Neck examination

Question 1

look

Answer 1

Erythema, swelling, scars, discharge.
Inspect neck for masses and asymmetry, including during swallow (ask patient to take a mouthful of water, hold, then swallow).

Question 2

palpate

Answer 2

From behind patient, use fingertips of both hands to examine neck nodes, working systematically through the different regions, and comparing sides – submental, submandibular, anterior triangle, posterior triangle, pre-auricular, post-auricular, occipital, supraclavicular, scalene.
Do not palpate Level 2 lymph nodes on both sides at the same time as this can cause a vasovagal episode in some patients.

Question 3

oral cavity

Answer 3

Outer mouth, lips, dentition, oral mucosa.
Surface of tongue and hard palate – asking patient to open mouth wide and using tongue depressor if needed; ask patient to move tongue to left to inspect right side of tongue, and vice versa. Buccal area (lateral, superior, inferior walls) and gingivolabial/gingivobuccal sulcus.
Floor of mouth – asking patient to lift up tongue, and using tongue
depressor if needed.

Question 4

throat

Answer 4

Uvula, soft palate, tonsillar tissue, tonsil fossae, palatal folds, posterior pharyngeal wall.
Getting patient to breathe through mouth or phonate can help lower tongue.

Question 5

listen

Answer 5

Listen to voice
Swallow
Stridor
Stertor.