Assessing Head and Neck

Sublingual gland

A salivary gland on either side of the tongue

Trachea

The air passage extending from the throat and larynx to the main bronchi

Adam's apple

The thyroid cartilage located just above the cricoid cartilage

The nurse is planning to assess an adult client's thyroid gland. The nurse should plan to

approach the client posteriorly.

While assessing an older adult client's neck, the nurse observes that the client's trachea is pulled to the left side. The nurse should

refer the client to a physician for further evaluation.

Vertebra prominens

Cervical vertebra (C7) that can be easily palpated when the neck is flexed

Trapezius and sternocleidomastoid

Paired muscles that allow movement and provide support to the head and neck

Thyroid gland

The largest of the endocrine glands, situated in the front and sides of the neck just below the thyroid cartilage.

Parotid gland

The largest of the three main parts of salivary glands, located on either side of the face, just below and in front of the ears

The nurse assesses an adult client's head and neck. While examining the carotid arteries, the nurse assesses each artery individually to prevent a

reduction of the blood supply to the brain.

The nurse is preparing to assess the lymph nodes of an adult client. The nurse should instruct the client to

sit in an upright position.

While assessing the head and neck of an adult client, the client tells the nurse that she has been experiencing sharp shooting facial pains that last from 10 to 20 seconds but are occurring more frequently. The nurse should refer the client for possible

trigeminal neuralgia

Cricoid cartilage

Ring-like cartilage forming the lower and back part of the larynx

An adult client visits the clinic and tells the nurse that she has had headaches recently that are intense and stabbing and often occur in the late evening. The nurse should suspect the presence of

cluster headaches.

A female client visits the clinic and tells the nurse that she frequently experiences severe recurring headaches that sometimes last for several days and are accompanied by nausea and vomiting. The nurse determines that the type of headache the client is describing is a

migraine headache.

A client visits the clinic and tells the nurse that he is depressed because of a recent job loss. He complains of dull, aching, tight, and diuse headaches that have lasted for several days. The nurse should recognize that these are symptoms of

tension headaches.

A female client visits the clinic and tells the nurse that she wants to "stay healthy." The nurse observes that the client has diffuse neck enlargement, is perspiring, and is quite fidgety. The client tells the nurse that she is "hungry all the time, but I have lost weight." A priority nursing diagnosis for the client is

thyroid dysfunction related to neck swelling, perspiration, and fidgeting and concern over weight loss.

Cranial nerve XI

Spinal accessory nerve-contraction of trapezius and sternocleidomastoid muscles

While assessing an adult client's skull, the nurse observes that the client's skull and facial bones are larger and thicker than usual. The nurse should assess the client for

acromegaly.

The nurse is preparing to perform a head and neck assessment of an adult client who has immigrated to the United States from Cambodia. The nurse should first

ask the client if touching the head is permissible

A client visits the outpatient center with a complaint of sudden head and neck pain and stiness. The client's oral temperature is 37.7 °C (100 °F). The nurse suspects the client is experiencing symptoms of

meningeal irritation.

The nurse is preparing to assess the neck of an adult client. To inspect movement of the client's thyroid gland, the nurse should ask the client to

swallow a small sip of water.

Hyoid bone

A horseshoe-shaped bone at the base of the tongue; the only bone in the body not directly attached to another bone

While assessing an adult client's head and neck, the nurse observes asymmetry in front of the client's ear lobes. The nurse refers the client to the physician because the nurse suspects the client is most likely experiencing a/an

parotid gland enlargement.

An older client visits the clinic accompanied by his daughter. The daughter tells the nurse that her father has been experiencing severe headaches that usually begin in the morning and become worse when he coughs. The client tells the nurse that he feels dizzy when he has the headaches. The nurse refers the client for further evaluation because these symptoms are characteristic of a

tumor-related headache.