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Mental status > ch 14 (Jarvis) Head, Face, Neck, and Regional Lymphatics > Flashcards

ch 14 (Jarvis) Head, Face, Neck, and Regional Lymphatics Flashcards

1
Q

frontal, parietal, occipital, and temporal

A

cranial bones

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2
Q

adjacent cranial bones unite at meshed immovable joints called the

A

sutures

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3
Q

crowns the head from ear to ear at the union of the frontal and parietal bones

A

coronal suture

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4
Q

separates the head lengthwise between the two parietal bones

A

sagittal suture

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5
Q

separates the parietal bones crosswise from the occipital bone.

A

lambdoid suture

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6
Q

articulate at sutures (note the nasal bone, zygomatic bone, and maxilla), except for the mandible (the lower jaw). It moves up, down, and sideways from the temporomandibular joint, which is anterior to each ear.

A

14 facial bones

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7
Q

The C7 vertebra has a long spinous process that is palpable when the head is flexed. Feel this useful landmark, the ?, on your own neck.

A

vertebra prominens

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8
Q

, the “atlas

A

C1

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9
Q

axis

A

C2

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10
Q

expressions are formed by the
-are mediated by cranial nerve VII, the facial nerve. Facial muscle function is symmetric bilaterally, except for an occasional quirk or wry expression

A

facial muscle

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11
Q

the openings between the eyelids—are equal bilaterally

A

palpebral fissures

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12
Q

the creases extending from the nose to each corner of the mouth

A

nasolabial folds

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13
Q

Facial sensations of pain or touch are mediated by the 3 sensory branches of

A

cranial nerve V, the trigeminal nerve.

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14
Q

Two pairs of salivary glands are accessible to examination on the face

A
    1. parotid glands- are in the cheeks over the mandible, anterior to and below the ear. They are the largest (parotid) of the salivary glands but are not normally palpable.
    1. submandibular glands- are beneath the mandible at the angle of the jaw- palpable
      (3. sublingual glands, lie in the floor of the mouth- palpable)
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15
Q

major neck muscles are the

-they are innervated by cranial nerve XI, the spinal accessory

A

sternomastoid and the trapezius

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16
Q

branches off the common carotid and runs inward and upward to supply the brain

A

internal carotid artery

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17
Q

supplies the face, salivary glands, and superficial temporal area

A

external carotid artery

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18
Q

accomplishes head rotation and flexion

A

sternomastoid

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19
Q

move the shoulders and extend and turn the head.

A

trapezius muscle

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20
Q

divides each side of the neck into two triangles
1.anterior triangle
2.posterior triangle ( posterior belly of the omohyoid muscle)
helpful guidelines to desc finding in neck

A

sternomastoid muscle

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21
Q

in front of the ear

A

Preauricular (Lymphatics)

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22
Q

superficial to the mastoid process

A

Posterior auricular (mastoid)(Lymphatics)

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23
Q

at the base of the skull

A

Occipital (Lymphatics)

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24
Q

midline, behind the tip of the mandible

A

Submental (Lymphatics)

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25
Q

halfway between the angle and the tip of the mandible

A

Submandibular (Lymphatics)

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26
Q

under the angle of the mandible

A

Jugulodigastric (tonsillar) (Lymphatics)

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27
Q

overlying the sternomastoid muscle

A

Superficial cervical(Lymphatics)

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28
Q

deep under the sternomastoid muscle

A

Deep cervical(Lymphatics)

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29
Q

in the posterior triangle along the edge of the trapezius muscle

A

Posterior cervical(Lymphatics)

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30
Q

just above and behind the clavicle, at the sternomastoid muscle

A

Supraclavicular(Lymphatics)

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31
Q

head and neck, arms, axillae, and inguinal region. The greatest supply is in the head and neck.

A

Nodes can be examined 4 areas:

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32
Q

trunk growth predominates, so head size changes in proportion to body height during wt age?

A

infancy

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33
Q

Head size is greater than chest circumference at?

A

birth (fetal period)

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34
Q

the mandible and maxilla are small, and the nasal bridge is low; thus the whole face seems small compared with the skull.

