Exam 3 - Head, Neck, & Regional Lymphatics Flashcards

1
Q

What are the cranial bones?

A

Frontal
Parietal
Occipital
Temporal

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2
Q

What are the cervical vertebrae and what is their function?

A

C1-C7
Support the cranium
C7 (vertebra prominens) is a useful landmark

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3
Q

Nerve that mediates facial muscles

A

CN VII

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4
Q

Name the salivary glands

A

Parotid
Submandibular
Sublingual

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5
Q

Where is the parotid salivary gland?

A

Cheeks over mandible

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6
Q

Where is the submandibular salivary gland?

A

Beneath mandible at angle of jaw

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7
Q

Where is the sublingual salivary gland?

A

Floor of the mouth

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8
Q

Where is the temporal artery and why is it important

A

Superior to temporalis muscle

Pulsation is palpable anterior to ear

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9
Q

Function of internal carotid artery

A

Supplies brain

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10
Q

Function of external carotid artery

A

Supplies face, salivary glands, superficial temporal area

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11
Q

Major neck muscles

A

Sternomastoid

Trapezius

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12
Q

Where is the sternomastoid located?

A

Runs from sternum and clavicle, diagonal across neck, to pastors process (behind ear)

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13
Q

Function of sternomastoid muscle

A

Head rotation and flexion
Divides each side of neck into two triangles; anterior and posterior, which are helpful guidelines when describing findings in the neck

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14
Q

Where is the trapezius muscle located?

A

Two, on upper back

From occipital bone and vertebrae, extend fanning out to scapula and clavicle

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15
Q

Function of the trapezius muscle

A

Move shoulders and extend and turn head

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16
Q

Cranial nerve that innervates the major neck muscles

A

CN XI (spinal accessory)

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17
Q

Where is the thyroid gland located?

A

Straddles trachea

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18
Q

Function of the thyroid gland

A

Synthesizes and secretes hormones that stimulate the rate of cellular metabolism: Thyroxine (T4) and Triiodothyronine (T3)

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19
Q

What does the thyroid cartilage look like?

A

Has a small, palpable V in upper edge = Adam’s apple

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20
Q

Where is the carotid cartilage located?

A

Beneath thyroid cartilage

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21
Q

Where is the Isthmus of the thyroid gland?

A

Hugs 2nd and 3rd tracheae rings

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22
Q

What are lymph nodes?

A

Small, oval clusters of lymphatic tissue that are set at intervals along lymph vessels

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23
Q

Function of lymph nodes

A

Slowly filter lymph and engulf pathogens

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24
Q

Where are lymph nodes located?

A

Present throughout the body, but are only palpable in head and neck, arms, axillae, and inguinal regions

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25
Q

List the lymph nodes in order of how you should palpate them

A
1- Preauricular
2- Posterior auricular
3- Occipital
4- Submental
5- Submandibular
6- Jugulodigastric
7- Superficial cervical
8- Deep cervical
9- Posterior cervical
10- Supraclavicular
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26
Q

Where do all head and neck structures eventually drain?

A

Into the deep cervical chain

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27
Q

Where is the Preauricular lymph node located?

A

In front of ear

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28
Q

Where is the posterior auricular (mastoid) lymph node located?

A

Superficial to mastoid process

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29
Q

Where is the occipital lymph node located?

A

At base of skull

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30
Q

Where is the Submental lymph node located?

A

Midline, behind tip of mandible

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31
Q

Where is the submandibular lymph node located?

A

Halfway between angle and tip of mandible

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32
Q

Where is the Jugulodigastric (tonsillar) lymph node located?

A

Under angle of mandible

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33
Q

Where is the superficial cervical lymph node located?

A

On top of sternomastoid muscle

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34
Q

Where is the posterior cervical lymph node located?

A

In posterior triangle, along edge of trapezius muscle

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35
Q

Where is the supraclavicular lymph node located?

A

Just above and behind clavicle, at sternomastoid muscle

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36
Q

Function of the lymphatic system

A

Detects and eliminates foreign substances from body

Gather clear, watery fluid (lymph) from tissue spaces into circulation

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37
Q

Leading cause of acute pain

A

Headaches

38
Q

Things headaches can be produced by:

A
Hypertension
Fever
Hypothyroidism
Vasculitis
Oral contraceptives
Bronchodilators
Alcohol
Nitrates
Carbon monoxide inhalation
39
Q

When are headaches a red flag?

A

If sever headache in pt who has never had one

40
Q

How do you know if a headache is a tension headache?

A

If it’s occipital, frontal, bandlike tightness

Viselike pain

41
Q

What are tension headaches associated with?

A

Anxiety/stress

42
Q

How can you tell if a headache is a migraine?

A

Supraorbital, retro-orbital, frontotemporal

Sever, throbbing pain

43
Q

What makes a migraine chronic?

A

If 15 or more days per month

44
Q

What makes a migraine episodic?

A

If <15 days per month

Last 1-3 days

45
Q

What are migraines associated with?

A

Nausea
Vomiting
Visual disturbances

46
Q

How can you tell if a headache is a sinus headache?

A

Pain around eye or cheek

47
Q

What makes a headache a cluster headache?

A

Unilateral pain, always on same side of head, excruciating

48
Q

What does temporal arteritis feel like?

