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Lecture

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Department
Nursing
Course
NURS 2200
Professor
Cynthia Barkhouse Mckeen
Semester
Winter

Description
Assessment of Head, Neck, Eyes, Ears, Nose, Mouth, Throat Objectives By reviewing the Bates video, completing readings & participating in lecture, the student will:  Review A & P of head, neck, eyes, ears, nose, mouth, throat  Explore questions to use when completing a focused interview  Describe techniques for assessment of these structures  Differentiate normal from abnormal findings in physical assessment of these structures  Describe developmental, psychosocial, cultural, & environmental variations in assessment techniques & findings  Discuss areas for health promotion & client teaching  Develop beginning competence level in clinical reasoning during a focused interview/physical assessment  Collect a health history related to pertinent signs & symptoms of the head & neck.  Inspect & palpate the skull noting size, contour, lumps, or tenderness.  Inspect the face noting facial expression, symmetry, skin characteristics, lesions.  Demonstrate & explain assessment of gross visual acuity, visual fields, external eye structures  Describe appearance of normal outer ear & external ear canal  Describe & perform tests for gross hearing acuity  Inspect & palpate the neck for symmetry, range of motion  Inspect & palpate trachea for midline position.  Record the findings systematically, reach an assessment of the health state, and develop a plan of care.  Discuss common variations and common abnormal findings that may be identified during assessment of the head, neck, eyes, ears  Be aware of inspection & palpation techniques for examining for lymphadenopathy & enlarged thyroid Assessment of the Head & Neck, Eyes & Ears Structures 1. Head: Skull, facial bones 2. Face: Sinuses, nose 3. Mouth:Lips, buccal mucosa, teeth, gums, tongue, pharynx, soft & hard palate, tonsils, & salivary glands 4. Neck:Thyroid, lymph nodes Cranial Bones Frontal region Parietal region Temporal region Occipital region Facial Landmarks Should be straight line between these Opening between upper and lower eyelid Should be equal Neck  Carotid and temporal arteries: Internal & external jugulars  Supported by vertebra and muscles  Neck muscles: Anterior and posterior triangles  Thyroid gland Triangles of the Neck Structures of Neck Vessels of the Neck Physical Assessment of the Head & Neck Techniques: inspection & palpation Position: sitting Getting started: Vital signs, pain consideration Focused Health History  Illness, infection, surgery or injury  Symptoms e.g. dizziness  Pain, tenderness  Lumps or swelling  Behaviours  Pregnant  Environment Areas of the Head  Inspection of the head & scalp  Inspection of the face  Observation of movements of the head, face, & eyes Abnormal: Headaches  Migraine: aura, photophobia, N & V  Cluster: numerous episodes, no aura, gradual onset- alcohol, stress  Tension: muscle contraction, gradual, due to stress, dental & other physical  Other: tumour, stroke, aneurysm Assessment of Head & Face: 1. Inspection of the Head & Face Head: size, shape, symmetry & position Facial: expressions, lesions, hair 2. Palpate the head, face & TMJ (TMJ: temperomandibular joint)  There should be no tenderness or soft areas (exception for infants)  To palpate the TMJ you would ask the patient to open and close mouth and deviate jaw from side to side. Determine sensation, motion and strength Assessment of the Neck:  Inspection of skin- ROM  Observation of the carotid arteries & jugular veins  Palpation of the trachea Inspecting the Neck  Examination of the neck to check that it is errect, midline with no lumps, bulges or masses  You will need to inspect the thyroid.  When examining the thyroid focus on the middle to lower third of the anterior neck, checking for enlargement Palpating the Trachea Assessing the Thyroid Gland Signs & Symptoms of Hyper/Hypo Thyroidism Hyperthyroidism Hypothyroidism  Muscle weakness  Muscle weakness  Irritability  Apathy, agitation  Decreased weight  Increased weight  Sleep disturbance  Increased sleep  Goiter  Goiter  Irregular menses  Cold intolerance  Flushed skin  Changes in menses  Dry skin Assessment: Ears, Nose, Mouth & Throat Ear: Sensory organ: functions for hearing & equilibrium Nose: Beginning of the respiratory track; smell Sinuses: Lighten weight of head; voice resonance Oral Cavity: Beginning of GI tract, communication Oral Cavity  Lips  Mouth  Inside of the cheeks  Teeth  Palate  Tongue  Mandible  Pharynx Assessment Techniques: Inspection, palpation, percussion & t
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