Comprehensive Health Assessment Study Guide
Chapter 13: Head and Neck
Chapter 14: Eyes
Chapter 15: Ears and Nose
Chapter 16: Throat and Oral Cavity
Chapter 17: Thorax and Lungs
Chapter 18: Cardiovascular System
Chapter 19: Peripheral Vascular System
Chapter 28: Children—Infancy Through Adolescence
Chapter 29: Pregnant Women
Chapter 30: Older Adult
GENERAL EXAMINATION PRINCIPLES
Standard Physical Examination Order
Most systems:
1. Inspection
2. Palpation
3. Percussion
4. Auscultation
5. Exception: Abdominal exam = auscultation before percussion/palpation.
General Assessment Priorities Always assess:
Appearance
Distress level
Symmetry
Mental status
Vital signs
Skin color
Respiratory effort
POSITIONING
Examination Preferred Position
Head/Neck Sitting
Eyes Sitting
ENT Sitting
Thorax/Lungs Sitting
Cardiovascular Sitting/supine/left lateral
Peripheral vascular Supine
Infants Parent’s lap if needed
CHAPTER 13: HEAD AND NECK
SUBJECTIVE DATA
Common Symptoms
Headache
Neck pain
Dizziness
Swollen glands
Dysphagia
Thyroid problems
HEADACHE ASSESSMENT
Use OLD CARTS
Onset
Location
Duration
Character
Aggravating factors
Relieving factors
Timing
Severity
HEADACHE RED FLAGS — “SNOOP”
Letter Meaning
S Systemic symptoms
N Neurologic symptoms
O Sudden onset
, Letter Meaning
O Older age onset
P Progressive pattern
TYPES OF HEADACHES
Type Key Features
Tension Band-like, bilateral
Migraine Pulsating, nausea, aura
Cluster Severe unilateral orbital pain
Temporal arteritis Jaw claudication, vision changes
OBJECTIVE ASSESSMENT
HEAD EXAMINATION
Inspection Assess:
Size
Shape
Symmetry
Facial movements
Lesions
Normal: Normocephalic, symmetric.
Palpation Assess:
Tenderness
Masses
Depressions
TEMPOROMANDIBULAR JOINT (TMJ)
Technique
1. Place fingers anterior to tragus
2. Ask patient to:
o Open/close mouth
o Move jaw laterally
Assess:
Clicking
Tenderness
ROM
TEMPORAL ARTERY ASSESSMENT Assess:
Tenderness
Thickening
Pulsation
Temporal arteritis = emergency.
LYMPH NODE EXAMINATION Sequence
1. Preauricular
2. Posterior auricular
3. Occipital
4. Tonsillar
5. Submandibular
6. Submental
7. Superficial cervical
8. Posterior cervical
9. Deep cervical
10. Supraclavicular
Lymph Node Findings
Finding Meaning
Soft/mobile Benign
Hard/fixed Malignancy
Tender Infection
Matted TB/cancer
Chapter 13: Head and Neck
Chapter 14: Eyes
Chapter 15: Ears and Nose
Chapter 16: Throat and Oral Cavity
Chapter 17: Thorax and Lungs
Chapter 18: Cardiovascular System
Chapter 19: Peripheral Vascular System
Chapter 28: Children—Infancy Through Adolescence
Chapter 29: Pregnant Women
Chapter 30: Older Adult
GENERAL EXAMINATION PRINCIPLES
Standard Physical Examination Order
Most systems:
1. Inspection
2. Palpation
3. Percussion
4. Auscultation
5. Exception: Abdominal exam = auscultation before percussion/palpation.
General Assessment Priorities Always assess:
Appearance
Distress level
Symmetry
Mental status
Vital signs
Skin color
Respiratory effort
POSITIONING
Examination Preferred Position
Head/Neck Sitting
Eyes Sitting
ENT Sitting
Thorax/Lungs Sitting
Cardiovascular Sitting/supine/left lateral
Peripheral vascular Supine
Infants Parent’s lap if needed
CHAPTER 13: HEAD AND NECK
SUBJECTIVE DATA
Common Symptoms
Headache
Neck pain
Dizziness
Swollen glands
Dysphagia
Thyroid problems
HEADACHE ASSESSMENT
Use OLD CARTS
Onset
Location
Duration
Character
Aggravating factors
Relieving factors
Timing
Severity
HEADACHE RED FLAGS — “SNOOP”
Letter Meaning
S Systemic symptoms
N Neurologic symptoms
O Sudden onset
, Letter Meaning
O Older age onset
P Progressive pattern
TYPES OF HEADACHES
Type Key Features
Tension Band-like, bilateral
Migraine Pulsating, nausea, aura
Cluster Severe unilateral orbital pain
Temporal arteritis Jaw claudication, vision changes
OBJECTIVE ASSESSMENT
HEAD EXAMINATION
Inspection Assess:
Size
Shape
Symmetry
Facial movements
Lesions
Normal: Normocephalic, symmetric.
Palpation Assess:
Tenderness
Masses
Depressions
TEMPOROMANDIBULAR JOINT (TMJ)
Technique
1. Place fingers anterior to tragus
2. Ask patient to:
o Open/close mouth
o Move jaw laterally
Assess:
Clicking
Tenderness
ROM
TEMPORAL ARTERY ASSESSMENT Assess:
Tenderness
Thickening
Pulsation
Temporal arteritis = emergency.
LYMPH NODE EXAMINATION Sequence
1. Preauricular
2. Posterior auricular
3. Occipital
4. Tonsillar
5. Submandibular
6. Submental
7. Superficial cervical
8. Posterior cervical
9. Deep cervical
10. Supraclavicular
Lymph Node Findings
Finding Meaning
Soft/mobile Benign
Hard/fixed Malignancy
Tender Infection
Matted TB/cancer
