Head and Neck Flashcards
Cardarelli sign
Press on the thyroid cartilage and displace the patient’s left.
Allows systolic pulsations from the aorta to be felt at the surface if an aneurysm is present.
Oliver sign
Gently grasp the cricoid cartilage and apply upward pressure.
Feel downward tug of the trachea if aneurysm is present.
Caput succedaneum
Subcutaneous edema over the presenting part of the head at delivery.
Cephalhematoma
Subperiosteal collection of blood, bound by the suture lines.
Brachiocephaly
Long, narrow heads esp. in preterm infants
Bossing
Bulging of the skull
Macewan sign
Percussion of the skull near the junction of the frontal, temporal, and parietal bones produce a stronger resonant sound when either hydrocephalus or a brain abscess is present
Cranial bruits
Common in children up to 5 years old
Chloasma
Mask of pregnancy
Blotchy, brownish hyper pigmentation of the face after 16 weeks of pregnancy
Migraine
Childhood onset Unilateral or generalized Hours to days Onset morning or night Pulsating or throbbing pain Prodromal: Vague neurologic changes, personality changes, fluid retention, appetite loss, scotoma (partial loss of vision or blind spot), aphasia, hemianopsia (decreased vision, blindness in half of visual field), aura Precipitated: Menstrual, missing meals, BC pills, stress letdown Frequency: 2x weekly Females Other: N/V
Medication Rebound HA
Holocranial (whole head) or diffuse
Hours to days
Begins within hours to days of last dose of med
Dull or throbbing
Prodromal: daily analgesics or daily caffeine
Frequency: gradual increase in HA frequency to daily
Female
Cluster HA
Adulthood
Unilateral
1/2 to 2 hours
Night
Intense, burning, boring, searing, knifelike
Prodromal: Personality changes, sleep disturbances
Precipitated by alcohol consumption
Several times nightly for several nights, then none
Males
Other: Lacrimation, nasal discharge
Hypertensive HA
Adulthood Bilateral or occipital Lasts hours Morning Throbbing Daily Males and females Generally remits as day progresses
Muscular Tension
Adulthood Unilateral or bilateral Hours to days Anytime Bandlike, constricting Daily Males and females Precipitated by stress, anger, bruxism
Temporal Arteritis
Older adulthood Unilateral or bilateral Hours to days Anytime Throbbing Daily Males and females
Space Occupying Lesion
Any age of onset Localized Rapidly increasing frequency Awakening from sleep Aggravated by cough, bending forward Temporal relation to the neoplasm Progressive Males and females Other: vomiting, confusion, abnormal, neurologic findings, gait abnormality, papilledema, nystagmus
Salivary Gland Tumor
Commonly in the parotid
Painless lump either in front of ear or under jaw
Difficult opening the mouth and tongue numbness or weakness
Thyroglossal Duct Cyst
Palpable cystic mass in the neck
remnant of fetal development
From the foramen cecum at junction of the anterior two thirds and posterior third of tongue
Tenderness, redness, swelling at midline of neck
Difficult swelling or breathing
Freely movable cystic mass in neck midline
Upward with tongue protrusion
Branchial Cleft Cyst
Congenital lesion formed by incomplete involution of branchial cleft
Epithelium-lined cyst with or without a sinus tract to overly skin
Solitary painless in lateral neck
May have intermittent swelling and tenderness
Discharge if associated with sinus tract
Oval, moderately movable smooth contender fluctuant mass along anteromedial border of sternocleidomastoid muscle
Asymptomatic
Infected, tenderness and erythema
Torticollis
Wry neck
Shortening or excessive contraction of the sternocleidomastoid muscle
Result of birth trauma, intrauterine malposition
Acquired: tumors, trauma, cranial nerve IV palsy, muscle spasm, infection, drugs
Firm, fibrous mass felt in the muscle
Primary hypothyroid
Thyroid gland produces insufficient thyroid hormone
Secondary hypothyroid
Insufficient thyroid hormone secretion d/t inadequate secretion of either TSH from the pituitary or thyrotropin releasing hormone (TRH) from the hypothalamus
Hyperthyroid
Prefer cool climate Weight loss Nervous, irritable, energetic Fine, hair loss Warm, fine, hyperpigmentation Thin fingernails Bilateral or unilateral proptosis (abnormal protrusion or displacement), lid retraction, double vision Goiter Tachycardia, dysrhythmia, palpitations Increased BMs Amenorrhea Weakness, esp. proximal muscles
Hypothyroid
Prefer warm climate Weight gain Lethargic, complacent Coarse hair, breaks Coarse, scaling, dry skin Thick fingernails No goiter Constipation Menorrhagia
Myxedema
Skin and tissue disorder usually d/t severe prolonged hypothyroid
Decrease in metabolic rate resulting in accumulation of hyaluronic acid and chondroitin sulfate in the dermis
Mucinous edema of facial features
Cognitive impairment, slowed mentation, poor concentration, decreased ST memory, social withdrawal, psychomotor retardation, depressed mood, apathy
Constipation
Muscle pains, hearing problems, deafness
Coarse, thick skin, thick nose, swollen lips, puffy eyes
Weight gain
Hashimoto Disease
Autoimmune antibodies against thyroid gland
Often causes hypothyroidism
More common in children, women 30-50 years old
Progresses slowly over number of years
S/S hypothyroid
Enlarged, contender, smooth thyroid
Encephalocele
Neural tube defect with protrusions of the brain and membranes that cover it through openings in the skull
Failure of the neural tube to close can occur any place on the scalp
Genetic component - families with hx of spina bifida, anencephaly
Seen by intrauterine US
Hydrocephalus
Problem in the formation, flow, absorption of CSF that leads to an increase in volume of the CSF Head enlargement Separation of cranial sutures Dilated scalp veins Tense anterior fontanelle Sunsetting sign Macewan sign "cracked pot" sound Increased tone/spasticity
Microcephaly
Circumference of head is smaller than normal because brain has not developed properly or has stopped growing
Present at birth, may develop in first few years of life
Congenital infections, neuroanatomic abnormalities (cerebral dysgenesis, craniostenosis)
Intellectual disability
Craniosynostosis
Mishappen skull
Sutures fused - restrict growth
