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