Bulacan State University

City of Malolos, Bulacan

COLLEGE OF NURSING

NCM 101-A : HEALTH ASSESSMENT

Nursing Assessment of Physical Systems:

HEAD and NECK

Head and neck assessment focuses on the cranium, face, thyroid gland, and lymph nodes
contained within the head and neck.

I. The Head
✓ A normal head size is referred to as normocephalic
A. Cranium
✓ Frontal (1 bone)
✓ Parietal (2 bones)
✓ Temporal (2 bones)
✓ Occipital (1 bone)
✓ Ethmoid (1 bone)
✓ Sphenoid (1 bone)
B. Face
✓ Maxilla (2 bones)
✓ Zygomatic (cheek) (2 bones)
✓ Inferior chonchae (2 bones)
✓ Nasal (2 bones)
✓ Lacrimal (2 bones)
✓ Palatine (2 bones)
✓ Vomer (1 bone)
✓ Mandible (jaw) (1 bone)

RHEALEEN VIRAY-VICEDO, RN, MAN

1
Instructor I
 C. Developmental Considerations
o Infants
✓ Fontanels (“soft spots”) – anterior and posterior fontanels
✓ Voluntary head control should be present by about 6 months of age

II. The Neck

A. Muscles and Cervical Vertebrae
✓ Sternocleidomastoid muscle – rotates and flexes the head
✓ Trapezius muscle – extends the head and move the shoulders
✓ 11th cranial nerve (spinal accessory nerve) – responsible for muscle movements
that permits shrugging of the shoulders
✓ Cervical vertebrae – C1(atlas), C2 (axis) up to C7
B. Blood vessels
✓ Internal and/or external jugular vein
✓ Carotid arteries
✓ Nursing consideration: Avoid bilaterally compressing the carotid arteries when
assessing the neck as it might reduce blood supply to the brain
C. Thyroid Gland
✓ Largest endocrine gland producing thyroid hormones (T3, T4 and
Thyrocalcitonin) that increase metabolic rate of most body cells.
✓ Points of reference for accurate thyroid palpation – the trachea, cricoid cartilage
and the thyroid cartilage (“Adam’s apple” for male clients)
✓ Common thyroid disorders – hypothyroidism and hyperthyroidism
(thyrotoxicosis)

III. Lymph Nodes of the Head and Neck

o Lymph nodes – they filter lymph
- a clear substance composed mostly of
excess tissue fluid which may or may not
contain bacteria or tumor cells; they also
produce lymphocytes and antibodies as
defense against foreign microbes of
substances.
✓ Normally not palpable but may
become overwhelmed with filtrates or
microbes leading to painful swelling on
palpation.
✓ Common types – preauricular,
postauricular, tonsillar, occipital,
submandibular, submental, superficial
cervical, posterior cervical, deep cervical
and supraclavicular

RHEALEEN VIRAY-VICEDO, RN, MAN

2
Instructor I