A

toddler

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35
Q

tension, migraine, sinus

- leading cause of acute pain

A

Headache are classified by etiology

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36
Q

is particularly disabling, affecting work productivity, routine household chores, and social relationships

A

Migraine HA

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37
Q

(frequency ≥15 days/month)

  • prevalent among whites and Hispanics.
  • etiologic explanation was spasm of cerebral vessels, causing vasodilation
A

Chronic migraine

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38
Q

spasm of cerebral vessels, causing vasodilation
-stimulation of cranial nerve V (trigeminal), with neurotransmitter changes in the central nervous system and changes in vessel tone.4

A

Chronic migraine

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39
Q

are occipital, frontal, or with bandlike tightness;

  • viselike pain, Bandlike tightness, Nonthrobbing, nonpulsatile
  • anxiety and stress associated
A

Tension headaches

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40
Q

are supraorbital, retro-orbital, or frontotemporal;
-throbbing pain, pulsating
-severe pain
-occur ≥15 days/month if chronic
or <15 days/month if episodic; each lasting 1 to 3 days
-Alcohol, stress, menstruation, and eating chocolate or cheese may precipitate migraines..
-Nausea, vomiting, and visual disturbances
-have a family history.
-lie down to feel better

A

migraines

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41
Q

produce pain around the eye or cheek

A

sinus headaches

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42
Q

, pain is always unilateral and always on the same side of the head
- excruciating(severity), Continuous, burning, piercing,
-move—even to pace the floor—to feel better.
Ipsilateral autonomic signs: Nasal congestion or runny nose, watery or reddened eye, eyelid drooping, miosis,
Feelings of agitation

A

cluster headaches

43
Q

nuchal rigidity and fever are associated with

-Acute onset of neck stiffnes-m word

A

meningitis or encephalitis.

44
Q

Hypertension, fever, hypothyroidism, and vasculitis

-meds cause HA- Oral contraceptives, bronchodilators, alcohol, nitrates, and carbon monoxide inhalation

A

produce headaches

45
Q

Loss of consciousness before a fall may have a?

A

cardiac cause (e.g., heart block).

46
Q

I feel like I’m going to faint” suggests

A

presyncope (dizziness)

47
Q

I feel like I’m spinning”

A

vertigo (dizziness)

48
Q

I feel like I’m going to fall down”

A

disequilibrium (dizziness)

49
Q

Vertigo together with unilateral hearing loss suggests

A

Meniere disease

50
Q

Tenderness suggests acute infection.

- Tension increases pain and disability, which produces more anxiety.

A

Neck

51
Q

difficulty swallowing

A

Dysphagia.

52
Q

history of prior irradiation of head, neck, upper chest

A

Increased risk for salivary and thyroid tumors

53
Q

may increase the risk for caput succedaneum(swelling of scalp), cephalhematoma, and Bell palsy

A

Forceps (during delivery of bby)

54
Q

is the term that denotes a round symmetric skull that is appropriately related to body size

A

Normocephalic (objective)

55
Q

Rigid head and neck occur with

A

arthritis.

56
Q

irradiation of head, neck, upper chest

A

Increased risk for salivary and thyroid tumors.

57
Q

under the tip of the chin is easier to explore with one hand. When you palpate with one hand, use your other hand to position the person’s head

A

submental gland (palpate node)

58
Q

tip the person’s head toward the side being examined to relax the ipsilateral muscle.Then you can press your fingers under the muscle

A

deep cervical chain(palpate node)

59
Q

by having the person hunch the shoulders and elbows forward; this relaxes the skin. The inferior belly of the omohyoid muscle crosses the posterior triangle here; do not mistake it for a lymph node.

A

Search for the supraclavicular node

60
Q

If any nodes are palpable, note their location, size, shape, delimitation (discrete or matted together), mobility, consistency, and tenderness. Cervical nodes often are palpable in healthy persons, although this palpability decreases with age
. Normal nodes feel movable, discrete, soft, and nontender.

A

palpate nodule

61
Q

means enlarge­ment of the lymph nodes (>1 cm) from infection, allergy, or neoplasm

A

Lymphadenopathy

62
Q

—acute onset, <14 days’ duration; nodes are bilateral, enlarged, warm, tender, and firm but freely movable.

A

Acute infection

63
Q

(e.g., in tuberculosis the nodes are clumped).

A

Chronic inflammation

64
Q

are hard (feel like a rock), >3 cm, unilateral, nontender, matted, and fixed to adjacent structures

A

Cancerous nodes

65
Q

are enlarged, firm, nontender, and mobile. Occipital node enlargement is common with HIV infection.

A

Nodes with HIV infection

66
Q

single enlarged, nontender, hard left supraclavicular node may indicate

A

neoplasm in thorax or abdomen (Virchow node).

67
Q

Painless, rubbery, discrete nodes that gradually appear occur with

A

Hodgkin lymphoma, commonly in the cervical region.

68
Q

occurs with accelerated or turbulent blood flow, indicating hyperplasia of the thyroid (e.g., hyperthyroidism).

