Doctors will often examine a patient’s neck for several important reasons. The neck contains vital structures, including nerves, blood vessels, and lymphatic tissue, that can provide clues about a person’s health. By observing and palpating the neck, doctors can check for abnormalities that may indicate underlying medical conditions.
Looking for Swelling or Lumps
One key reason doctors examine the neck is to check for any swelling, lumps, or masses that may be present. There are many important structures in the neck, including the thyroid and parathyroid glands, lymph nodes, and muscles. Swelling or lumps in the neck may indicate:
- Enlarged thyroid gland (goiter)
- Enlarged lymph nodes due to infection or cancer
- Swollen salivary glands, which may indicate blockage of a salivary duct by a stone or tumor
- Lipomas (non-cancerous fatty tumors)
- Cysts (fluid-filled sacs)
By palpating the neck and noting any abnormalities in size or consistency, the doctor can identify potential problems that warrant further investigation.
Checking Lymph Nodes
Doctors routinely check the lymph nodes in the neck as part of a physical exam. There are clusters of lymph nodes located under the chin, along the front and sides of the neck, and above the collarbones. These lymph nodes filter bacteria and other contaminants from lymph fluid as it circulates through the body.
Enlarged or tender lymph nodes may indicate:
- An infection, such as strep throat or mononucleosis
- An inflammatory or autoimmune condition
- Cancer, such as leukemia or lymphoma
By examining the lymph nodes, the doctor can look for signs of infection or swelling that warrant further testing.
Assessing Range of Motion
Doctors will often have patients move their head in different directions during a neck exam. This allows them to assess the range of motion of the neck and check for limitations. Restricted range of motion may be a sign of:
- Arthritis in the cervical spine
- A herniated disc in the neck
- A pulled neck muscle (cervical strain)
- Narrowing of the spinal canal (spinal stenosis)
Assessing range of motion also allows the doctor to determine if neck stiffness is present. Stiffness can have many causes, including meningitis, cervical spondylosis, or neck injury.
Looking for Signs of Trauma
Doctors will carefully inspect the neck for any signs of trauma, especially in patients who have been in accidents or suffered other injuries. Trauma to the neck may indicate a serious problem like a:
- Fractured vertebra
- Spinal cord injury
- Concussion
- Whiplash
Signs the doctor looks for include bruising, cuts, abnormal curvature of the spine, or tenderness over the spine. Imaging tests like x-rays or CT scans may be ordered if trauma is suspected.
Checking Nerve Function
Comprehensive neck exams include tests of nerve function. Doctors will assess the symmetrical function of the nerves by checking abilities like muscle strength, reflexes, and sensation in the arms, hands, and legs. Asymmetric findings may point to nerve root compression, a pinched nerve in the neck, or other neurological issues that warrant further evaluation.
Feeling for Crepitus
During neck exams, doctors will often gently move the neck while feeling over the back of the neck with their fingers. This allows them to check for crepitus, a cracking or grinding sensation that may be felt with joint movement.
Crepitus indicates degenerative changes like osteoarthritis or spondylosis. These can cause bone spurs and cartilage damage in the cervical spine leading to pain and stiffness.
Listening to Carotid Bruits
Using a stethoscope, doctors will listen on both sides of the front of the neck when checking carotid circulation. This allows them to listen for carotid bruits – abnormal swishing or whooshing sounds caused by turbulent blood flow.
Carotid bruits may be a sign of atherosclerotic plaque buildup inside the carotid arteries. Such blockages increase stroke risk. Further imaging like an ultrasound would be warranted if a carotid bruit is found.
Observing Jugular Venous Pressure
Visual inspection of the jugular vein that runs down both sides of the front of the neck allows doctors to estimate jugular venous pressure (JVP). Increased pressure may indicate:
- Heart failure
- Pericardial effusion (fluid around the heart)
- Thyroid issues
Elevated JVP along with other symptoms may prompt further cardiovascular evaluation.
Conclusion
In summary, doctors perform comprehensive neck exams for many reasons. By inspecting, palpating, moving the neck, and completing neurological assessments, doctors can identify many possible medical issues. Finding anything abnormal will then prompt the doctor to order further imaging or testing to reach a formal diagnosis and guide appropriate treatment.