Head, Neck, Face Flashcards
STRUCTURE AND FUNCTION
.
THE HEAD
.
The______- is a rigid bony box that protects the brain and special sense organs, and it includes the bones of the cranium and the face .
A)skull
B)cervical
C)both a and b
A
cranial bones:are
A) frontal, parietal, occipital, and temporal.
B) frontal, parietal, occipital, and zygomatic.
A
The adjacent cranial bones unite at meshed immovable joints called the
A)sutures
B)phontenels
A
At birth the sutures are soft and messy when they ossify?
A) The sutures gradually ossify during early childhood
B)The sutures gradually ossify during early adult hood
A
The_______ suture crowns the head from ear to ear at the union of the frontal and parietal bones
A)coronal
B)parietal
A
The_______ suture separates the head lengthwise between the two parietal bones
A)sagittal
B)cornal
A
The_________ suture separates the parietal bones crosswise from the occipital bone.
A)lambdoid
B)cornal
A
The 14 facial bones also articulate at sutures (note the nasal bone, zygomatic bone, and maxilla), except for
A)the mandible (the lower jaw). It moves up, down, and sideways from the temporomandibular joint, which is anterior to each ear.
B)false 22 facial bones
A
The cranium is supported by the cervical vertebra: C1, the “atlas”; C2, the “axis”; and down to C7.
A)True
B)false
True
The cranium is supported by the cervical vertebra: C1, the
A)”atlas”;
B)”axis”;
A
The cranium is supported by the cervical vertebra: C2
A) “atlas”
B)”axis”
B
The expressions are formed by the facial muscle, which are mediated by cranial nerve
A)VII, the facial nerve.
B)IV, the facial nerve
A
Facial muscle function is symmetric bilaterally, except for an occasional quirk or wry expression.
A)true
B)false
True
The palpebral fissures-the openings between the eyelid are equal bilaterally
A)true
B)false
True
Facial sensations of pain or touch are mediated by the three sensory branches of cranial nerve
A)V, the trigeminal nerve.
B)VI, the trigeminal nerve
A
Two pairs of salivary glands are accessible to examination on the face.select all that apply A) The parotid glands B)The submandibular glands . , C)the sublingual glands D)temporal gland
A B
The _____________ are in the cheeks over the mandible, anterior to and below the ear. They are the largest of the salivary glands but are not normally palpable.
A)The submandibular glands
B)parotid glands
B
. The _________________ are beneath the mandible at the angle of the jaw. A third pair, the sublingual glands, lie in the floor of the mouth.
A)parotid glands
B)submandibular glands
B
) The temporal artery lies superior to the temporalis muscle; its pulsation is palpable anterior to the ear.
A)true
B)false
True
THE NECK
.
The______ is delimited by the base of the skull and inferior border of the mandible above, and by the manubrium sterni, the clavicle, the first rib, and the first thoracic vertebra below.
A)neck
B)cranial
A
Think of the neck as a conduit for the passage of many structures, which are lying in close proximity: blood vessels, muscles, nerves, lymphatics, and viscera of the respiratory and digestive systems. Blood vessels include the common and internal carotid arteries and their associated veins.
A)true
B)false
True
The internal carotid branches off the common carotid and runs inward and upward to supply the brain; the external carotid supplies the face, salivary glands, and superficial temporal area.
A)true
B)falsse
True
The ___________ carotid branches off the common carotid and runs inward and upward to supply the brain;
A)internal
B)external
A
the________ carotid supplies the face, salivary glands, and superficial temporal area.
A)internal
B)external
B
The carotid artery and internal jugular vein lie beneath the
A)sternomastoid muscle.
B)trapezes muscle
A
The external jugular vein runs diagonally across the sternomastoid muscle.
A)true
B)false
A
The major neck muscles are the sternomastoid and the trapezius; they are innervated by cranial nerve XI, the spinal accessory.
A)true
B)false
A
What are the two major neck muscles?
A)sternomastoid and trapezes
B)trapezes and biceps
A
The major neck muscles are the sternomastoid and the trapezius; they are innervated by cranial nerve
A)XI, the spinal accessory.
B)XII the spinal nerve
A
The sternomastoid muscle arises from the sternum and the clavicle and extends diagonally across the neck to the mastoid process behind the ear. It accomplishes head rotation and head flexion.
A)true
B)false
A
The two trapezius muscles on the upper back arise from the occipital bone and the vertebrae and extend fanning out to the scapula and clavicle. The trapezius muscles move the shoulders and extend and turn the head.
A)true
B)false
A
The sternomastoid muscle divides each side of the neck into two triangles. The anterior triangle lies in front, between the sternomastoid and the midline of the body, with its base up along the lower border of the mandible and its apex down at the suprasternal notch. The posterior triangle is behind the sternomastoid muscle, with the trapezius muscle on the
A)true
B)false
A
The anterior triangle lies in front,
A) between the sternomastoid and the midline of the body, with its base up along the lower border of the mandible and its apex down at the suprasternal notch.