A

Throbbing pain

49
Q

What is presyncope?

A

Light headed/swimming sensation or feeling of fainting or falling

50
Q

What is presyncope caused by?

A

Decrease of blood flow to the brain

51
Q

What is vertigo?

A

True rotational spinning

52
Q

Types of vertigo and what they mean

A

Objective - pt feels like the room is spinning

Subjective - pt feels like they are spinning

53
Q

If a pt has vertigo with unilateral hearing loss, what could that mean?

A

Meniere disease

54
Q

What is disequilibrium?

A

Shakiness or instability when walking, related to musculoskeletal disorder or multi sensory deficits

55
Q

Pt has acute onset of neck stiffness with HA and fever

A

Meningitis

56
Q

If pt has lumps or swelling in neck and feels tenderness when palpating

A

Acute infection

57
Q

If pt has persistent lump

A

Be suspicious of malignancy

If pt age 40+, assume malignancy until proven otherwise

58
Q

If pt has history of radiation, what are they at an increased risk of?

A

Risk for salivary and thyroid tumors

59
Q

Trouble swallowing

A

Dysphagia

60
Q

Pt has an abnormally small head

A

Microcephaly

61
Q

Pt has an abnormally large head

A

Macrocephaly

62
Q

Obstruction of drainage of cerebrospinal fluid that results in accumulation, increasing intracranial pressure and enlargement of head

A

Hydrocephaly

63
Q

Excessive secretion of GH from pituitary gland after puberty resulting in enlarged skull and thickened cranial bones

A

Acromegaly

64
Q

If pt has tenderness and hard band to palpating in temporal area

A

Temporal arteritis

65
Q

If pt has facial asymmetry with central brain lesion

A

Stroke

66
Q

If pt has facial asymmetry with peripheral CN VII damage

A

Bell palsy

67
Q

If pt has immobility of facial features with a flat and expressionless face

A

Parkinson syndrome

68
Q

Cranial nerve affected with Bell palsy

A

CN VII

69
Q

When checking neck ROM and pt has a head tilt

A

Occurs with muscle spasm

70
Q

When checking pt’s neck ROM, and they have a rigid head and neck with ratchety or limited movement. Person turns at shoulders

A

Arthritis

71
Q

What does lymphoid enlargement look like?

A

Unilateral lump or diffuse and looks like a donut

72
Q

If pt has a swollen parotid gland

A

Seen with mumps

And AIDS

73
Q

What is lymphadenopathy?

A

Enlargement of lymph nodes > 1 cm

74
Q

What could lymphadenopathy be caused by?

A

Infection, allergy, or neoplasm

75
Q

What would make you think a patient has an acute infection in lymph nodes?

A
Acute onset
<14 days
Nodes enlarged bilaterally
Warm
Tender
Firm but freely movable
76
Q

What would make you think a pt has chronic inflammation of their lymph nodes?

A

> 14 days duration

77
Q

Example of chronic inflammation of lymph nodes

A

Tuberculosis

78
Q

What would make you think a pt has cancerous lymph nodes?

A
Hard rocks
>3 cm
Unilateral
Nontender
Matted
Fixed
79
Q

What would make you think a pt has an HIV infection?

A
Nodes enlarged
Firm
Nontender
Mobile
Occipital node enlargement common
80
Q

What would make you think a pt has a neoplasm in their thorax or abdomen?

A

Single enlarged
Nontender
Hard left supraclavicular node

81
Q

What would make you think a pt has Hodgkin lymphoma?

A

Nodes are painless
Rubbery
Discrete nodes that gradually appear (commonly in cervical region)

82
Q

What does it mean if a pt’s trachea is pushed to the affected side?

A

Aortic aneurysm
Tumor
Unilateral thyroid lobe enlargement
Pneumothorax

83
Q

What does it mean if a pt’s trachea is pulled toward the affected side?

A

Large atelectasis
Pleural adhesions
Fibrosis

84
Q

What does it mean if a pt has a tracheal tug?

A

Rhythmic downward pull, synchronous with systole

Occurs with aortic arch aneurysm

85
Q

What should you look at when palpating the thyroid gland?

A

Look for diffuse enlargement or nodular lump

86
Q

What would be abnormal when palpating the thyroid gland?

A

Enlarged lobes that are easily palpated before swallowing or are tender to palpation or presence of a lump

87
Q

What do cancerous nodes on a thyroid gland feel like?

A

Usually hard and fixed to surrounding structures

88
Q

**How does the thyroid negative feedback system work?

A

1- hypothalamus secretes TRH, which
2- acts on anterior pituitary to secrete TSH, which
3- directs thyroid gland to produce T3 & T4 hormones. When T3 & T4 are high in blood stream, they
4- direct the pituitary and hypothalamus to shut off their signaling hormones
When T3 & T4 levels are low, pituitary sends out increasing TSH to stimulate new production of T3 & T4

89
Q

What is Graves’ disease?

A

Hyperthyroidism = increased metabolism

90
Q

What does Graves’ disease look like?

A

Goiter
Eyelid retraction
Bulging eyes

91
Q

What is myxedema?

A

Hypothyroidism = decreased metabolism

Usually caused by Hashimoto thyroiditis

92
Q

What does myxedema look like?

A

Fatigue

Cold intolerance