21
skill 2-4
Assessing the head and neck
(continued)
Comments
Excellent
Satisfactory
Needs practice
Copyright © 2014 by Wolters Kluwer Health | Lippincott Williams & Wilkins.
Checklists for Clinical Nursing Skills by Louise Sparkes, Jennifer Bassett and Elisabeth Jacob.
23. Palpate and lightly percuss over the frontal and maxillary
sinuses.
24. Occlude one nostril externally with a finger while the
patient breathes through the other; repeat for the other
side.
25. Inspect the internal nostrils using an otoscope with a
nasal speculum attachment.
26. Palpate the temporomandibular joint by placing your
index fingers over the front of the patient’s ears as you ask
them to open and close their mouth.
27. Inspect the lips, oral mucosa, hard and soft palates,
gingivae, teeth and salivary gland openings by asking the
patient to open their mouth wide, then using a tongue
blade and penlight.
28. Inspect the tongue. Ask the patient to stick out their
tongue. Place a tongue blade at the side of the tongue
while the patient pushes it to the left and right with their
tongue. Inspect the uvula by asking the patient to say ‘ahh’
while sticking out their tongue. Palpate the tongue for
muscle tone and tenderness.
29. Palpate from the forehead to the posterior triangle of the
neck for the posterior cervical lymph nodes using your
finger pads in a slow, circular motion.
30. Inspect and palpate in front of and behind the ears, under
the chin and in the anterior triangle for the anterior
cervical lymph nodes.
31. Inspect and palpate the left and right carotid arteries.
Palpate one carotid artery at a time.
Use the bell of the
stethoscope to auscultate the arteries.
32. Inspect and palpate the trachea.
33. Palpate the thyroid gland by standing behind the patient
and placing your hands around their neck with your
fingertips over the lower half of the trachea. Ask the
patient to swallow and feel for enlargement of the gland
as it rises. Palpate each lobe of the thyroid by having the
patient turn their head slightly towards the side to be
examined and then gently displace the trachea with one
hand. Ask the patient to swallow and palpate the thyroid
with your other hand. Feel for size, shape, symmetry,
tenderness and any nodules. Repeat for the other side. If
enlarged, auscultate the thyroid gland using the bell of the
stethoscope.
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