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Nursing 202 > Head and Neck, Regional Lymphatic System > Flashcards

Head and Neck, Regional Lymphatic System Flashcards

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1
Q

Head structure

A

cranial bones
sutures
facial bones
facial muscles
salivary glands

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2
Q

Neck structure

A

neck muscles
anterior and posterior triangles
thyroid gland

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3
Q

Lymphatics

A

preauricular
posterior auricular-mastoid
occipital
submental
submandibular
tonsillar
superficial cervical
deep cervical
posterior cervical
supraclavicular

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4
Q

Developmental considerations for infants

A

fontanelles, head growth and lympthatic system

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5
Q

Pregnant women

A

slight enlargement of thyroid

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6
Q

older adults

A

sagging facial skin

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7
Q

Developmental considerations infants

A

skull-head circumference, caput succedaneum, cephalhematoma
Face-symmetry, appearance, presence of swelling
Neck-muscle development and head control
special considerations

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8
Q

Developmental considerations in older adults

A

presence of senile tremors, concave cervical curve, and dizziness on range of motion

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9
Q

Subjective data-health history

A

headache
head injury-loss of consciousness
dizziness-spinning, lightheadedness
neck pain or limitation of motion
lumps or swelling
history of head or neck surgery
thyroid problems

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10
Q

additional health questions-infants

A

prenatal drug exposure, type of delivery, growth pattern

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11
Q

additional health history questions-older adults

A

dizziness and neck pain

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12
Q

Objective data-physical exam

A

head-insepct and palpate skull
size and shape (normocephalic)
Temporal area-artery and mandibular joint
Head-insepct the face
Facial structures
sinuses

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13
Q

Inspect

A

symmetry and ROM

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14
Q

Palpate

A

Lymph nodes-location, size, shape, mobility, consistency and tenderness
Trachea and thryoid gland (posterior and anterior) also auscultate for bruit

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15
Q

Promoting health

A

Helmet use is legislated provincially
helmets reduce the risk of head or brain injury by 85-88%
ensure sport specific helmets are worn

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16
Q

Pediatric facial diferences

A

Fetal alcohol syndrome
Down’s Syndrome
Allergic saulte and crease
Atopic (allergic) facies

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17
Q

External anatomy of the eye

A

eyelids, palpebral fissure, limbus, canthus, caruncle

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18
Q

What are the visual pathways and visual fields

A

Refraction of light rays
Crossing of fibres at optic nerve

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19
Q

What are the visual reflexeses

A

Pupillary light reflexes
fixation
accomodation

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20
Q

Developmental considerations for older adults with eyes

A

presbyopia
macular degenration
cataracts
glaucoma
diabetic retinopathy
decreased tear production
decreased adaptation to darkness
cultural-african descents 3-6 x more rate of glaucoma

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21
Q

Developmental considerations for the eyes in children

A

They have limited eye function at birth
By age 7-8 they are far-sighted

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22
Q

Subjective data-health History in eyes

A

vision difficulty-decreased acuity, blurring, blind spots
Pain
strabismus and diplopia
redness and swelling
watering and discharge
history of ocular problems
glaucoma
glasses or contacts
self care behavioiurs-eye protection and last exam
any medications
vision loss

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23
Q

Additional health history questions for infants in eyes

A

other’s vaginal infection during delivery
developmental milestones
routine vision testing
safety measures

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24
Q

additional health questions for older adults with eyes

A

movement and visual difficulty
glaucoma testing
catarcts
dryness of eyes
decreased activities

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25
Q

Objective Data-physical exam

A

prep-position
equipment-snellen eye chart, handheld visual screener, opaque card or occuluder
penlight
applicator stick
opthalmoscope
Central vision acuity-snelen eye chart and ner vision
Visual fields-confrontation test

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26
Q

External inspection of the eyes

A

general-inspection is preorbital edema
eyebrows, eyelids and lashes (ptosus and xanthelasma)
Eues (exophthalmos)

