chapter 6 head/neck

Question 1

neck stiffness

Answer 1

• other symptoms associated with: ha, neck pn, shldr pn, arm pn
• common causes: muscle sprain/strain
• if assoc. with high fever, n/v, sleepiness, ha-possible meningeal irritation
• can be assoc. with chest pn from MI or angina

Question 2

pemberton’s sign

Answer 2

• thyroid can expand into chest cavity and impair venous outflow from hd and neck
• ask pt to raise arms until touching head-after a few seconds-minutes pt’s head flushes or cyanotic–positive sign

Question 3

symptoms of hyperthyroidism

Answer 3

• general: preference to cold, wt loss
• eyes: prominence of eyeballs, puffy eyelids, double vision, decreased motility
• neck: goiter
• cardiac: palpitations, peripheral edema
• GI: increased bm’s
• GU: polyuria, decreased fertility
• neuromuscular: fatigue, wkness, tremors
• emotional: nervousness, irritability
• dermatologic: hair thinning, increased perspiration, change in skin texture, change in pigmentation

Question 4

s&s of hypothyroidism

Answer 4

• general: wt gain, feeling chilly
• GI: constipation
• CV: fatigue
• nervous: speech disorders, short attention span, tremor
• musculoskeletal: lethargy, thickened dry skin, hair loss, brittle nails, leg cramps, puffy eyelids/cheeks
• reproductive: heavier menses, decreased fertility

Question 5

neck mass

Answer 5

• pain assoc. with mass-usually acute infection
• masses present for few days usually inflammatory
• masses present for months or more neoplastic-no change in size or shape-benign or congenital lesion
• pt40: malignant mass
• midline: usually benign or congenital-i.e. dermoid cyst
• lateral: neoplastic; lateral upper: mets from tumors of hd and neck; lateral lower: mets from tumors of breast and stomach
• branchial cleft cyst: located laterally usually benign and pnless

Question 6

ear pain

Answer 6

• can be primary or secondary
• not always infection
• other causes: TMJ problems, dental, sinus infection, musculoskeletal from cervical neck, neurological problems
• most common cause is infection

Question 7

erythema on tympanic membrane

Answer 7

• indicative of infection

- may have loss of bony landmarks

Question 8

tympanic membrane scaring

Answer 8

• may be normal finding unless accompanied by significant hearing loss
• may be result of trauma or severe infections
• trauma related to loud noise-i.e. shot guns or other weapons
• other trauma could be falls or direct trauma to head

Question 9

pre-auricular node

Answer 9

• drains eyelids and conjunctivae, temporal region, pinna

- common causes of enlargement: scalp lesion, infection of external ear, pathology of face and forehead

Question 10

tonsillar node

Answer 10

drain tongue, floor of mouth , oropharynx

Question 11

submaxillary (submandibular) node

Answer 11

-drain tongue, teeth, floor of mouth, pharynx

Question 12

submental node

Answer 12

-drain same areas as submaxillary, as well as teeth and intra-oral cavity

Question 13

anterior cervical (jugular) node

Answer 13

-drains anterior third of scalp, facial structures, and thyroid, and internal structures of throat, part of pharynx and tosils

Question 14

supraclavicular node

Answer 14

• drains part of thoracic cavity and abdomen

- enlargement usually from mets from lungs or breast ca

Question 15

occipital node

Answer 15

-drains the scalp

Question 16

posterior cervical node

Answer 16

• drains thyroid and posterior 2/3 of scalp

- frequently enlarged due to upper respiratory infections i.e. mononucleosis