PCM1: Head & Neck Exam

=Head Exam=

Describe general examination of the head looking for abnormal facies, masses

 * Part the hair while palpating and observing

Describe surface anatomy of sinuses and check for tenderness
=Nose Exam=

Demonstrate ability to use otoscope or nasal speculum to examine the normal anatomy of the nose

 * Observe the septum, middle and inferior turbinates, middle and inferior meatus, and the normal nasal mucous membranes.
 * Test cranial nerve 1
 * Palpate sinuses: frontal & maxillary sinuses

=Oral Cavity Exam=
 * Use penlight or otoscope to visualize completely.
 * Important to ask patient to breath regularly through the mouth.
 * Use tongue to depress the tongue.


 * 1) Examine buccal mucosa
 * 2) Examine under tongue
 * 3) Say "Ahhh". Test CN X (and CN IX, stylopharyngeus muscle only).
 * 4) Test cranial nerves

Demonstrate ability to use tongue blade to identify mouth structures
=OroPharnyx Exam=

=Neck Exam=

Examine Lymph Nodes & other structures

 * Anterior Lymph Nodes:
 * 1) anterior cervical
 * 2) submental
 * 3) submandibular/tonsilar
 * 4) preauricular
 * Anterior Lymph Nodes:
 * 1) posterior auricular
 * 2) occipital
 * 3) posterior cervical
 * 4) supraclavicular


 * Technique: use the finger pads with three circular motions of increasing pressure.
 * Examine size, texture, and tenderness for pathology.

Inspect & Palpate thyroid gland

 * 1) Inspect for symmetry, size. This is best done by asking the patient to take a sip of water.
 * 2) Palpate
 * 3) Gently feel 3cm inferior to thyroid cartilage pertrusion. It can be most comfortable to do this behind the patient.
 * 4) Ask patient to swallow or provide a glass of water. Feel both sides and the isthmus.

Describe characteristics of a pathological lymph node

 * Easily palpable lymph nodes are not generally found in healthy adults.
 * Large lymph nodes feel like a large mass rather
 * Harder and more defined nodes are more likely malignancies
 * Tenderness on touch
 * Redness
 * Warm
 * No thrill or pulse (that's a blood vessel!)