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27
Q

Inspect what on the eyes

A

cornea and lens (shine light from side)
conjunctiva and sclera (patient looks up, and pull lids down gently)

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28
Q

Extraocular Muscle Function

A

Inspect-diagnostic positions test
patient follows movement of object 12 inches away
Normal-track with both eyes
nystagmus only normal at extreme lateral gaze

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29
Q

Accomodation

A

Have patient focus on examiners finger and move it towards their nose
observe for convergence and pupillary constriction

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30
Q

Pupillary light reflex

A

part of neuro exam
dark room , shin light from side and measure pupils before and after light
pupil should be resting 3-5mm
brisk or sluggish response?
consensual response-opposite pupil also constricts

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31
Q

PERRLA

A

pupils, equal, round, reaction to light and accomodation

32
Q

Access visual acuity

A

Snellen eye chart
20 feet away
20/20 vision is normal
top # is distance from chart and bottom is # someone with normal vision could read the line
20/30 is nearsight
higher the bottom number the worst the nearsighted is

33
Q

Development of the eyes for kids

A

children 2 and a half to 3 test by showing familiar objects
children 3-8 get tumbling e effect

34
Q

Use of ophthalmoscope

A

functions as appendage of examiners eye
shine light into eye. find red reflex, then follow in to view ocular fundus

35
Q

Locate the optic disk?

A

next to macula

36
Q

What is a cataract

A

cloudiness in the lens of the eye

37
Q

What is a glaucoma test

A

It determines if the optic nerve is damaged-which may cause a visual problem

38
Q

What is arcus senilis

A

lipid ring at corner of retina
indicated carotid artery disease

39
Q

Structure of the external ear

A

external ear-external auditory canal and tympanic membrane

40
Q

Structure of middle ear

A

Middle ear has malleus, incus and stapes and the eustachian tube

41
Q

What is the structure of the inner ear

A

inner ear-vestibule and semicircular canals (bony labryinth)
cochlea

42
Q

What is the function of the ear

A

hearing and balance
sound waves travel through external auditory canal to the tympanic membrane (translucent pearly grey that seperates external and middle ear)
Auditory canal is lined with galnds that secrete cerumen

43
Q

Function of the middle ear

A

contains malleus, incus and stapes
it conducts sound vibrations
reduces amplitude of loud noises
equalizes air pressure via euschian tube to prevent tympanic membrane rupture

44
Q

Function of inner ear

A

vestibule and semicurcular canals (balance) and cochlea (hearing)
info then travels to the brain via cranial nerve VII

45
Q

Developmental considerations for infants and children with ears

A

shorter, horizontal eustchian tube -pathogens move from nasopharynx to middle ear
increased incidence of otitis media if bottle fed lying down

46
Q

Developmental considerations for older adults with ears

A

cilia course and stiff, impacted cerumen
presbycusis-gradual hearing loss

47
Q

Cultural and social considerations for the ear

A

increased incidence of otitis media in aboriginal children, premature infants, infants with down syndrome, infants fed in supine position
Cerumen-genetically determined-dry and wet cerumen
hearing loss is the 3rd most chronic condition in older adults-audism-discrimination based on hearing loss

48
Q

Promoting health

A

earbuds placed directly in the ear canal
related to hearing loss
use larger headphones that are noise cancelling
60-60 rule

49
Q

Subjective data-health history for ears

A

earaches(otalgia)
infections
discharge (ottorhea)
hearing loss
environmental noise
tinnitis
vertigo
self care-hearing protection and the last hearing test
Infants specifically-ear infections, hearing loss, injury

50
Q

Objective Data-Physical Exam Ears

A

prep-poaition and clean the ear
equi[ment-otoscope plus bright light, and pneumatic bulb attachment(kids)
External ear-inspect and palpate size and shape, check skin condition, tenderness, external auditory meatus

51
Q

Otoscopic exam

A

Position head and ear, method of holding and inserting otoscope
external canal-colour, swelling, lesions and discharge (colour and odor)

