case study

A. Head position and tremor

B. Skull and scalp symmetry, shape, lesions, and trauma; skull size

C. Facial symmetry, shape, unusual features, pigmentation, and tics

D. Frontal and maxillary sinuses and mastoid process for patency without tenderness

E. Scalp symmetry, tenderness (particularly over areas of frontal and maxillary sinuses), movement; hair texture, color, and distribution

F. Temporal arteries

G. Salivary glands

II. Inspection and palpation of the neck

A. Neck symmetry, fullness, and ROM (masses, webbing, and skinfolds)

B. Trachea position or tugging (protrusions, asymmetry)

C. Movement of hyoid bone and cartilages with swallowing

D. Lymph nodes

E. Paravertebral musculature and spinous processes

F. Thyroid size, shape, and configuration (consistency, nodules, enlargement, tenderness)

G. Carotid artery condition (distention or asymmetry)

H. Anterior triangle and posterior triangle

III. Auscultation of head and neck areas

A. Temporal artery for bruits

B. Over the eyes for bruits

C. Thyroid for bruits

IV. Palpation of the temporomandibular joint for crepitus