3 Inspection of neck
Neck is the part connecting the head with the trunk of the body ; the anterior part is called neck and the posterior part is called nape .Normal neck should be erect and symmetrical with the trachea located on the middle .Laryngeal protuberance is prominent in the male and invisible in the female .The neck can be rotated , bent and raised freely in standing and sitting position .So inspection of neck concentrates on the shape and movement of the neck .
1.1.2.3.1 Changes of the shape
The commonly seen changes are :
Goiter: Goiter refers to unilateral or bilateral lumps like tumor below the laryngeal protuberance which is either small or large and movable with swallowing , usually caused by stagnation of liver qi and retention of phlegm , sometimes due to local climate and environment.
Sorofula : Scrofula refers to cervical clustered nodules , usually caused by asthenic fire scorching phlegm into nodules due to asthenia of lung and kidney yin , or by accumulation of qi and blood in the neck due to attack by wind fire and seasonal pestilence
1.1.2.3.2 Changes of movement
Abnormal changes of the movement of the neck include the following aspects ;
Flaccidity of the neck : Weakness of the neck unable to support the head is called flaccidity of the neck .Flaccidity of the neck in the babies over 4 months old is due to congenital deficiency , insufficiency of essence and marrow , or due to postnatal improper feeding which leads to asthenia of qi and blood and malnutrition of the skeleton .Flaccidity of the neck with dispirtedness in chronic and severe disease in due to exhaustion of essence .
Stiff neck : Stiff neck refers to spasm of the muscles and sinews over the neck , making it difficult for the neck to bend , raise and rotate , Stiffness of the neck after cold attacking the neck .Sfiffness of neck with high fever , headache and vomiting is usually due to heat virulence in febrile disease attacking the upper ;stiffness of neck and back with posterior bending of the head , stretching of the trunk , bending of the spine and spasm of the limbs is called opisthotonus , usually seen in tetanus and exogenous febrile disease with wind generated by extreme heat .
