Above the clavicles you look, then touch, and almost never tap — but the order still matters, and there is exactly one region of the body where it flips. Build the examination sequence for four regions, then describe a cervical node the way a chart demands and let the bench tell you whether it is inflammation or something that leaves the room with you.
1 · Which region are you examining?
Pick the region, then tap the four techniques in the order you would actually perform them.
2 · Build the order
Size — 1.0 cm
Consistency
Mobility
Tenderness and warmth
How long has it been there?
The swallow test
Neck slightly extended, hand the patient a cup of water, watch and palpate while they swallow. One cup of water, three answers.
What did the mass do?
The trachea
Index finger in the suprasternal notch, slip gently to each side. The space between trachea and sternocleidomastoid should be equal.
Tracheal position
Is the patient short of breath with absent breath sounds on one side?
Auscultate in only two places above the clavicles. The bell over each carotid, and the bell over an enlarged thyroid listening for a bruit while the patient holds their breath. Never palpate both carotids at once, and never massage the carotid sinus.
Pick a region and build the orderThe bench grades each slot and explains the reason behind the rule.