Hi, I'm Meris, and in this video, I'm going to be talking to you about unexpected findings while performing a neck assessment. I'm going to be following along using our flashcards. These are our health assessment flashcards, which are available on our website, leveluprn.com. You can either grab a set for yourself, or you can even check out Flashables, which are our digital flashcards that are available to you the second you purchase them if you want to follow along with me.
All right. Let's get started.
So first up, let's talk about tracheal deviation. Tracheal deviation is what it sounds like. It's a deviation, a change in the normal or expected position of the trachea. So typically, we expect the trachea to be midline. It should be running straight down the middle of the neck. That's because it's going to go all the way down until it splits at the carina, goes into the right and the left main stem bronchi, and supplies both lungs.
However, if there is an injury that is affecting the chest, the neck, or the lungs, we can see tracheal deviation, and what happens here is-- let's assume we have a collapsed lung, whether that is spontaneous or through trauma. Let's say my right lung is fully collapsed. That right lung is no longer pulling in and releasing any sort of air, right? That right lung is no longer in the equation whatsoever.
The left lung, the unaffected, the good lung, is the only one that is moving air in and out. So a late sign of a collapsed lung or a tension pneumothorax would be a deviation of the trachea to the unaffected side. The trachea is going to get pulled over to the side that's using it the most.
So any injury that's going to affect the neck, the chest, or the lungs could result in tracheal deviation. I need you to understand that this is an unexpected finding, and this is a late finding associated with a tension pneumothorax or a collapsed lung.
Now, moving on, let's talk about lymphadenopathy. And if you watched my previous video about lymph nodes, you know that lymph nodes should be soft, movable, less than 1 cm in diameter, and nontender. That's what we want a lymph node to be. However, lymphadenopathy is going to be the presence of swelling or any sort of pathological change to a lymph node. So a lymph node that is now enlarged, is perhaps painful or swollen. This is going to be a gland that is affected by lymphadenopathy. Now, this can indicate infection. It can also indicate allergies or neoplasm. Neoplasm meaning cancer, malignancy. So it does not always mean this, right? Lymphadenopathy can just be I'm having some allergies, or I recently had a cold, or I got scratched by my cat, and I've got a swollen lymph node on my elbow there. That's all totally fine, normal, healthy response. It's just an unexpected finding. But in some rare cases, lymphadenopathy can be associated with malignant neoplasm, especially lymphoma. All right. Moving on.
Let's talk about the thyroid. So our thyroid is a nice butterfly-shaped gland that should not be visible. It should just be nice and flat, and the only time you may be able to see it is when a person swallows.
But if we have enlargement of the thyroid or nodules in the thyroid, this would be an unexpected finding as well, and this is a term that you need to know. This is called a goiter. And a goiter is just the term that is used to describe irregular growth of the thyroid. Just a little side note for you. If you've ever noticed that our table salt, if you buy table salt at the grocery store, it says it is iodized, and that is because we need iodine as part of our diet to regulate thyroid function, and in places where we don't have a lot of iodine in our diet, we need to add it to things such as fortified salt, right? We need to supplement the salt on the table so that everybody is getting a good amount of iodine in their diet to help to decrease the risk for goiter. All righty.
And now I talked to you about JVD in the last one. In the last video, we talked about how to measure and assess for JVD, but remember that jugular venous distention, JVD, or any kind of visible pulsations along here in the jugular vein, this is not a good finding. This is an unexpected finding, for sure, and it certainly can indicate fluid volume overload. Remember, I've got a traffic jam going on somewhere in my body, usually from my heart. It's causing this fluid volume overload. It's causing this backup of fluid that is pushing up into my jugular vein. So fluid volume overload is associated with jugular venous distention. The two go hand in hand.
And lastly, we talked about how to auscultate for a bruit, and a bruit that is heard in the carotid arteries there. A bruit can indicate any kind of cardiovascular disease. There could be a lot of different causes for this. It could be due to arteriosclerosis, atherosclerosis. This could be due to carotid stenosis. There's lots of different things, but what you need to understand is that a carotid bruit indicates that there is some sort of cardiovascular disease. All right.
Now I'm going to ask you some quiz questions to test your knowledge of key facts I provided in this video.
The trachea will deviate to which side, the affected or the unaffected side?
The unaffected side.
Which term is used to describe irregular growth of the thyroid?
That term is goiter.
JVD is most commonly observed with which fluid volume imbalance?
Fluid volume overload.
All right. That is it for this video. I hope you found it useful. I would love for you to leave me a comment and let me know how many of those quiz questions you got right. And if you've got anything else to add, I would love to hear it, and I know everybody else would as well.
All right. Thanks so much and happy studying.
