Exam 2 Flashcards
How many bones are in the cranium?
8
How many bones are in the face?
14
Sternocleidomastoid muscle
Rotates and flexes the head
Trapezius muscle
Extends the head and moves the shoulders
What are the cranial nerves?
I olfactory; smell
II optic; vision
III oculomotor; eye movement
IV trochlear; eye movement
V trigmenal; face
VI abducens; eye movement
VIII Auditory (vestibulocochlear); hearing/balance
XI spinal accessory; motor head and neck
XII hypoglossal; motor- lower throat tongue mobility + strength
Blood vessels located in the neck?
- internal jugular veins and carotid arteries. Located parallel and anterior to the sternocleidomastoid muscles
*DO NOT compress both sides at the same time it can cause patient to pass out
Hypothyroidism presentations?
-High sensitivity to cold
-Constipation
-depression
-Fatigue
-Increase in weight
-Bradycardia
Hyperthyroidism presentations?
-Weight loss
-Tachycardia
-Anxiety
-Nervousness
-Enlarged palpable thyroid soft blowing/swishing sound when asculated (bruit)
-Exophthalmos: bulging of the eyes (with Graves’ disease only)
Symptoms of Meningitis
Nausea, vomiting, *neck stiffness
Lymph nodes of the head and neck
-Preauricular
-Postauricular
-Occipital
-Tonsillar
-Submandibular
-Submental
-Superficial cervical
-Posterior cervical
-Deep cervical
-Supraclavicular
*if healthy should be less than 1cm
What to note when palpating the lymph nodes?
-Size + shape
-Delimitation (position or boundary)
-Mobility
-Consistency
-Tenderness + location
Tender and enlarged lymph nodes suggest?
Acute infections
Lymphadenopathy
Swollen lymph nodes
Goiter
Enlarged thyroid gland
(can be caused by iodine deficiency)
Asymmetry of earlobes occurs with?
Parotid glad enlargement
Types of headaches and their characteristics
- Sinus headache: deep, constant, throbbing pain. Occurs with or after a cold. My occur in one area of along eyebrow ridge and below cheek
- Cluster headache: stabbing pain. May be accompanied by ingesting alcohol. Localized in the eye region
- Tension Headache: dull, tight, diffuse. May occur with stress, anxiety, or depression. Located in the frontal, temporal, or occipital region
- Migraine Headache: nausea, vomiting, sensitivity to light and noise. Located around eyes, cheeks, or forehead; may affect only one side of the face
Acromegaly
Enlargement of the facial features, hands, and feet
Cushing’s syndrome
Moon shaped face w reddened cheeks and increased facial skin
Bell’s palsy
twitching, weakness, paralysis, drooping eyelids or corner of mouth
Abbreviations for eye and ears
OS= left eye
OD= right eye
OU= both eyes
AS= left ear
AD= right ear
AU= both ears
Mnemonic for assessing pupils
PERRLA
Pupils
Equal
Round
Reactive
Light
Accommodation
What are the eye directions?
- Esotropia: eye turns inward
- Exotropia: eye turns out
- Hypertropia: eye turns up
- Hypotropia: eye turns down
Abnormalities of the eye
- Papilledema: swelling of optic disk
- Muscular degeneration (black hole is seen) *use amsler test
- Glaucoma: test with puff of air *tonometry test. Normal pressure 10-21 < risk for glaucoma
- Cataracts: 1st common source of blindness *cloudiness of the eye
What are the vision tests and how they are performed?
- Snellen chart: tests distant visual acuity; lines of different letters stacked one above the other
- E chart: tests distant visual acuity for clients who cannot read or has a verbal handicap
- Jaegar test: near vision test; done by holding pocket screener or newspaper 14 inches away
What time should be longer when assessing the ears?
Air conduction > Bone conduction
Conductive hearing loss
Something blocks or impairs the passage of vibrations from getting to the inner ear
Sensorineural or perceptive hearing loss
Damage is located in inner ear
Tinnitus
Ringing in the ears *could be a symptom of ototoxic medications
-ototoxic medication can cause hearing loss
Inappropriate use of ototoxic drugs during pregnancy is a risk for?
Baby having hearing loss
Risk factors for otitis media?
Babies fed from a bottle, especially lying down
Risk reduction to preserve hearing?
If you have a newborn, avoid feeding from bottle while laying on back
Ear tests and how to conduct them?
- Whisper test: have client place finger on tragus of ear and whisper a a two syllable word 1-2 feet behind the client
- Webber test: place tuning fork on center of head or forehead
- Rinne test: place tuning fork on mastoid process and then anterior ear
- Romberg test: tests equilibrium; place arms around patient to ensure they dont fall
Where should the cone of light be seen in right and left ear?
