300ClassNotesCH13HEAD,NECK,LYMPATICS Flashcards
Facial muscle
function symmetrical Facial structures—symmetric Eyebrows, eyes, ears, nose, mouth appear the same
CN VII (facial nerve)
Three (3) pairs of salivary glands
Parotid gland—in the cheeks over the mandible
Submandibular glands—beneath the mandible at the angle of the jaw
Sublingual glands—lie in the floor of the mouth
Temporal artery location
superior to the temporalis muscle; pulse anterior to the ear
Vessels in neck
Common carotid artery External carotid artery Internal carotid artery Internal jugular vein External jugular vein
Major neck muscles
Sternomastoid—allows head rotation, flexion
Trapezius—allows shoulder movement, extension and turning of the head
Major neck muscles
Sternomastoid—allows head rotation, flexion
Trapezius—allows shoulder movement, extension and turning of the head
CN XI (spinal accessory nerve)
- Thyroid gland
Straddles the trachea
Has 2 lobes
Synthesizes and secretes thyroid hormones
Highly vascular
Lymphatics
Part of immune system—detect and eliminate foreign substances
Lymphatic nodes located through body but accessible in only 4 areas:
Head and neck
Arms, axilla
Inguinal region
The head and neck contain ____ lymphnoides
60-70
Lymphadenopathy
Increased size of lymph nodes ( > 1 cm)
Indicates infection, allergy, or neoplasm
Check areas enlarged nodes drain for the source of a problem
Developmental Competence: Infants regarding head size
fontanels close within first 2 years (anterior fontanel)
Head size greater than chest circumference at birth
posterior close 1-2 months
Developmental Competence: Adolecents: regarding thyroid
enlargement of thyroid cartilage—voice deepens
Developmental Competence: aging adults
: facial bones and orbits appear more prominent
Subjective data: Headaches:
caution if client has severe headache without history of headaches
Use PQRSTU
Associated factors/symptoms: N/V; visual changes; fever
Subjective data: Head Injury:
get the story
Associated factors/symptoms: neck pain; visual changes; nasal or ear discharge
Subjective data: Dizziness
: Use PQRSTU
Also ask about—food/fluid intake; vomiting; bloody or black stools; occupation; falls
Subjective data: Neck Pain
Use PQRSTU
Determine whether there is a history of injury
Ask about: occupation; stress
Objective Data: head/face
Note—size; shape; symmetry; skin; muscle tone
Assess CN VII
Objective Data: Neck
Assess for general swelling Note range of motion Assess carotid pulsation—one side only! Check for lymph node enlargement Assess CN XI
Objective Data: Trachea
Palpate to establish it is midline
Why would it not be in the midline?
Thyroid gland: should not be
Should not be visibly enlarged
Should not be easy to palpate
Infants and children: Fontanels
Anterior fontanel will bulge with crying or lying down
Fontanels will feel firm, concave
Infants and children: Two common variations in newborn making head appear assymetric; Caput succedaneum & Cephalhematoma
Caput succedaneum—edematous swelling and ecchymosis of presenting part of head
Cephalhematoma—subperiosteal hematoma, reabsorbed during first few weeks of life
Infants and children: Molding is
overriding of cranial bones during birth-lasts only a few days or a week
Infant can turn head side to side by
2 weeks
Head controlled achieve by
4 months
Are child lymph nodes more easy to palpate than adults
yes
What is nuchal ridigty
neck stiffness), photophobia (intolerance of bright light) and headache.
how do you assess for nuchal ridgity
It is a sign of irritation of the meninges, such as seen in meningitis, subarachnoid hemorrhages and various other diseases.
what does nuchal rigidity mean
resistance to flexion can be a sign of nuchal rigidity and pain of flexion indicated meningeal irritation or meningitis
Sign and symptoms that occur with concussion
headache or pressure, N/V sensitivity to light and/or sound, changes to reaction time, balance, and/or coordination, changes in memory, judgments, and or speech, sleep pattern changes
Sign and symptoms can arise how in concussions
quickly or be delayed, appearing over several days. Most individuals sign and symptoms disappear in ten days
one concussion raises the risk of what? especially when
having another, especially with in 10 days of the initial concussoin
Upper tracheal ring
cricoid cartilage
thyroid cartilage
is just above the cricoid—also known as Adam’s Apple
what would cause the trachea to move towards unaffected side
pneumothorax, tumor, unilateral thyroid enlargement
what would cause the trachea to move towards affected side
atelectasis, pleural adhesion or fribrasis
