Head/face/neck Flashcards
What glands are accessible to examine?
sublingual and submandibular
What gland are on the cheeks and over the mandible?
Parotid
How can you assess the thyroid?
Palpating-
Tilt pt’s head back
Inspect the neck when they swallow
Auscultation-
Using the bell side of your stheoscope and listen for a presence of a bruit (whooshing,blowing sound) when gland is enlarged
When would you auscultate the thyroid gland?
When it is enlarged
Types of thyroid diseases
Grave’s diseases- hyperthyroidism, increased thyroid hormones
Myxedema-hypothyroidism, low amount of thyroid hormones
Correct way for assessing the lymph nodes
Using circular motion with your fingers, palpate the nodes, using gentle pressure
Lympathic drainage patterns
When enlarged, check the area they drain for the source of the problem. Check upstream to the enlarged node
Abnormal findings in the lymph nodes
parotid is swollen with mumps( enlargement has been associated with AIDS)
Lymphadenopathy- enlargement of lymph nodes from infection, allergy, or neoplasm
Acute infection- nodes are bilateral, enlarged, warm, tender, and firm, but freely moveable
Chronic infection- nodes are clumped
Cancerous-hard(like a rock), >3cm, unilateral, nontender, matted, and fixed to adjacent structures
Nodes w/HIV- enlarged, firm, nontender, hard left supraclavicular node my indicate neoplasm
Hodgkin lymphoma- painless, rubbery, discrete that gradually appear
Preauricular
Front of the ear
Posterior auricular
Superficial to the mastoid process
Occipital
At the base of the skull
Submental
Midline, behind the tip of the mandible
Submandibular
Halfway between the angle and the tip of the mandible
Jugulodigastic
Under the angle of the mandible
Superficial cervical
Overlaying the sternomastoid muscle
Deep cervical
Deep under the sternomastoid muscle
Posterior cervical
In the posterior triangle along the edge of the trapezius muscle
Supraclavicular
Just above and behind the clavicle, at the sternomastoid muscle
What is a development consideration at birth for infants
The head is larger than the chest circumference, and the neonate’s skull bones are separated by sutures and fontanels
Development considerations for the lymphoid tissue
Well developed at birth
Grows to adult size at 6
At age 10-11, lymph tissue exceeds adult sizes and then atrophies
Development considerations for pregnancy with the thyroid
Thyroid glands enlarges as a result of hyperplasia of the tissue and increased vascularity
Development considerations for aging adults
The facial bones and orbits appear more prominent as the facial skin sags due to decreased elasticity, moisture, and subcutaneous fat.
How to get subjective data?
Ask questions that investigate headaches, head injuries, dizziness, neck pain, limited ROM, numbness, tingling, diffuiculting swallowing,, history of smoking, history of surgeries,
In children: ask if mother used etoch, drugs, natural/c section birth, if babies growth was on schedule
Aging adults: dizziness, ability to drive, and sleep
How to get objective data
Inspecting, palpating, listening/ausculting
When inspecting the head what should appear normal
Eyes, eyebrows, ears, nose, and mouth, as well as the palpebral fissures, and the nasolabial folds
Caput succedaneum
Edematous swelling of the presenting part of the head caused by birth trauma. It feels soft and may extend across suture lines but requires no treatment and gradually resolves in a few days
Cephalhematoma
A subperiosteal hemorrhage that is soft, fluctuating, and well defined over one cranial bone b/c the periosteum holds the bleeding in place. Due to birth trauma and is reabsorbed gradually, over time, without treatment
Tonic neck reflex
occurs when an infant is supine; the head is turned to one side (extension of same arm and leg, flexion of opposite arm and leg). After ages 3-4 months, the head os maintained in the midline
Down syndrome facial characteristics
Upslanting eyes with inner epicanthic folds, flat nasal bridge, small broad flat nose, protruding thick tongue, ear dysplasia, short broad neck with webbing, and small hands with single palmer crease