  • soft, pulsatile, whooshing, blowing sound heard best with the bell of the stethoscope
  • After 5 years of age, indicate increased intracranial pressure, aneurysm, or arteriovenous shunt.
A

bruit

69
Q

[increased cerebrospinal fluid]).
-Delayed closure or larger-than-normal fontanel size occurs with
enlargement of the head. The face looks small compared with the enlarged cranium. The increasing pressure also produces dilated scalp veins, frontal bossing, and downcast or “setting sun” eyes (sclera visible above iris). The cranial bones thin, sutures separate, and percussion yields a “cracked pot” sound (Macewen sign

A

hydrocephalus (pediatric abnormalities)

70
Q

is a subperiosteal hemorrhage, which is also a result of birth trauma

  • goes down w/ 1st few wks w/no treatment
  • risk for jaundice as the red blood cells within the hematoma are broken down and reabsorbed
A

cephalhematoma

71
Q

is a severe deformity caused by premature closure of the sutures. This causes a distinctive head shape that correlates with the specific closed suture.
-Mechanisms involve genetic mutations coding structural proteins or growth factor receptors. Severe deformities cannot contain the brain, eyes, and optic nerves inside the cranial vault, and hypoplasia of the face results, warranting surgery.

A

craniosynostosis (Pediatric Abnormalities)

72
Q

may occur as the infant continually sleeps in the recommended position on the back to decrease the incidence of sudden infant death syndrome (SIDS)
-flattening of the dependent cranial bone, the occiput, in an infant

A

positional molding (positional plagiocephaly)// (Pediatric Abnormalities)

73
Q

requires a custom-shaped helmet to afford room for brain growth in the flattened area while moderating growth in other areas. Used before sutures fuse.

A

Marked plagiocephaly

74
Q

true tense or bulging fontanel occurs with

A

acute increased intracranial pressure.

75
Q

Depressed and sunken fontanels occur with

A

dehydration or malnutrition

76
Q

occur with increased intracranial pressure

A

Marked pulsations

77
Q

when supine and the head is turned to one side (extension of same arm and leg, flexion of opposite arm and leg)

  • disappears between 3 and 4 months
  • beyond 5 months may indicate brain damage
A

tonic neck reflex

78
Q

occurs with habit spasm, poor vision, and brain tumor

A

children head tilt

79
Q

after 4 months may indicate mental or motor retardation.

A

Head lag

80
Q

second trimester may ? show on the face. This is a blotchy, hyperpigmented area over the cheeks and forehead that fades after delivery.

A

chloasma

81
Q

forgetfulness of recent events, loss of consciousness, and mental cloudiness, headache, nausea and vomiting, loss of balance, and blurred vision. Later signs include difficulty in concentrating, poor short-term memory, slow reaction time, and irritability.

A

concussion

82
Q

most common chromosomal aberration (trisomy 21). Head and face characteristics may include upslanting eyes with inner epicanthal folds; flat nasal bridge; small, broad, flat nose; protruding, thick tongue; ear dysplasia; short, broad neck with webbing; and small hands with single palmar crease. Child also has mental disability, often congenital heart deformities.

A

Down Syndrome (Pediatric Abnormalities)

83
Q

Children with chronic allergies often develop characteristic facial features. These include exhausted face, blue shadows below the eyes (“allergic shiners”) from sluggish venous return; a double or single crease on the lower eyelids (Morgan lines); central facial pallor; and open-mouth breathing (allergic gaping), which can lead to malocclusion of the teeth and malformed jaw because the child’s bones are still forming.

A

Atopic (Allergic) Facies// (Pediatric Abnormalities)

84
Q

Characteristic facies include narrow palpebral fissures, epicanthal folds, thin upper lip, and midfacial hypoplasia. These malformations may be recognizable at birth but more so during childhood. FASDs include a wide range of neurologic and behavioral deficits,8 even without facial malformations. Infants often have smaller head circumference, decreased birth weight and length, feeding problems, and irritability

A

Fetal Alcohol Spectrum Disorders (FASD)

85
Q

The transverse line on the nose is also a feature of chronic allergies. It is formed when the child chronically uses the hand to push the nose up and back (the “allergic salute”) to relieve itching and free swollen turbinates, which allow air passage.

A

Allergic Salute and Crease

86
Q

hematoma in one sternomastoid muscle, probably injured by intrauterine malposition, results in head tilt to one side and limited neck ROM to the opposite side. You feel a firm, discrete, nontender mass in mid-muscle on the involved side.

A

Congenital Torticollis// Swellings on the Head or Neck

87
Q

Endemic goiter, a chronic enlargement of the thyroid gland, is common in wide regions of the world (especially mountainous regions) where the soil is low in iodine. Iodine is an essential element in the formation of thyroid hormones.

