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Health Assessment > Ch 12: Head And Neck With Vision And Hearing Basics > Flashcards

Ch 12: Head And Neck With Vision And Hearing Basics Flashcards

1
Q

How many bones is the facial skeleton composed of

and what a soft organs does it contain and support EEN(M)T

A

Fish skeleton is composed of 22 bones

Contains and supports

  • eyes
  • eyes
  • nose
  • mouth
  • throat
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2
Q

What do the suture lines in the facial bones join together

Name the 3 sutures and where they are

A

The suture lines join the facial bones together, there’s 3

  • coronal
  • sagittal
  • lambdioidal
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3
Q

What do the facial muscles enable (allow basic movements)

A

Facial muscles allow

  • chewing
  • smiling
  • frowning
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4
Q

What are the two major neck muscles what do they make up and go to the serve as

What is the major blood vessel found in the anterior posterior triangle

A

Two major neck muscles are 1.sternocleidomastoid
2. Trapezius

Make up the anterior posterior triangle that is used as a landmark when assessing Neck

Carotid is found in between the anterior posterior triangle

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5
Q

What blood supply components can you find in the head and neck

A

Carotid artery
Temporal artery
Enteral and internal jugulars

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6
Q

What are the cranial nerves that you can test in the head and neck (broad category)

Give name and test

A

CN v: trigeminal - sense test (dull or sharp)

Cn vii: facial- mimicking facial movements

Cn xi: accessory- neck movement and rom

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7
Q

What does the CN v trigeminal nerve supply, and where does it apply it to

A

Trigeminal nerve supplies motor and sensory innervation to forehead and cheeks

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8
Q

Give a brief breakdown of the process of vision (five total steps)

A
  1. Light enters cornea
  2. Bent into central fovea (macula)
  3. Object inverted reversed and focused on to retina
    4 simulation sent through visual pathway to brain
  4. Image converted to original form
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9
Q

Give the three portions of the neural pathway to the CNS

A
  1. Optic nerves
  2. Optic chiasm
  3. Optic trucks
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10
Q

What is the complex function of hearing

A

The complex function of hearing is sound

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11
Q

Give us your body systems that the structures of the head and neck interact with

A

Integumentary(skin), neurological (CN), respiratory (trachea), vascular (arteries),
GI, lymphatic (lymph nodes), endocrine (thyroid)

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12
Q

Give the five structures of the head (what its commonly referred to as)

A

1. Eyes

  1. ears
  2. nose
  3. mouth
    - throat
  4. brain
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13
Q

When assessing the head shape and size what is the specific word you use to describe it

A

Normocephalic

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14
Q

A few conditions of the head and neck
Describe each

  1. Acromegaly
  2. Hydrocephalic
  3. Puffy moon face
A
  1. Excessive growth hormone causing thick skin and facial bones
  2. Excessive CSF causing cranium enlargement
  3. Cushing syndrome
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15
Q

What do you look at when doing a head assessment from the mouth down

A 
Note nasal labial folds (symmetrical?)
Note skeletal structure
    -muscles
    -blood supply: external/internal               carotid arteries 
Salivary glands (3types) 
   1. parotid:top 1/2 by molars
   2. Submandibular
   3. Sublingual

Note TMJ
- no any resistance, crepitus, pain, tenderness

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16
Q

When doing a head assessment what are the cranial nerves you test for (2 specific one related to head, not to include eyes)

Give number give name give what they test

A

CN v: Trigeminal-Sharp or dull 4 QUAD
- test sensory (sharp/dull) and motor (TMJ)

CN vii: facial- mimic faces
-test sensory (peppermint gum on ea side of tongue) and motor (mimic faces)

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17
Q

When doing a neck assessment what is the cranial nerve you test and how do you test it

A

CN xi: accessory - shrug shoulder/ ROM

  • Apply resistance to shoulders have patient shrug
  • turn head v resistance
  • Range of motion of neck
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18
Q

When doing a neck assessment what landmark do you note

What are the components of the landmark

What is palpable within the landmark

A

Note the anterior posterior triangle composed of the sternocleidomastoid and trapezius muscle

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19
Q

Where is the trachea in relation to the thyroid and what are you noting about the trachea

A

The trachea is under the thyroid and you are noting if it is midline also noting the Cricoid Cartilage for any pain or discomfort/ midline

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20
Q

What is an important aspect of the neck assessment to note (extra structure related to endocrine system) and how do you assess it

A

The thyroid is vital to the neck assessment you asses by having your fingers over patients throat and have them swallow 

Go behind patient have them look forward tilt it down and turn all the way to the right palpate thyroid then turn all the way to the left palpate thyroid

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21
Q

What shape is a butterfly and we’re in your palpating as patient swallows what are you palpating

A

Thyroid is butterfly shaped with two lobes

As the patient swallows when you’re palpating with two fingers you are palpating the isthmus

