Chapter 14-17 Flashcards
rigid bony box that protects the brain and special sense organs and it includes the bones of the cranium and the face
skull
What are the four cranial bones?
frontal, parietal, occipital, and temporal
adjacent cranial bones unite at meshed immovable joints
sutures
Three types of sutures:
coronal, sagittal, lambdoid
separates the head lengthwise between the two parietal bones
sagittal
separates the parietal bones crosswise from the occipital bone
lambdoid
crowns the head from ear to ear at the union of frontal and parietal bones
coronal
located on C7, on the neck
Vertebra prominens
A physician tells the nurse that a patients vertebra prominens is tender and asks the nurse to reevaluate the area in 1 hour. The area of the body the nurse will assess is:
a. Just above the diaphragm.
b. Just lateral to the knee cap.
c. At the level of the C7 vertebra.
d. At the level of the T11 vertebra.
C.
**The C7 vertebra has a long spinous process, called the vertebra prominens, which is palpable when the head is flexed.
What gland is in the cheek over the mandible , anterior to or below the ear?
parotid
What gland is beneath the mandible at the angle of the jaw?
submandibular
What gland lies on the floor of the mouth?
sublingual
What lies superior to the temporalis muscle; its pulsation is palpable anterior to the ear?
temporal artery
What are the major neck muscles?
What cranial nerve do they innervate at?
sternomastoid and trapezius
They are innervated by cranial nerve XI (the spinal accessory)
The nurse notices that a patients palpebral fissures are not symmetric. On examination, the nurse may find that damage has occurred to which cranial nerve (CN)?
a. III
b. V
c. VII
d. VIII
C.
**asymmetry of palpebral fissures may be attributable to damage to CN VII (Bell palsy).
What describes the delimited by the base of the skull and inferior border of the mandible above and by the manubrium sterni, the clavicle, first rib, first thoracic vertebra?
Neck
Sternomastoid muscle divides each side of the neck into two triangles:
anterior and posterior
endocrine gland that is rich in blood supply; synthesizes and secretes T3 and T4 hormones that stimulate the rate of cellular metabolism; this gland has two lobes
thyroid gland
midline, behind the tip of the mandible
submental
Which cranial nerve?
Facial sensations of pain or touch
Cranial nerve V, Trigeminal
What artery supplies the face, salivary glands, and superficial temporal area?
external carotid artery
What artery branches off the common carotid, runs inward and upward to supply the brain?
internal carotid artery
behind the sternomastoid muscle
posterior triangle
lies in front, between the sternomastoid and midline of the body, lower border of the mandible
anterior triangle
in front of the ear
preauricular
superficial to the mastoid process
posterior auricular
under the angle of the mandible
jugulodigastric (tonsillar)
just above and behind the clavicle, at the end of the sternomastoid muscle
supraclavicular
spaces where the sutures intersect in the bones of the neonatal skull; these membrane covered “soft spots” allow for the growth of the brain
fontanels
the leading cause of acute pain and lost of productivity; classified as tension, migraine, sinus.
headache
How do you assess for objective data of the head?
no lumps, no lesions, no tenderness, no trauma
How do you assess objective data of the face?
symmetric, no drooping, no weakness, no involuntary movements
How do you assess for objective data of the neck?
supply with full ROM, no pain. symmetric, no cervical lymphadenopathy or masses. trachea midline. thyroid not palpable. no bruits.
an autoimmune disease with increased production of thyroid hormones causes an increased metabolic rate. this is manifested by goiter, eyelid retraction, exophthalamos
grave’s disease or hyperthyroidism
Symptoms of hyperthyroidism include?
nervousness, fatigue, weight loss, muscle cramps, heat intolerance
Signs of hyperthyroidism include?
forceful tachycardia, shortness of breath, excessive sweating, thin silky hair, warm/ moist skin, muscle tremor, infrequent blinking
deficiency of thyroid hormone means that the thyroid furnace is cold. usual cause is hashimoto thyroiditis.
