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NR 302 Exam 2 Review
EXAM 2 REVIEW CHECK OF KNOWLEDGE
Let this be a review check of your studies, but also assessment will include
class presented content, your assigned readings and resources. Don’t forget
to practice your assessment checkoff skills on your return demonstration form
those are the techniques you will be tested on as they apply to the content
below.
SKIN, HAIR, NAILS, HEAD, FACE, AND REGIONAL LYMPHATICS: CHAPTER
12,13
1. Describe the function of lymph nodes and explain the technique approach
when assessing lymph nodes.
• To detect and eliminate foreign substances from the body. The
vessels gather the clear, watery fluid (lymph) from the tissue
spaces into the circulation. The nodes slowly filter the lymph
and engulf pathogens, preventing harmful substances from
entering the circulation.
• Using a gentle circular motion of your finger pads, palpate the
lymph nodes. Beginning with the preauricular lymph nodes in
front of the ear, palpate the 10 groups of lymph nodes in a
routine order. Many nodes are closely packed, so you must be
systematic and thorough in your examination. Once you
establish your sequence, do not vary or you may miss some
small nodes. Use gentle pressure because strong pressure
could push the nodes into the neck muscles. It is usually most
efficient to palpate with both hands, comparing the two sides
symmetrically. However, the submental gland under the tip of
the chin is easier to explore with one hand. When you palpate
with one hand, use your other hand to position the person's
head. For the deep cervical chain, tip
2. Technique of inspections of the head, face and neck and its normal and
abnormal findings
1. Head
• Note the general size and shape. To assess shape, place your
fingers in the person's hair and palpate the scalp.
• Normal Findings- The skull normally feels symmetric and
smooth. Cranial bones that have normal protrusions are the
forehead, the side of each parietal bone, the occipital bone,
and the mastoid process behind each ear. There is no
tenderness to palpation.
• Abnormal findings- lumps, depressions, or abnormal
protrusions. Deformities: microcephaly, abnormally small head;
, 2
macrocephaly, abnormally large head (hydrocephaly,
acromegaly)
2. Face
• Inspect the face, noting the facial expression and its
appropriateness to behavior or reported mood. Although the
shape of facial structures may vary somewhat depending on
ancestry, features always should be symmetric. Also note any
involuntary movements (tics) in the facial muscles. Note any
abnormal facial structures (coarse facial features,
exophthalmos, changes in skin color or pigmentation) or any
abnormal swelling.
• Normal findings- Anxiety is common in the hospitalized or ill
person. Expect symmetry of eyebrows, palpebral fissures,
nasolabial folds, and sides of the mouth.
• Abnormal findings- Hostility or aggression. Asymmetry with
central brain lesion (e.g., stroke) or peripheral cranial nerve VII
damage (Bell palsy). Abnormal Facies with Chronic Illness.
Edema in the face occurs first around the eyes (periorbital) and
the cheeks where the subcutaneous tissue is relatively loose.
Note grinding of jaws, tics, fasciculations, or excessive blinking.
3. Neck
• Head position is centered in the midline, and the accessory
neck muscles should be symmetric. Note any limitation of
movement during active motion. Ask the person to touch the
chin to the chest, turn the head to the right and left, try to
touch each ear to the shoulder (without elevating shoulders),
and extend the head backward. When the neck is supple,
motion is smooth and controlled. Test muscle strength and the
status of cranial nerve XI by trying to resist the person's
movements with your hands as the person shrugs the
shoulders and turns the head to each side. Also note any
obvious pulsations.
• Normal Findings- The head should be held erect and still.
• Abnormal findings- Head tilt occurs with muscle spasm. Rigid
head and neck occur with arthritis. Note pain at any particular
movement.
• Note ratchety or limited movement from cervical arthritis or
inflammation of neck muscles. The arthritic neck is rigid; the
person turns at the shoulders rather than at the neck. Thyroid
enlargement may be a unilateral lump, or it may be diffuse and
look like a doughnut lying across the lower neck
3. Define a bruit, describe its significance, and describe the sound it makes.
• Bruit- This is a soft, pulsatile, whooshing, blowing sound heard
best with the bell of the stethoscope. The bruit is not present
normally. A bruit occurs with accelerated or turbulent blood
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NR 302 Exam 2 Review
EXAM 2 REVIEW CHECK OF KNOWLEDGE
Let this be a review check of your studies, but also assessment will include
class presented content, your assigned readings and resources. Don’t forget
to practice your assessment checkoff skills on your return demonstration form
those are the techniques you will be tested on as they apply to the content
below.