A

Simple Diffuse Goiter (SDG)// Swellings on the Head or Neck

88
Q

Multiple nodules usually indicate inflammation or a multinodular goiter rather than a neoplasm.

A

Thyroid—Multinodular Goiter (MNG)//Swellings on the Head or Neck

89
Q

This is a smooth, firm, fluctuant swelling on the scalp that contains sebum and keratin. Tense pressure of the contents causes overlying skin to be shiny and taut. It is a benign growth

A

Pilar Cyst (Wen)

90
Q

Rapid painful inflammation of the parotid occurs with mumps. Mumps is a contagious viral infection of the salivary glands preventable by a vaccine. Parotid swelling also occurs with blockage of a duct, abscess, or tumor. Note swelling anterior to lower ear lobe. Stensen duct obstruction can occur in aging adults dehydrated from diuretics or anticholinergics.

A

Parotid Gland Enlargement

91
Q

T3 and T4 hormones are high in the bloodstream (“hot” like a furnace), they (4) direct the pituitary and hypothalamus to shut off their signaling hormones. That is the negative feedback

A

Thyroid Hormone Disorders

92
Q

An autoimmune disease with increased production of thyroid hormones causes an increased metabolic rate, just like ramping up the furnace. This is manifested by goiter, eyelid retraction, and exophthalmos (bulging eyeballs). Symptoms include nervousness, fatigue, weight loss, muscle cramps, and heat intolerance. Signs include forceful tachycardia; shortness of breath; excessive sweating; fine muscle tremor14; thin silky hair; warm, moist skin; infrequent blinking; a staring appearance; and brisk ankle jerks.

A

Graves Disease (Hyperthyroidism)// Thyroid Hormone Disorders

93
Q

deficiency of thyroid hormone means that the thyroid furnace is cold. This reduces the metabolic rate and, when severe, causes a nonpitting edema or myxedema. Usual cause is Hashimoto thyroiditis. Symptoms include fatigue and cold intolerance. Signs include puffy, edematous face, especially around eyes (periorbital edema); puffy hands and feet; coarse facial features; cool, dry skin; dry, coarse hair and eyebrows; slow reflexes; and sometimes thick speech.

A

Myxedema (Hypothyroidism)// Thyroid Hormone Disorders

94
Q

Excessive secretion of growth hormone from the pituitary gland after puberty creates an enlarged skull and thickened cranial bones

A

Acromegaly//

Abnormal Facies With Chronic Illness

95
Q

With excessive secretion of adrenocorticotropic hormone (ACTH) and chronic steroid use, the person develops a rounded, “moonlike” face; prominent jowls; red cheeks; hirsutism on the upper lip, lower cheeks, and chin; and acneiform rash on the chest.

A

Cushing Syndrome//(Abnormal Facies With Chronic Illness)

96
Q

A lower motor neuron lesion (peripheral), producing rapid onset of cranial nerve VII paralysis of facial muscles; almost always unilateral. This may be a reactivation of herpes simplex virus (HSV-1) latent since childhood

A

Bell Palsy (Left Side)/(Abnormal Facies With Chronic Illness)

97
Q

upper motor neuron lesion (central). A stroke is an acute neurologic deficit caused by blood clot of a cerebral vessel, as in atherosclerosis (ischemic stroke), or a rupture in a cerebral vessel (hemorrhagic stroke). If you suspect a stroke, ask if the person can smile.

A

Stroke or “Brain Attack”/(Abnormal Facies With Chronic Illness)

98
Q

deficiency of the neurotransmitter dopamine and degeneration of the substantia nigra of the basal ganglia in the brain. The immobility of features produces a face that is flat and expressionless, “masklike,” with elevated eyebrows, staring gaze, oily skin, and drooling.

A

Parkinson Syndrome/(Abnormal Facies With Chronic Illness)

99
Q

Accompanies chronic wasting diseases such as cancer, dehydration, and starvation. Features include sunken eyes; hollow cheeks; and exhausted, defeated expression.

A

Cachectic Appearance/(Abnormal Facies With Chronic Illness)

100
Q

Exophthalmos is associated with

A

hyperthyroidism.

101
Q

Bowed long bones and an acorn-shaped cranium result

from .

A

Paget disease

102
Q

is a deficiency of thyroid hormone that, when severe, causes a nonpitting edema or myxedema.
- puffy edematous face, especially
around the eyes (periorbital edema); coarse facial features; dry skin; and dry, coarse hair and
eyebrows

A

Myxedema (hypothyroidism)

103
Q

bilateral, enlarged, warm, tender, and firm but freely

movable

A

Acutely infected lymph nodes

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