Head, Eyes, Lymph Nodes Flashcards
Cranial Bones (11)
MAIN (4) Frontal Parietal Occipital Temporal
OTHERS (7) Lacrimal Nasal Ethmoid Zygomatic Maxilla Mandible Sphenoid
Salivary Glands (3)
- Parotid: in cheeks over mandible
- Submandibular: beneath mandible
- Sublingual: lies in floor of mouth
Neck muscles (2)
Sternomastoid - enables head rotation
Trapezius - move shoulders, extends and turn head.
Innervated by cranial nerve XI (11)
Thyroid Gland
Endocrine gland that straddles the trachea in middle of the neck
Thyroid gland function
Synthesizes and secretes:
• Thyroxine (T4)
• Triiodothyroine (T3)
Lymphatic system
Major part of the immune system which detects and eliminates foreign substance from the body.
Lymph nodes (10)
1) Preauricular: front of ear
2) Posterior auricular: behind ear
3) Occipital: base of head
4) Submental: behind tip of mandible
5) Submandibular: halfway between angle and tip of mandible
6) Jugulodigastric: under angle of mandible
7) Superficial cervical: overlying sternomastoid muscle
8) Deep cervical: deep under sternomastoid muscle
9) Posterior cervical: in posterior triangle along edge of trapezius muscle
10) Supraclavicular: behind clavicle
Bones of neonatal skull are separated by
Sutures and fontanels
COLDSPA
Characteristics: What does it feel like?
Onset: When did it start?
Location: Where is it?
Duration: How long does it last?
Severity: How much does it affect you?
Predisposing factors: What relieves or worsens it?
Associated factors: Any related symptoms?
Preparation
Have patient remove hats, wigs or hair ornaments if present
Client seated looking straight ahead
Inspection of the head
Normocephalic and symmetrical
Equal distribution of hair which is smooth without infestations
No signs of lesions, lacerations or lumps
Normal complexion with rest of body
Abnormal: hydrocephalus or acromegaly, jaundice, pallor, cyanosis
Palpation of head
No tenderness
Temporal artery 3+ with normal rhythm
Temporomandibular has smooth movement with no limitations
Inspection of face
Normal facial expressions
Facial structures symmetrical
Note any involuntary movement (tics)in facial muscles
Abnormal: Bell’s palsy, exophthalmos, jaundice, cyanosis, jaundice
Palpation of face
Inspect sinuses for edema or discoloration
Frontal sinus and maxillary sinuses palpate without tenderness
Inspection and Palpation of neck
Head position is midline and accessory muscles are symmetrical
Head is held erect and still
Normal ROM, no swelling of thyroid gland
Lymph nodes are non tender and non palpable. If nodes are enlarged or tender, check area they drain as source
Thyroid gland is difficult to palpate. No enlargement nor presence of nodules. If enlarged auscultate bruits.
Infant and Children head variations
Caput Succedaneum
Cephalhematoma
Infant and children neck variations
Child’s lymph nodes are palpable but usually not cervical. Less than 3 mm
Cranitotabes
Softening of skull’s outer layer
Caput Succedaneum
Edematous swelling and ecchymosis of presenting part of head caused by child birth
Cephalhematoma
subperiosteal hemorrhage, a result of birth trauma
TRUE OR FALSE: Thyroid gland may be palpable normally during pregnancy
TRUE
Chloasma
Blotchy, hyperpigmented area over face and forehead in pregnancy which fades after delivery
Hydrocephalus
Obstruction of drainage of cerebrospinal fluid resulting in
- Excessive accumulation
- Increasing intracranial pressure
- Enlargement of head
Acromegaly
Excessive secretion of growth hormone from pituitary gland after puberty which creates enlarged skull, thicken cranial bones, massive face and coarse features.
Canthus
Corner of eye, angle where lids meet
Palpebral fissure
Oval open space between eyelidsb
Conjunctiva
Transparent, protective covering of exposed part of eye
Cornea
Covers and protects iris and pupils, bends incoming light rays
Lacrimal gland
Secrets tears, located in upper outer corner over eyes
Eye
A sphere of three (3) concentric coats
- Outer fibrous sclera - Middle vascular choroid - Inner nervous retina
Sclera
Tough, protective white covering
Iris
Functions as a diaphragm, controls amount of light admitted into retina
Normal pupil
Round and regular, size determined by balance between PNS and SNS
Pupillary light reflex
Normal constriction of pupils when bright light shines on retina
Accommodation
Adaptation of eye for near vision
- Convergence (motion toward) of the axes of the eyeballs
- Pupillary constriction
Causes of decreased visual functioning in older adults
Cataract formation
Glaucoma
Macular degeneration
Loss of central vision
Strabismus
Crossed eyes
Diplopia
Double vision
Photophobia
Sensitivity to light
Equipment needed for eye examination
- Snellen Chart
- Occluder
- Penlight
Confrontation test
Compares client’s peripheral vision with yours
Hirschberg test
Assess parallel alignment in eye axes by shining a light toward client’s eyes.
Reflection of light in cornea should be the same spot in both eyes
PERRLA
Pupils Equal Round Reactive to Light and Accommodation
Direct light reflex
Constriction of same sided pupil
Consensual light reflex
Simultaneous constriction of other pupil
TRUE OR FALSE: Pupils dilate in response to light
FALSE
Test visual acuity
Snellen chart
Test visual fields
Confrontation test
Exophthalmos
Protruding eyes
Enophthalmos
Sunken eyes
Ptosis
Drooping upper lid
Glaucoma
a disturbance in the circulation of aqueous fluid, which causes an increase in intraocular pressure
myopia
nearsightedness
hyperopia
farsightedness
