When performing the physical examination, what objective data should the nurse inspect and palpate for the head and neck?

When performing a physical examination of the head and neck, the nurse should inspect for skin integrity, lymph nodes, facial symmetry, color of lips and conjunctiva. The scalp should be inspected for any lesions or masses. The hair texture should also be assessed for any thinning or patterned loss.

The ears should be assessed for any drainage from the canal or obstruction in hearing. Inspecting behind the ear can reveal nystagmus (involuntary rhythmic eye movements) which can indicate a possible neurological disorder. The eyes should be assessed simultaneously for visual acuity, redness/inflammation that may indicate infection as well as pupil size and symmetry to evaluate cranial nerve involvement.

The face should then be palpated along with areas around the forehead and temples to assess muscle tone and strength as well as sensation related to trigeminal nerves (CN V). Neck mobility and range of motion can also help identify any potential issues with movement such as torticollis. Palpating the lymph nodes can help detect enlarged glands suggesting infection or other illnesses such as leukemia that may present itself in this area. Additionally, it is important to inspect all aspects of pigmentation on the head and neck when evaluating skin health including moles, freckles etc., noting changes over time if applicable (ABCDE rule). Lastly assessing palpation deep down into muscle tissue through hand pressure can help determine tightness/tenderness which could suggest trauma or musculoskeletal injury that needs further medical attention beyond what basic assessment offers.