head, lymph, neck, thyroid Flashcards
when does the posterior fontanelle close?
2 mos
when does the anterior fontanelle close?
15 mos to 2 years
headache red flag signs
onset after age 50
acute onset (hrs)
markedly elevated BP - HTN crisis
s/s of infx or rash - meningitis
HA w pregnancy - preeclampsia
vomiting - IICP
head trauma
most frequently fractured facial bone
nasal bone
4 types of skull fractures
linear
depressed
basal
diastatic
linear fracture
most common, traveses full thickness of bone with radiating fracture lines away from point of impact
derpressed fracture
skull indentation from direct blow
basal skull fracture
affect base of skull, causes bruising behind ears (battle’s sign) and/or bruising around eyes (Racoon eyes)
diastatic fracture
occurs along a suture line, more likely to occur in infants and children
epidural hematoma
severing of middle meningeal artery due to blunt trauma or injury of the skull
craniosyntosis
early fusion of the bones of the skull; results in intracranial pressure or skull abnormalities
check fontanelles!
fetal alcohol syndrome
smooth philtrum, thin upper lip, flat nasal bridge, short or upturned nose, and wide-set eyes with eipcanthal folds
caput
“finger indent”/edema in scalp after birth
common
cephalohematoma
bulging of head structures due to suction during birth
concerning if it crosses the suture line or is present months after birth
molding
head structure change due to pressures from birth process
resolves quickly
red flag lymph node characteristics
VISIBLE, hard, fixed, matted, >1cm in size, unilateral, generalized
rEDNESS, EDEMA, ERYTHEMATOUS LINES
where are the preauricle lymph nodes
in front of ear
where are the post auricle lymph nodes
behind ear
where are the upper cervical lymph nodes
behind jaw near ear
where are the posterior lymph nodes
side of neck
where are the supraclavicular lymph nodes
above clavicle
where are the submental lymph nodes
below chin
where are the submandibular lymph nodes
under jaw
where are the submandibular lymph nodes
under jaw
shotty
cluster of multiple, small, contiuous lymph nodes along chain
pediatric change for lymph
ages 4-8 commonly have palpable cervical lymph nodes
should not be tender, should be symmetrical
lymphadenitis
enlarged lymph node
lymphangitis
inflammation of lymph node
pediatric change of neck
weaker neck muscles until adolescence - higher risk of C spine injury
torticollis
tilt to one side
posterior approach for thyroid palpation
stand behind pt, hold below cricoid cartillage, ask pt to swallow
peds thyroid consideration
shorter necks as infants
pregnancy thyroid considerations
abnormal thyroid function may mimic pregnancy
hyperthyroidism - incresed risk of complications from preeclampsia
symmetrical enlargement is expected
older adult thyroid consideration
changes to endocrine system - fibrotic thyroid
medications
thyroid disease may present differently
thyroid disease common
hypoparathyroidism
decreased secretion of PTH leading to hypocalcemia
commonly caused by accidental removal of PTH glands
hyperparathyroidism
enlarged parathyroid glands produce excess PTH, resulting in hypercalcemia
early sign of malignancy
