Physical Assessment: Head, Face and Neck

Why is it important to do physical assessment?

Before any intervention can be done, it is vital to do physical assessment because this will serve as the basis for giving the right implementation. Physical assessment is like collecting the data that you have gathered and once done, you then now ready to formulate your intervention based on the data you have collected as you then formulate your goals as well.

Head, face and neck physical assessment is important. This will help you assess on possible causes, signs or symptoms that the patient feels or manifested to show so that you can provide the right process of giving quality care to your patient.

Part of Janet Weber, Jane Kelley and Ann Sprengel's contribution in their book, Health Assessment in Nursing Laboratory Manual, 3rd Edition (pages 73-74) reveals the physical assessment on head, face and neck. This, I will share it with you.

Assessment Skill
1. Gather equipment (gloves, penlight or flashlight, small glass of water, stethoscope).
2. Explain the procedure to the client.

Head and Face
1. Inspect head for size, shape and configuration.
2. Palpate head for consistency while wearing gloves.
3. Inspect face for symmetry, features, movement, expression and skin condition.
4. Palpate temporal artery for tenderness and elasticity.
5. Palpate temporomandibular joint for range of motion, swelling, tenderness, or crepitation by placing index finger over the front of each and asking client to open mouth. Ask if client has history of frequent headaches.

Neck
1. Inspect neck while it is in a slightly extended position (and using a light) for position, symmetry and presence of lumps and masses.
2. Inspect movement of thyroid and cricoid cartilage and thyroid gland by having client swallow a small sip of water.
3. Inspect cervical vertebrae by having client flex neck.
4. Inspect neck range of motion by having client turn chin to right and left shoulder, touch each ear to the shoulder, touch chin to chest, and lift chin to ceiling.
5. Palpate trachea by placing your finger in the sternal notch, feeling to each side, and palpating the tracheal rings. 
6. Palpate the thyroid gland.
7. Auscultate thyroid gland for bruits if the gland is enlarged (use bell of stethoscope).
8. Palpate lymph nodes for size/shape, delimination, mobility, consistency and tenderness (refer to display on characteristics of lymph nodes).
a. Preauricular nodes (front of ears)
b. Postauricular nodes (behind of ears)
c. Occipital nodes (posterior base of skull)
d. Tonsillar nodes (angle of the mandible, on the anterior edge of the sternocleidomastoid muscle)
e. Submadibular nodes (medial border of the mandible); don't confuse with the lobulated submandibular gland
f. Submental nodes (a few centimeters behind the tip of the mandible); use one hand
g. Superficial cervical nodes (superficial to the sternomastoid muscle)
h. Posterior cervical nodes (posterior to the sternocleidomastoid and anterior to the trapezius in the posterior triangle)
i. Deep cervical chain nodes (deep within and around the sternomastoid muscle)
j. Superclavicular nodes (hook fingers over clavicles and feel deeply between the clavicles and the sternomastoid muscles)

Analysis of Data
1. Formulate nursing diagnoses (weakness, risk, actual).
2.Formulate collaborative problems.
3. Make necessary referrals.

Why do people need to be impatient?...In fact, they don't have to.

Attitudes. This matters most in any field.

It is apparently not a match when someone does the right way and shows the right attitude and then for all of a sudden being that right in actions may turn out to be bad, being an impatient person.

Wait. To wait. To wait even more. To wait much harder than what one thinks. To wait for more years until the grass dries up. To wait for even a lifetime of many lives build and rebuild. To wait for the right time.

This kind of "waiting" is like mustering to have patient. One can't be impatient if he knows how to wait. To wait one's turn when falling in line no matter how long the line is. To wait for more years in order to taste the happiness of life through satisfied decisions due to waiting patiently.

Well, I don't know if you agree with me that oftentimes wrong path leads to a person all the time if he doesn't know how to wait. Just like, if you want to be loved by a person, you need to wait and be patient for you will not find that person that you love if you don't make "patient" your leader. Thus, if you force yourself to strike to the point while it is hot, then you will end up paying what you deserve.

I don't say here that you need to grow old and be old in waiting. At the very most part, that is not my point. All can be done in prayer that, that waiting will soon or probably take place now. That is for sure, you need to pray, pray and even pray more while you hope and be patient.

As what Celine Dion says in a song, "When you want it the most, there is no easy way out." How? Be patient, pray, hope and don't be impatient.