Right ear seen at 5 o’clock
Left ear seen at 7 o’clock
When assessing ears with an otoscope
- pull ear up and back for adults and older children
- Pull ear down and back for infants and children under 3 years
Presbycusis
Hearing loss common after 50 years of age
Otalgia
Earache
Vertigo
Spinning motion
BPPV
Benign paroxysmal positional vertigo *can test with Epley Maneuver
Otitis externa
Swimmers ear. PAIN when pinna and tragus are moved
Darwin tubercle
Small painless nodule on the helix
Acute otitis media
Tympanic membrane is red, bulging w no light reflex
Serous otitis media
fluid collects in the middle ear causing an obstruction of the auditory tube
Ostosclerosis
Abnormal spongy bone formation found around the stapes
Most common site for tongue cancer
Side of tongue
Most common site for oral cancer
Under the tongue
Epistaxis
Nose bleed
*kiesselbachs area= common site for nose bleeding
Rhinorhea
Runny nose
Most common oral cancer
Squamous cell carcinoma on the lip
Disphagea
Difficulty swallowing
Bruxism
Grinding of the teeth
Distinctive mouth odors
- Fruity breath
- Ammonia smelling: kidney disease
- Stool smelling breath: intestine blockage
- Sulfur smelling: liver disease
Giving meds buccal route
In the cheek
Sublingual meds
Under the tongue
Blue-black line in gums
Led poisoning
How to grade tonsils?
1+ normal
2+ midway between tonsillar pillars and uvula
3+ touching uvula
4+ touching each other
Thrush
White fungal infection on the tongue
*can be caused by not washing mouth out when using inhaler
Carbon monoxide poisoning
Lips are reddish
Frenulum
Connects tongue to floor of mouth
What are the names of the sinuses that can be assessed and the ones you cannot assesses
Can assess: Frontal and maxillary sinuses
Cannot assess: sphenoidal and the ethmoidal
Signs of vitamin B12 deficiency?
Smooth, red, shiny tongue, without papillae
Torus palatinus
Hard mass found in midline of palate of mouth
Aging of the head, face, and Neck
- Decrease in pulsation of temporal artery
- Facial wrinkles
- Neck pain with arthritis
- kyphosis
- palpable thyroid feels more nodular
Aging of the eyes
-Presbyopia
-Yellowish bulbar conjunctiva
- Arcus senilis
- Entropy and ectropian
When using an opthalmascope
Right hand with right eye
Left hand with left eye
Accommodation
Assessing by looking at pupillary response near (constrict) and far (dilate)
Aging of the ears
-Presbycusis
-Elongated ear lobes
- harder cerumen (ear wax)
- Cilia more rigid
- eardrum appears cloudy
Aging of mouth, throat, nose, and sinuses
- receding gums
- tooth surfaces worn down
- decreased smell and taste
- oral mucosa is dry
- varicose veins in ventral surface of tongue
Location of Supersternal notch, angle of Louis, and xyphoid process?
- Supersternal notch: between clavicles
- Angle of Luis: on the manubrium
-Xyphoid process: bottom point of the manubrium
What notch should your lungs be at during inhalation and exhalation
- inhalation: 7th or 8th
- exhalation: 5th or 6th
Fremitus
Vibrations of air in the bronchial tubes
*have patient repeat ninety-nine
Difference between left and right lung
Right: 3 sections
Left: 2 sections
COPD
Barrel lungs
Clubbed finger nails
Tripod position (orthopenic position)
*do not increase O2 will make patient worse
Crepitus
Crackling sensation; feels like rice crispies
Normal breath sounds
- Bronchial: high pitch, short during inspiration long during expiration; trachea and thorax
- Bronchovesicular: moderate pitch, same during inspiration and exhalation; over major bronchi, between scapulae, around upper sternum
- Vesicular: low pitch, long in inspiration short in exhalation; peripheral lung fields
Aging in thorax and lungs
- Dyspnea
- chest pain
- ability to cough effectively
- kyphosis
- decrease in thoracic expansion
- sternum and ribs may be more prominent
How many pairs of ribs are there?
12
Tachypnea
Respirations over 20
Bradypnea
Respirations less than 12
Where are you more likely to find breast cancer?
Upper outer quadrant
What is it called when males have a greater amount of breast tissue?
Gynecomastia
Most common cancer among women
Breast cancer
*5-10% breast cancer are hereditary from the BRCA gene
Adventious breath sounds
- Crackle: crumbly hair by ear sound; COPD, pneumonia
- Wheeze: Hight pitched , musical sounds; asthma
- Stridor: high pitched whistle or squeak; obstruction or narrowing of upper airway
Hyperplasia
Enlarged red gums; may cover some of exposed teeth
Normocephaly
“Normal” head size