myxedema or hypothyroidism
Symptoms of hypothyroidism:
fatigue and cold intolerance
Signs of hypothyroidism:
puffy, edematous face especially around the eyes, puffy hands and feet, coarse facial features, cool/ dry skin, dry/coarse hair or eyebrows, slow reflexes; sometimes thick speech
excessive secretion of growth hormone from the pituitary gland after puberty creates and enlarged skull and thickened cranial bones
acromegaly
Objective data of acromegaly:
elongated head, massive face, overgrowth of the nose and lower jaw; heavy eyebrow ridge, and coarse facial features.
a rapid onset of cranial nerve VII paralysis of the facial muscles; almost always unilateral
bell palsy
excessive secretion of ACTH and chronic steroid use, the person develops a rounded, “moonlike” face; prominent jowls, red cheeks, hirsutism on upper lips, lower cheeks, and chin.
cushing syndrome
deficiency of the neurotransmitter dopamine; immobility of features like “masklike” with elevated eyebrows, staring gaze, oily skin, and drooling.
parkinson syndrome
two rapid window shades that protect the eye from injury, strong light, and dust
eyelids
elliptical open space between the eyelids
palpebral fissure
the border between the sclera and cornea
limbus
corner of the eye and angle where the lids meet
canthus
fleshy mass containing sebaceous glands
caruncle
in the upper lid, strips of connective tissue that gives it shape
tarsal plates
modified sebaceous glands that secrete and oily lubricating material onto the eyelids; stops the tears from overflowing
meibomian glands
thin mucous membrane folded like an envelope between the eyelid and the eyeball
conjuntiva
provides constant irrigation to keep the conjunctiva and cornea moist and lubricated
lacrimal apparatus
What cranial nerves involves movements of the eyes?
abducens or cranial nerve VI
trochlear or cranial nerve IV
oculomotor or cranial nerve III
A patient is unable to differentiate between sharp and dull stimulation to both sides of her face. The nurse suspects:
a. Bell palsy.
b. Damage to the trigeminal nerve.
c. Frostbite with resultant paresthesia to the cheeks.
d. Scleroderma.
B.
When examining the face of a patient, the nurse is aware that the two pairs of salivary glands that are accessible to examination are the ___________ and ___________ glands.
a. Occipital; submental
b. Parotid; jugulodigastric
c. Parotid; submandibular
d. Submandibular; occipital
C.
A patients laboratory data reveal an elevated thyroxine (T4) level. The nurse would proceed with an examination of the _____ gland.
a. Thyroid
b. Parotid
c. Adrenal
d. Parathyroid
A.
A male patient with a history of acquired immunodeficiency syndrome (AIDS) has come in for an examination and he states, I think that I have the mumps. The nurse would begin by examining the:
a. Thyroid gland.
b. Parotid gland.
c. Cervical lymph nodes.
d. Mouth and skin for lesions.
B.
When examining children affected with Down syndrome (trisomy 21), the nurse looks for the possible presence of:
a. Ear dysplasia.
b. Long, thin neck.
c. Protruding thin tongue.
d. Narrow and raised nasal bridge.
A.
A woman comes to the clinic and states, Ive been sick for so long! My eyes have gotten so puffy, and my eyebrows and hair have become coarse and dry. The nurse will assess for other signs and symptoms of:
a. Cachexia.
b. Parkinson syndrome.
c. Myxedema.
d. Scleroderma.
C.
During ocular examinations, the nurse keeps in mind that movement of the extraocular muscles is:
a. Decreased in the older adult.
b. Impaired in a patient with cataracts.
c. Stimulated by cranial nerves (CNs) I and II.
d. Stimulated by CNs III, IV, and VI.
D.
the inner layer of the eye, is where light waves are changed into nerve impulses.
retina
located on the nasal side of the retina. Its color is a creamy yellow-orange to a pink, and the edges are distinct and sharply demarcated
optic disc
occurs with local infections, crying, and systemic conditions such as heart failure, renal failure, allergy, and hypothyroidism.
periorbital edema
Define anisocoria:
unequal pupil size
Whats the term for when person has shadows or diminished vision in one quadrant or one half of the visual field?
retinal detachment
What is the term for an inflammation of the lacrimal sac? and for inflammation of the eyelids?
Dacryocystitis; Blepharitis
