Neck[1]2

Assessing the Neck

Examination includes the muscles, lymph nodes, trachea, thyroid gland, carotid arteries and jugular veins

Anatomy of the Neck • Anterior Triangle – Medial Border of Sternocleidomast oid Muscle and Mastoid

• Posterior Triangle – Formed by Trapezius and Sternocleidomast oid (SCM) Muscles and

Anatomy of the Neck Includes: • Trachea •Thyroid glands

Anatomy of the Neck • • • • • • • •

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

1) Preauricular

2) Postauricular

Lymph Nodes 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 • Inspect the thyroid gland:

Posterior Approach

Anterior Approach

Thyroid Gland • 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

Thyroid Gland • 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