Head and Neck Exam

Question 1

General observation

Answer 1

Symmetry, size, contour issues 
Eye position
Nose
Ears - high, low, rotated
Hair issues

Question 2

Neck general observation

Answer 2

Trachea position
Mm definition 
Jugular vein
Carotid artery
Thyroid cartilage

Question 3

Pigmentation/Discoloration

Answer 3

Asymmetry of pigmented area
Border is irregular
Color variation in area
Diameter greater than 6mm
Elevation and elargement

Question 4

Movement

Answer 4

General ROM
Abnormal movement patterns
Eye motion
Mouth opening and closing

Question 5

Mouth inspection

Answer 5

Use pen light
May need tongue depressor and gloves
Can check CN IX, X, and XII at this time

Question 6

CN testing that can be done now - simple commands

Answer 6

CN VIII - motor function
CN V - clench your teeth
CN VII - frown or wrinkle your forehead, close eyes tightly smile and show your teeth, puff your cheeks and hold

Question 7

Palpation

Answer 7

Facial mm and lymph nodes

Question 8

Lymph nodes size, shape, description, mobility consistency

Answer 8

less than 1 cm
Oval
Discrete
Freely mobile
Soft
No pain or tenderness

Question 9

Abnormal findings for lymph nodes

Answer 9

Enlarged or tender - acute inflmmation
Enlarged and nontender - chronic condition or serious pathology
Firm, rubbery, hard - RED flag
Matted - might be chronic infection or metastasis
Fisxed and hard - metastasis

Question 10

Specific node - red flags

Answer 10

Supraclavicular and axillary and auricular

Question 11

What else to palpate

Answer 11

Parotid gland
Submandibular gland
Sublingual gland
Temporal artery
Carotid artery

Question 12

Sinus palpation

Answer 12

Frontal
Ethmoid
Maxillary
Transillumination

Question 13

Skull palpation

Answer 13

Shape
Tenderness
Consistency (edema, lumps)
Skin condition
Hair texture

Question 14

Skull infants

Answer 14

suture line palpation (6 months)
soft spots (2 yrs)

Question 15

Trachea and thyroid

Answer 15

Identify position
Indentify thyroid cartilage
Identify insertion of SCM
Post approach easier

Question 16

Percussion

Answer 16

not useful in head and neck exam

Question 17

Auscultation

Answer 17

Carotid arteries
Thyroid
Should not hear anything! Have patient hold breath

Question 18

CN 1

Answer 18

Olfactory

Use pleasant, familiar smells

Question 19

CN II

Answer 19

Optic
Visual acuity and visual fields
Acuity with Snellen eye chart
Fields with confrontation test for peripheral vision

Question 20

CN III, IV, VI

Answer 20

Oculomotor, Trochlear, Abducens
Pupillary light reflex - direct and consenual light refelxes
Accomodation - eyes ability to focus from a far object to a closer object

Question 21

Medial rectus

Answer 21

CN III

nasal

Question 22

Lateral rectus

Answer 22

CN VI

Temporal

Question 23

Superior rectus

Answer 23

CN III

Up an temporal

Question 24

Inferior rectus

Answer 24

CN III

Down and temporal

Question 25

Inferior oblique

Answer 25

CN III

Up and nasal

Question 26

Superior oblique

Answer 26

CN IV

Down and nasal

Question 27

CN V

Answer 27

Ophthalmic
Maxillary
Mandibular (includes taste)
Motor function - Mass, temp, ptery
Corneal reflex

Question 28

CN VII

Answer 28

Facial
Sensory - taste
Motor - Moore pg 848

Question 29

CN VIII

Answer 29

Vestibulocochlear
Hearing - whisper and rub hair together
Tuning fork tests - WEber and RInne

Question 30

CN IX and X

Answer 30

Glossopharyngela and Vagus
Sensory - no ttypically done
Motor - gag reflex, ahhh for pharyngeal movement, voice quality

Question 31

CN IX

Answer 31

Accessory

SCM and trap

Question 32

CN XII

Answer 32

Tongue condiiton and strength