52
Q

Tympanic membrane

A

Color and characteristics
positon
integrity of membrane

53
Q

Tympanic tube insertation

A

ENT places tube

54
Q

Testing Hearing

A

Test hearing acuity-conversational speech, whispered voice test
Tuning forks (Weber) not precise data
Vestibular apparatus (Romberg test)

55
Q

Development of ears in children

A

ear position
timing of otoscopic exam
positioning of children
testing hearing acuity and developmental milestones
behavioural manifestations of hearing loss

56
Q

Development of ears in adults

A

loss of elasticity of pinna
eardrum gets whiter and more opaque and duller
loss of hearing high tones, and consonants in whispered voice test
isolation in groups

57
Q

Nose Structure

A

first segment of respiratory system-warms, moistens and filters air, shaped as a triangle

58
Q

Mouth structure

A

first segment of digestive system and an airway for respiratory
bordered by lips, soft and hard palate, cheecks and tongue
contains teeth, gums, tongue and salivary glands

59
Q

Throat structure

A

area behind the mouth and nose
seperated from the mouth by tonsils

60
Q

Structure and Function of nose

A

external nose
nasal cavity-septum, turbinated and meatus

61
Q

Paranasal sinuses

A

frontal, maxillary, ethmoid and sphenoid

62
Q

Salivary gland examples

A

parotid
submandibular
sublingual
teeth and gums

63
Q

Developmental Considerations for infants with the nose, mouth and throat

A

salivation
deciduous teeth
nose-obligate nose breathers
positioning
tonsils
mouth and throat-sucking tubercle

64
Q

Pregnant women developmental considerations (nose mouth and throat)

A

pregnancy related gingivitis
nasal stiffness
epistaxis
hyperemic gums

65
Q

Developmental considerations for nose mouth and throat for older adults

A

diminished smell and taste
atrophic tissues
dental changes (malocclusion)
malntrition
purse string appearance of mouth
yellow teeth

66
Q

Cultural and social considerations for nose, mouth and throat

A

there is an increased incidencd of dental disease among indigenous people (chnages from traditional diets, lack of access to fluoridated water and dental health services)
correlation between socioeconomic vatriables and dental disease (inadequate dental insurance)

67
Q

Subjective data for the nose

A

discharge(rhinorrhea)
frequent colds (upper respiratory)
sinus pain
Trauma
Epistaxis (nosebleeds)
allergies
altered sense of smell

68
Q

Subjective data-mouth and throat

A

sores or lesions
sore throat
bleeding gums
toothache
hoarseness/dysphagia/altered taste
smoking/alcohol consumption
self care behaviours-dental care patterns

69
Q

Additional health history questions for infants and children (mouth and throat)

A

Mouth disease
throat disease
tooth development
self-care behaviours

70
Q

Additional health history questions for older adults mouth and throat

A

mouth dryness xerostomia)
teeth/denturess
mouth care
taste and smell
effect on nutrition

71
Q

Promoting Health-smokeless tobacco

A

chewing tobacco and snuff (dry or moist)
this can lead to oral, esophageal or pancreatic cancer
early signs of oral cancer include-ulcers, sores that do not heal
white or red patches
prolonged sore throat or feeling that something is in your throat
numbness or tingling
unexplained bleeding

72
Q

Physical exam of nose

A

inspect and plaplate external nose, and nasal cavity
hold the otoscope, nasal septum and turbinates
Havepatient block one nostril and sniff

73
Q

Physical exam of sinuses

A

Palpate the sinus area
frontal and maxillary sinuses

74
Q

Physical exam of the mouth

A

inspect-lips, teeth and hums, tongue (test cranial nerve)
buccal mucosa
palate and uvula

75
Q

Physical exam of the throat

A

tonsils (grading between 1 and 4
1 is visible
2 is halfway between tonsillar pillars and uvula
3 is touching uvula
4 is touching each other
use of tongue blade
posterior pharyngeal wall

Nursing 202 (15 decks)

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