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22
Q

What are the thyroid hormones and what do they control

A

Thyroid hormones are T3 and T4 that control the metabolic rate

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23
Q

What is a normal finding when palpating the thyroid gland (say it as if you were doing assessment)

A

If I were gland normally should be non-palpable but symmetric with no masses

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24
Q

What do tender warm And palpable lymph nodes mean

A

If tender and warm there is an infection of a lymph node

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25
Q

What are characteristics of a cancer is lymph node that need immediate investigation (include numberical size)

A

If a lymph node is + 1CM, fixed (doesn’t move) hard non-tender and or rubbery 
There needs to be immediate evaluation for cancer

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26
Q

When you were searching for tracheal deviation and you note tracheal deviation what else do you see

and what does it indicate

When is the diagnosis especially notable

A

If noted tracheal deviation you will also see cyanosis and shortness of breath because a patient is experiencing an emergency tension pneumothorax

Especially if patient involved in MVC

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27
Q

How many pairs of parathyroid glands do we have what do they produce what do they secrete and what are normal findings

A

We have two pairs of parathyroid glands embedded in thyroid gland lobes

they produce PTH

Secrete calcium and calcitonin

Normal findings are nonpalpable

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28
Q

How do you know to suspect a meningitis alert

A

If the patient comes in complaining of a headache, has a fever, and nuchal rigidity there is a meningitis alert

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29
Q

How many lymph nodes do we have in the head and neck and what bigger system are they part of other than lymphatic

A

80 lymph nodes total that are part of the immune system

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30
Q

What is the purpose of lymph notes and where do they drain too

A

They filter potential pathogens and drain fluid that moves out of the circulation into the:

  • right subclavian
  • thoracic duct
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31
Q

How do you know if a node is going upstream Instead of down like it’s supposed to

A

The note will be enlarged( inflamed)

32
Q

What are normal age related findings to find in older adults (4things )

Facial structure
Mouth
Eyes normal finding
Ears

A
  • more prominent bony structures (face)
  • tooth loss
  • Glare intolerance
  • thickened eardrums
33
Q

What is a Abnormal finding in older adults in relation to Parkinson’s

A

Abnormal: a mask like facial appearance where :

  1. muscles are rigid
  2. decreased reflexes
  3. a shuffling gate
34
Q

Why are skin lesions more likely in older adults

A

Because of thinning skin making tears highly likely

35
Q

In what area of skin do you carefully want to search for skin cancer in your older population

A

In areas that are commonly exposed to sun

36
Q

What to disease processes are more common as you get older and only increase with age

A

Hypo and hyper thyroidism

37
Q

Give all related information for hypo thyroidism

When it’s an emergency
what the patient’s labs will look like
and what findings will you see

A

Myexedema is an emergency

⬆️TSH (+5) ⬇️T3 (under 80)/T4 (under 5)

Findings:
⬆️CO2⬇️O2

38
Q

Give all related information for hyperthyroidism

Including when it’s an emergency
, labs you’ll see in the patient,
findings you’ll see in the patient,
and what it poses an increased risk for

A

Thyroid storm (graves dis) = emergency

Labs
⬇️TSH (below 0.3)⬆️T3 (+200) /T4(+12)

Findings

  • tachycardia
  • diarrhea
  • anxiety
  • fever
  • weakness

Hyper thyroidism poses an increased risk for thyroid tumors

39
Q

What are normal TSH lab findings

A

0.3-5

40
Q

What are normal T3 findings

A

80-200

41
Q

What are normal T4 findings

A

5.0-12

42
Q

 give four instances you would perform in Urgent Assessment

In relation to head and brain injury

A

1. Trauma

  1. Epidural hematoma
  2. Subarachnoid bleed
  3. Traumatic brain injury
43
Q

How does an epidural hematoma present and how do you fix it

A

Epidural hematomas present with bleeding around protective layer around brain skull

Fixed with burr hole craniotomy

44
Q

What does a subarachnoid bleed present with

Describe no injury (cause)
Describe when injury (how it develops)

A

Subarachnoid bleed present with severe sudden onset headache

No injury : caused by aneurysm
Injury: after a fall patient won’t remember but headache gets so bad that they come to the ER

45
Q

If a patient has a acute head or neck injury what do you do and what are you wait for to ensure no damage

A

With a cute head or neck injuries you immobilize (aka stabilize) the C-spine Until cross lateral x-ray ensures there is no damage

46
Q

If there is an acute head injury What status change are you noting
what is the acronym used to assess alertness
and what does it stand for

A

With a cute hand injuries you’re noteing a mental status change

Acronym is AVPU

Stands for alert to verbal, pain, or unconscious

47
Q

How do you know to be alert for meningitis when a patient comes to the ER

A

If patient has a headache, fever, and nuchal rigidity be alert for meningitis

48
Q

How do you know to differentiate a possible cardiac situation From meningitis

What do cardiac situations present with

A

Cardiac situations have no fever or headache

Present with referred pain to left arm jaw or neck

49
Q

How do you know to suspect if a lymph node is cancers

A

Upon inspection if lymph node is palpable, + 1CM, fixed (does not move) hard, rubbery

