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NR 302 Week 5-Edapt-HEENT Assessment..
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Head, Face, Neck, Nose, Mouth, & ThroatFunction of the Lymph Nodes
Lymph nodes are a network of small bean-shaped structures that collect and filter excess fluid produced by an immune
response. While this collection system is located all over the body, the head, eyes, ears, nose, and throat assessment
includes the ones located in the head and neck area.
Lymph nodes are not cancerous lumps, nor are they a network of vessels that carry blood to or away from the heart.
Infant Considerations
Fontanelle (not concave, indent, or divot) is the term for the space between the bones of the skull in a newborn where the
sutures are not fully formed.
Health History: Head
Asking about frequent or severe headaches is part of the health history of the head.
Piercings can usually be evaluated during the inspection process, and hearing is addressed when asked about the health
history of the ear. Food intake is more about the gastrointestinal system.
The Health History
Head, Neck, and Lymph
unusually frequent or severe headaches
facial or neck pain
difficulty turning, flexing, or extending the neck
painful or painless lumps or masses in the head or neck
history of traumatic brain injury
past athletic participation including high-contact sports like football
Nose, Mouth, and Throat
past oral care practices including dental health
history of allergies
difficulty chewing or swallowing food
difficulty with teeth or gums
partially or completely blocked nares
history of snorting or inhaling drugs or vapors
past vaping or smoking cigarettes, pipes, or cigars
family history of mouth cancer or genetic syndromes
history of giving oral sex and any associated sexually transmitted infections
Lifestyle
Risk Factors for the Head and Neck
not using safety equipment such as helmets and seat belts
alcohol or drug consumption
Risk Factors for the Nose, Mouth, and Throat
cigarette, vape, cigar, or chewing tobacco use
lack of routine dental care
not practicing proper hand hygiene and infection prevention practices
poor nutritional intake
Preparing to Assess
, Inspecting and Palpating the Head
Some questions to ask when inspecting and palpating the head include:
Is the head posture erect or slumped? What might that indicate?
Is there symmetry (equality) comparing one side of the head to the other?
Are any obvious lumps viewable?
Are there any lumps or abnormalities that are palpable but not visible?
Are there any signs of parasitic infestations?
Are there any palpated depressions or soft areas over the skull (adults)?
Are the fontanelles soft or depressed (infants)?
Inspecting and Palpating the Neck
The assessment of the neck should include the inspection and palpation of the neck structures including the lymph nodes,
trachea, and thyroid.
Inspect the neck for
symmetry and midline alignment of the trachea
scars that might indicate prior surgeries
visible lumps or areas of protrusion or swelling over the anterior aspect of the neck
Palpate the neck for
lumps or protrusions (note the size, density, ease of mobility, and overall shape)
location of the trachea (which should be midline)
Inspecting and Palpating the Lymph Nodes
Lymph nodes are small, oval-shaped structures located in the neck, under the arms, and in the groin region. The largest
number of lymph nodes in the body are found in the neck area.
It is important to inspect and palpate for enlarged lymph nodes because they can be a sign of serious problems that need to
be evaluated further. Most lymph nodes are not palpable when someone is healthy. Occasionally, a palpable lymph node
can be felt, is usually less than 1cm, soft, non-tender, and slightly movable.
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