SKIN, HAIR, NAILS, HEAD, FACE, AND REGIONAL LYMPHATICS: CHAPTER
12,13
1. Describe the function of lymph nodes and explain the technique approach
when assessing lymph nodes.
• To detect and eliminate foreign substances from the body. The
vessels gather the clear, watery fluid (lymph) from the tissue
spaces into the circulation. The nodes slowly filter the lymph
and engulf pathogens, preventing harmful substances from
entering the circulation.
• Using a gentle circular motion of your finger pads, palpate the
lymph nodes. Beginning with the preauricular lymph nodes in
front of the ear, palpate the 10 groups of lymph nodes in a
routine order. Many nodes are closely packed, so you must be
systematic and thorough in your examination. Once you
establish your sequence, do not vary or you may miss some
small nodes. Use gentle pressure because strong pressure
could push the nodes into the neck muscles. It is usually most
efficient to palpate with both hands, comparing the two sides
symmetrically. However, the submental gland under the tip of
the chin is easier to explore with one hand. When you palpate
with one hand, use your other hand to position the person's
head. For the deep cervical chain, tip
2. Technique of inspections of the head, face and neck and its normal and
abnormal findings
1. Head
• Note the general size and shape. To assess shape, place your
fingers in the person's hair and palpate the scalp.
• Normal Findings- The skull normally feels symmetric and
smooth. Cranial bones that have normal protrusions are the
forehead, the side of each parietal bone, the occipital bone,
and the mastoid process behind each ear. There is no
tenderness to palpation.
• Abnormal findings- lumps, depressions, or abnormal
protrusions. Deformities: microcephaly, abnormally small head;
, 2
macrocephaly, abnormally large head (hydrocephaly,
acromegaly)
2. Face
• Inspect the face, noting the facial expression and its
appropriateness to behavior or reported mood. Although the
shape of facial structures may vary somewhat depending on
ancestry, features always should be symmetric. Also note any
involuntary movements (tics) in the facial muscles. Note any
abnormal facial structures (coarse facial features,
exophthalmos, changes in skin color or pigmentation) or any
abnormal swelling.
• Normal findings- Anxiety is common in the hospitalized or ill
person. Expect symmetry of eyebrows, palpebral fissures,
nasolabial folds, and sides of the mouth.
• Abnormal findings- Hostility or aggression. Asymmetry with
central brain lesion (e.g., stroke) or peripheral cranial nerve VII
damage (Bell palsy). Abnormal Facies with Chronic Illness.
Edema in the face occurs first around the eyes (periorbital) and
the cheeks where the subcutaneous tissue is relatively loose.
Note grinding of jaws, tics, fasciculations, or excessive blinking.
3. Neck
• Head position is centered in the midline, and the accessory
neck muscles should be symmetric. Note any limitation of
movement during active motion. Ask the person to touch the
chin to the chest, turn the head to the right and left, try to
touch each ear to the shoulder (without elevating shoulders),
and extend the head backward. When the neck is supple,
motion is smooth and controlled. Test muscle strength and the
status of cranial nerve XI by trying to resist the person's
movements with your hands as the person shrugs the
shoulders and turns the head to each side. Also note any
obvious pulsations.
• Normal Findings- The head should be held erect and still.
• Abnormal findings- Head tilt occurs with muscle spasm. Rigid
head and neck occur with arthritis. Note pain at any particular
movement.
• Note ratchety or limited movement from cervical arthritis or
inflammation of neck muscles. The arthritic neck is rigid; the
person turns at the shoulders rather than at the neck. Thyroid
enlargement may be a unilateral lump, or it may be diffuse and
look like a doughnut lying across the lower neck
3. Define a bruit, describe its significance, and describe the sound it makes.
• Bruit- This is a soft, pulsatile, whooshing, blowing sound heard
best with the bell of the stethoscope. The bruit is not present
normally. A bruit occurs with accelerated or turbulent blood
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