Head And Neck With Lymphatics Flashcards
Coronal Suture
Crosses the top of the scalp from ear to ear
Sutures
Join bones together in head
Sagittal suture
Crosses the skull from anterior to posterior
Lambdoidal suture
Separates Occipital and parietal
When documenting physical assessments, nurses must take care to describe the location of scalp or skull findings according to_______
Bones and sutures
Major facial muscles
Frontalis Temporalis Zygomaticus Masseter Buccinators Orbicularis oculi Orbicularis oris
Blood supply to the head is through __________
Carotid artery
Trigeminal nerve V supplies _________
Motor and sensory innervations to forehead,checks and chin
Major neck muscles
Sternocleidomastiod and trapezius
Three pair of salivary glands
Parotid
Submandibular
Sublingual
Neck is supported by
C1-7
Useful neck landmark
Vertebral prominence (C7)
What are the common measurable thyroid hormones?
T3 and T4, which control metabolic rate and can affect almost every body system
If the posterior portion if the thyroid gland is enlarged, it may not________
Be palpable
Hard to palpate in healthy people
Parathyroid gland produces?
Calcitonin-helps moves calcium into bones
Approximately, how many lymph nodes are in head and neck?
80 lymph nodes
Purpose of lymphatics?
Filter pathogens from the body and drain fluid that has moved outside circulation back into the body
Enlarged lymph node indicates?
Inflammation that is “upstream” from it
Silent thyroiditis
Women may present with signs and symptoms of hyperthyroidism followed by hypothyroid symptoms
Why is it important to assess the size of the anterior or posterior fontanels?
To determine ossification is happening at appropriate time
3 months posterior
18 months anterior
In children 1-5, nurses may palpate small, non tender, movable nodes in head and neck. Described as?
Shotty
Any history of trauma to the head, neck or both warrants?
Careful assessment of these structures for bleeding, swelling, loss of mobility or pain
If a patient is unable to provide a complete history due to a severe headache , it is still important to get?
A focused history and physical examination looking for neurological changes
Neck pain is often related to?
Muscles spasms or tension
Neck pain associated with fever and headache may indicate?
Meningitis
Any patient with sudden neck or jaw pain should immediately be evaluated for?
Cardiac etiologies
Lymphatics larger than cm 1 cm, fixed, irregular, or hard or rubbery require emergency investigation for?
Cancer
Hyperthyroidism may present as?
Tachycardia, diarrhea, anxiety, fever, weakness, psychosis, coma and death
Hypothyroidism
Fatigue, anorexia, cold intolerance, dry skin, brittle coarse hair, menstrual irregularities, weight gain or difficulty losing weight, decreased libido
Hyperthyroidism
Fatigue, weight loss, anxiety, palpitations,rapid pulse, heat intolerance, fine limp hair diaphoresis, muscle weakness
In older adults, arthritic changes in the cervical spine may present as?
Neck pain or loss of sensation or strength of extremities
Do you have patient remove wig or hairpieces for exam?
Yes
Before exam, what do you warn the patient about?
Neck will be palpated, manipulated, inspected mad the procedure will not hurt.
Let pt know to inform you if any part of the exam causes pain
Inspection of head
Check:
Symmetry
Deformities
Inspection of hair:
Texture Color Cleanliness Distribution Density
Inspection of neck
Lesions, limitations in movement
Look at neck muscles
Palpitation of scalp
Masses or lesions
Wear gloves
Palpitation of thyroid
Asses for enlargement
Unilateral bulging may be thyroid goiter, cyst or tumor
Tenderness is associated with acute infection, traumatic injury, radiation thyroiditis
Palpitation of lymph nodes
Enlargement or tenderness
Auscultation of the thyroid
Listen for bruit
Facial asymmetry may indicate damage to what nerve or what?
CN VII or stroke
Acromegaly
Enlarged bones or tissues
Cushing’s syndrome
Puffy “moon” face
Increased facial hair in females
Periorbital edema
CHF and hypothyroidism
Unusual distribution or patterns of hair growth on the face or skull are associated with?
Endocrine abnormalities
Any nits (white or brown specs) attached to hair shaft may be signs of?
Pediculosis (lice)
Traction alopecia
May occur with tight braiding
Palpable, tender, and warm lymph nodes usually indicate?
Infection in the area from which the the lymph vessels drain to that node
Chloasma
Present on face of pregnant women
Blotchy and hyper pigmented patch appears on cheeks and fades in postpartum period
Asymmetry of am infant head can occur from?
Infant one one position for prolonged period of time and premature closing of sutures
Hypothyroidism is more common in infants with?
Down’s syndrome
The lymph nodes that lie superficial to the mastoid bone are the
Posterior auricular nodes
Hydrocephalus
Abnormal collection of cerebral spinal fluid in ventricles of brain causes enlargement of brain
Fetal alcohol syndrome
Developmental delays and congenital abnormalities
Microcephaly, flattened check bones, small eyes, flattened upper lip
Down’s syndrome
Congenital condition with an extra chromosome or translocation of chromosome 14 or 15 with 21 or 22
Microcephaly, flattened occipital bone, slanted small eyes, depressed nasal bridge, low set ears and protruding tongue
Cretinism (congenital hypothyroidism)
Puffy facial features often larger than normal tongue. Common in parts of the world where diet is deficient in iodine
Bell’s Palsy
Paralysis, usually unilateral, of facial nerve CN VII can be transient or permanent
Parkin’s disease
Degenerative neurological disease
Mask like facial appearance, rigid muscles, diminished reflexes and shuffling gait
Scleroderma
Hardening of the skin, usually in hands and face first
Goiter
Enlarged thyroid gland
Myxedema
Severe hypothyroidism, preorbital swelling mad edema of face, hands and feet
Acute situations include
head and neck injuries, neck pain, enlarged lymph nodes, thyrotoxicosis
Bruit may be present with?
hyperthyroidism and thyrotoxicosis
Infant should be able to hold head up by?
four months
caput succedanem
swollen and ecchymotic area caused by the birth process as the head is squeezed
cephalahematoma
hemorrhage defined over single cranial bone
