head face neck hape Flashcards
common or concerning symptoms of the head
Neck mass or lump
Thyroid mass, nodule, or goiter
Neck pain
Headache
what are lymphatic drainage patterns helpful for?
helpful when assessing possible malignancy or infection. For suspected malignant or inflammatory lesions, look for enlargement of the neighboring regional lymph nodes; when a node is enlarged or tender, look for a source in its nearby drainage area.
when should a persisent neck mass raise concern for malignancy?
in an adult older than 40
what do enlarged tender lymph nodes normally accompany?
pharyngitis
thyroid function and goiter
thyroid function may be increased, decreased, or normal
what do intolerance to cold, weight gain, dry skin, and slowed heart rate point to
hypothyroidism
what might intolerance to heat, weight loss, moist velvety skin, and palpitations point to
hyperthyroidism
key components of head and neck examination
-Examine the hair (quantity, distribution, texture, any pattern of loss).
-Examine the scalp (scaliness, lumps, nevi, lesions). -Examine the skull (size, contour, deformities, depressions, lumps, tenderness).
-Inspect the skin in the head and face (expression, contours, asymmetry, involuntary movements, edema, masses).
-Palpate the cervical lymph nodes (size, shape, delimitation, mobility, consistency, tenderness). -Examine the trachea (deviation, breath sounds over it).
-Examine thyroid gland (size, shape, and consistency).
what might an enlarged skull signify?
hydrocephalus or Paget disease of bone
hirsutism
(excessive facial hair) may appear in some women with polycystic ovary syndrome.
what does an enlargement of a supraclavicular node, especially on the left (Virchow’s node) suggest?
possible metasasis from a thoracic or an abdominal malignancy
what do hard or fixed lymph nodes suggest?
malignancy
what do enlarged or tender lymphnodes call for ? (if unexplained)
(1) re-examination of the regions they drain and (2) careful assessment of lymph nodes in other regions to identify regional from generalized lymphadenopathy.
what is generalized lymphadenopathy seen in?
multiple infectious, inflammatory, or malignant conditions such as HIV or AIDS, infectious mononucleosis, lymphoma, leukemia, and sarcoidosis.
what does tracheal deviation caused by masses in the neck raise suspicion of?
conditions in the thorax such as a mediastinal mass, atelectasis, or a large pneumothorax
stridor
is an ominous, high-pitched musical sound from severe subglottic or tracheal obstruction that signals a respiratory emergency.
Causes include epiglottitis,2 foreign body, goiter, and stenosis from placement of an
artificial airway
pemberton sign
used to evaluate venous obstruction in patients with goiters. The sign is positive when bilateral arm elevation causes facial plethora
what disease is the thyroid soft and what disease is it hard?
soft in graves and hard in hashimotos
what is Jugular venous distention a hallmark of?
heart failure
thyroid health promotion and counseling
Screening for thyroid dysfunction
Thyroid cancer screening
cushing syndrome
The increased adrenal cortisol production of Cushing syndrome produces a round or “moon” face with red cheeks. Excessive hair growth may be present in the mustache, sideburn areas, and chin (as well as the chest, abdomen, and thighs).
nephrotic syndrome
Glomerular disease causes excess albumin excretion, which reduces intravascular colloid osmotic pressure, causing hypovolemia, then sodium and water retention. The face becomes edematous and often pale. Swelling usually appears first around the eyes and in the morning. When severe, the eyes appear slit like.
myxedema
In severe hypothyroidism (myxedema) mucopolysaccharide deposition in the dermis leads to a dull, puffy facies. The edema, often pronounced around the eyes, does not pit with pressure. The hair and eyebrows are dry, coarse, and thinned, classically with loss of the lateral third of the eyebrows. The skin is dry.