50
Q

How do you know to suspect for infection in lymph nodes

A

If lymph node is palpable, TENDER, warm

51
Q

What are you check for if a patient comes in complaining of otitis media (middle ear infection) or pharyngitis

A

Check the post and preauricular nodes to see if warm, tender, palpable

52
Q

If excess fluid moves out of the circulation where does the lymphatic system drain it back into

A
  1. the R. Subclavian

2. Thoracic duct

53
Q

When collecting subjective data what are assessment risk factors
(3 broad)

A
  1. personal history
  2. Medication
  3. Family history
54
Q

When collecting subjective data what personal history is relevant to risk factors for the head and neck

A

Any head injuries (falls) or spontaneous injuries like a subarachnoid bleed

55
Q

When collecting subjective data What medications are relevant to the assessment of risk factors

A

Synthroid and anything containing iodide

56
Q

When collecting subjective data what is Relevant family history information in relation to the assessment of risk factors

1 relates to throid

A

Any history of cancer, hypo/hyper thyroidism

57
Q

For the head and neck how do you reduce injury risk

Primary

A

PRIMARY PREVENTION

Use a helmet, seatbelt, car seats

58
Q

For the head and neck how do you prevent thyroid disorder complications

Tertiary

A

TERTIARY PREVENTION

Receive treatment

59
Q

For the head and neck how do you Facilitate early detection of masses or malignant nodes

A

SECONDARY PREVENTION

Follow up with annual screenings

60
Q

What is an important fact in relation to pregnant women for migraines

A

Pregnant women suffer more migraines because of hormonal changes

61
Q

What is the percentage of women who suffer from an enlarged thyroid postpartum

A

5 to 10% of women suffer in a large thyroid postpartum

62
Q

What is a common assessment finding in children ages 1 to 5 among there lymph nodes that is not a cause for concern

A

In children 1 to 5 It is common to find a palpable node that is nontender and freely movable

63
Q

Give a few common head and neck symptoms And quick facts about them

A

Headache, neck pain
-Head injury, CVA, meningitis, MI, migraines

Limited neck movement
-range of motion no extremity numbness or sensory loss

Hypo/hyper thyroidism

Sleepiness

64
Q

If a patient has facial drooping and has undergone a mental status change what are you assessing for and

what is the acronym you use to assess

A

With facial DROOPING and a mental status change assess for CVA

Use FAST

F facial symmetry

A alert and oriented

S slurred speech

T time of onset (only have 3 hrs for thrombolytic)

65
Q

Give the major lymph nodes in the head or neck

Two have other names and 2 of them added

A

*Preauricular
*Postauricular
*submandibular
*Submental
*Tonsillar (AKA Retropharyngeal)
*Anterior cervical (AKA sub maxillary)
*Posterior cervical
deep
*Occipital
*Supraclavicular
 infra clavicular

66
Q

What does it mean if your submandibular lymph nodes are enlarged

A

Means in mouth/throat inflammation

67
Q

What is the exact position of your posterior cervical lymph node

A

Behind sternocleidomastoid

68
Q

If you palpate a LEFT supraclavicular note what is it associated with and what is the other name

A

Palpating a LEFT supraclavicular note is associated with gastric and lung cancer

Other name : verclause note

69
Q

Starting head assessment what are you expecting

A 
Inspect head symmetry
-no noted the deformities, symmetrically bilateral 
Assess hair and scalp
-no noted lesions or masses
-scalp intact
-no noted pedicosis 
-no noted areas of alopecia
-no breakage at ends
-no noted hair loss
 facial symmetry
--eyebrows, eyelashes, Eyes, ears, nose, nasal labial folds, mouth

Trachea
-mIDLINE

Thyroid
-no Goiter present

70
Q

When do you auscultate a thyroid and for what

A

Only if patient has a goiter

For a bruit with the bell

71
Q

What are you always wanna wear when inspecting the scalp

A

Gloves because of pediculosis, nits

72
Q

What areas of the body should you use cultural considerations when examining that are based on genetics

A
  • skin color
  • Eye shape
  • nose
  • lips
73
Q

Who is TSH secreted by

A

The anterior pituitary gland

74
Q

If there is a neck injury or head trauma what are a few diagnostic test s you would run

A

City, MRI, lumbar puncture (meningitis), 3 thyroid labs

75
Q

What are nursing diagnosis related to head and neck

A
  1. Activity intolerance
  2. Fatigue
  3. Chronic pain
  4. Knowledge deficit related to new diagnosis
76
Q

What are outcomes related to the head and neck

A

Patient verbalizes increased energy

Pain goals are met

77
Q

What are nursing interventions we can do for head and neck

A
  1. Allow rest period before activity

2. Small short term activity goals

Health Assessment (20 decks)

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