ASSESSING THE NECK

Anatomy of the neck

Examination includes the muscles, lymph nodes, trachea,

thyroid gland, carotid arteries and jugular veins.

• Anterior Triangle
– Medial Border of Sternocleidomastoid Muscle
and Mastoid
• Posterior Triangle
– Formed by Trapezius and Sternocleidomastoid
(SCM) Muscles and Clavicle.
Includes:
• Trachea
• Thyroid glands
• Lymph Nodes
• Occipital
• Post auricular
• Preauricular
• Submandibular
• Submental
• Tonsillar
• Posterior cervical
• Deep cervical
• Supraclavicular

Assessing the Neck

• Inquire if the client has any history of the following:
• Problems with neck lumps
• Neck pain or stiffness
• When and how any lumps occur
• Previous diagnosis of thyroid problems
• Other treatment provided
Neck Muscles
• Inspect the neck muscles for abnormal swellings or
masses
• Observe the head movement
• Move the chin to the chest
• Move the head back so that the chin points
upward
• Move the head so that the ear is moved toward
the shoulder on each side
 • Turn the head to the right and to the left
Assess the muscle strength.

Lymph Nodes
Palpate the entire neck for enlarged lymph nodes
• Face the client, bend the head slightly forward,
toward the side being examined
• Palpate the nodes using the pads of the fingers in
a gentle rotating motion
1. Preauricular
2. Postauricular
3. Submental
4. Submandibular
5. Tonsillar
6. Anterior Cervical
7) Posterior Cervical
8) Supraclavicular

Trachea
• Palpate the trachea for lateral deviation
• Place fingertip or thumb on the trachea in the
suprasternal notch
• Move finger laterally to the left and the right in
spaces bordered by the clavicle, the anterior
aspect of the sternocleidomastoid muscle, and the
trachea

Thyroid Gland
 Posterior approach
 Anterior approach
 • Palpation of Thyroid
– Size — R>L. Normally does not Extend above
Thyroid Cartilage
– Shape — Butterfly
– Consistency — Firm but not Hard
– Sensation — Non-Tender
– Surface — Normally Smooth. Nodules may
Occur with Age or Cancer of Thyroid.
– Movement — Rises with Swallowing
• If enlargement of the gland is suspected:
– Auscultate over the thyroid area for bruit ( a soft
rushing sound created by turbulent blood flow)
– Use the bell of the stethoscope

Lifespan Considerations
• Examine the neck while the infant or child is lying
supine
• An infant’s neck is normally short, lengthening by
about age 3 years. This makes the palpation of the
trachea difficult