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Head & Lymph Nodes examination

Head & Lymph Nodes examination Head - Inspection Facies: Examination of the head includes inspection of the face, skin, hair, scalp and skull. Begin by observing facial features, understanding that they may vary by sex and race. Inspect the eyebrows, eyelids, palpebral fissures, nasolabial folds and mouth, noting any asymmetry. Remember that certain disease states can affect these features (e.g. hypothyroidism, acromegaly). Many genetic disorders cause characteristic facies identified through careful inspection. When inspecting the facies, note if the patient appears his stated age, older or younger, if he appears in good or poor general health, and if there is any generalized swelling or periorbital edema. Skin: Facial skin should also be carefully inspected, noting color, pigment changes, texture, hair distribution, rashes or lesions. Hair: Inspect and palpate the hair, noting its texture, distribution, quantity and pattern of hair loss if any. Part the hair in several places, looking for scalp scaliness, lumps, lesions or nits. Skull: Inspect the skull, noting the general size, shape and symmetry. Lymph Nodes The major lymph nodes of the head and neck area should be palpated with the patient in an upright position. Findings which should be noted in the patient record include enlarged palpable nodes, fixed nodes, tender nodes and whether the palpable nodes are single or present in groups. Single or multiple non-tender, and fixed nodes are very suspicious for malignancy. Groups of tender nodes usually occur in conjunction with some type of acute infection. Occasionally nodes will remain enlarged and palpable after an infection. This is a relatively common occurrence especially within the submandibular group of lymph nodes. When examined, these nodes should be small (less than 1 cm), non-tender and mobile. Remember to correlate findings from the medical history and general appraisal of the patient to the observations made during the head and neck examination. For example, a previous history of cancer should cause the clinician to be more suspicious of newly appearing palpable nodes than if there is no history of cancer. If suspicious nodes are discovered, the patient should be referred to a physician for immediate evaluation   / clinicine-10.  . [email protected] https://t.me/Clinicine