: • Trachea • Thyroid glands • Lymph Nodes • Occipital • Post auricular • Preauricular • Submandibular • Submental • Tonsillar • Posterior cervical • Deep cervical • Supraclavicular Assessing the Neck • Inquire if the client has any history of the following: • Problems with neck lumps • Neck pain or stiffness • When and how any lumps occur • Previous diagnosis of thyroid problems • Other treatment provided Neck Muscles • Inspect the neck muscles for abnormal swellings or masses • Observe the head movement • Move the chin to the chest • Move the head back so that the chin points upward • Move the head so that the ear is moved toward the shoulder on each side

• Turn the head to the right and to the left Assess the muscle strength. Lymph Nodes Palpate the entire neck for enlarged lymph nodes • Face the client, bend the head slightly forward, toward the side being examined • Palpate the nodes using the pads of the fingers in a gentle rotating motion 1. Preauricular 2. Postauricular 3. Submental 4. Submandibular 5. Tonsillar 6. Anterior Cervical 7) Posterior Cervical 8) Supraclavicular Trachea • Palpate the trachea for lateral deviation • Place fingertip or thumb on the trachea in the suprasternal notch • Move finger laterally to the left and the right in spaces bordered by the clavicle, the anterior aspect of the sternocleidomastoid muscle, and the trachea Thyroid Gland  Posterior approach  Anterior approach

• Palpation of Thyroid – Size — R>L. Normally does not Extend above Thyroid Cartilage – Shape — Butterfly – Consistency — Firm but not Hard – Sensation — Non-Tender – Surface — Normally Smooth. Nodules may Occur with Age or Cancer of Thyroid. – Movement — Rises with Swallowing • If enlargement of the gland is suspected: – Auscultate over the thyroid area for bruit ( a soft rushing sound created by turbulent blood flow) – Use the bell of the stethoscope Lifespan Considerations • Examine the neck while the infant or child is lying supine • An infant’s neck is normally short, lengthening by about age 3 years. This makes the palpation of the trachea difficult