B)is behind the sternomastoid muscle, with the trapezius muscle on the
A
. The posterior triangle is behind the sternomastoid muscle?
A)with the trapezius muscle on the other side and with its base along the clavicle below. It contains the posterior belly of the omohyoid muscle.
B)false, their are no triangles
A
The ________ gland is an important endocrine gland with a rich blood supply. It straddles the trachea in the middle of the neck. This highly vascular endocrine gland synthesizes and secretes thyroxine (T4) and triiodothyronine (T3), hormones that stimulate the rate of cellular metabolism.
A)thyroid
B)parotid
C) sublingual
A
The gland has two lobes, both conical in shape, each curving posteriorly between the trachea and the sternomastoid muscle. The lobes are connected in the middle by a thin isthmus lying over the second and third tracheal rings.
A)thyroid
B)sublingual
C)parotid
A
Just above the thyroid isthmus, within about 1 cm, is the ________ cartilage or upper tracheal ring.
A)cricoid
B)cartilage
C)hyoid
A
Just above the thyroid isthmus, within about 1 cm, is the cricoid cartilage or upper tracheal ring. The _______ cartilage is above that, with a small, palpable notch in its upper edge.
A)hyoid
B)thyroid
C)both a and b
B
Just above the thyroid isthmus, within about 1 cm, is the cricoid cartilage or upper tracheal ring. The thyroid cartilage is above that, with a small, palpable notch in its upper edge. This is the prominent “Adam’s apple” in males.
A)true
B)false
A
The highest is the hyoid bone, palpated high in the neck at the level of the floor of the mouth.
A)true
B)false
A
LYMPHATICS
.
the head and neck have a rich supply of
A)lymph nodes
B)lymph sections
C)both a and b
A
• Preauricular, in front of the ear
-Posterior auriwlar (mastoid), 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
-Jugulodigastric, under the angle of the mandible
-Superficial cervical, overlying 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
A)Note that their labels correspond to adjacent structures.
B)false
A
When nodes are abnormal, check the area they drain for the source of the problem. Explore the area proximal (upstream) to the location of the abnormal node
A)true
B)false
A
The lymphatic system is an extensive vessel system, which is separate from the cardiovascular system and is phylogenetically older.
A)true
B)false
A
The lymphatics are a major part of the immune system, whose job it is to detect and eliminate foreign substances from the body.
A)true
B)false
A
The vessels allow the flow of clear, watery fluid (lymph) from the tissue spaces into the circulation.
A)true
B)false
A
___________ are small, oval clusters of lymphatic tissue that are set at intervals along the lymph vessels tissue that are set at intervals along the lymph vessels like beads on a string.
A)phagocytes
B)Lymph nodes
C)both a and b
B
The nodes filter the lymph and engulf pathogens, preventing potentially harmful substances from entering the circulation.
A)true
B)false.
A
Nodes are located throughout the body but are accessible to examination only in four areas: head and neck, arms, axillae, and inguinal region. The greatest supply is in the head and neck.
A)true
B)false
A
Nodes are located throughout the body but are accessible to examination only in four areas: A)head and neck, arms, axillae, and inguinal region.
B)head and neck,chest, arms, and legs
A
The greatest supply is in the head and neck
A)lymph nodes
B)fugal
A
DEVELOPMENTAL COMPETENCE
Infants and Children
.
The bones of the neonatal skull are separated by sutures and by fontanels, the spaces where the sutures intersect. These membrane-covered “soft spots” allow for growth of the brain during the 1st year.
A)true
B)false
A
__________They gradually ossify; the triangle-shaped posterior fontanel is closed by l to 2 months, and the diamond-shaped anterior fontanel closes between 9 months and 2 years.
A)fontanels
B)sutures
A
the triangle-shaped posterior fontanel is closed by
A)l to 2 months,
B) 9 months and 2 years
A
the diamond-shaped anterior fontanel closes
A) closed by l to 2 months,
B)between 9 months and 2 years
B
Head size is greater than chest circumference at birth.
A)true
B)false
A
The head size grows during childhood, reaching 90o/o of its final size when the child is 6 years old. But during infancy, trunk growth predominates so that head size changes in proportion to body height.
A)true
B)false
A
. Facial bones grow at varying rates, especially nasal and jaw bones.
A)true
B)false
True
In the toddler, the mandible and maxilla are small and the nasal bridge is low, so that the whole face seems small compared with the skull.
A)true
B)false
A
Lymphoid tissue is well developed at birth and grows to adult size when the child is
A)2 years old.
B)6 years old.
C)both a and b
B
The child’s lymphatic tissue continues to grow rapidly until age 10 or 11 years, actually exceeding its adult size before puberty. Then the lymphatic tissue slowly atrophies.
A)true
B)false
A
In adolescence, facial hair appears on boys, first above the lip, then on cheeks and below the lip, and last on the chin.
A)true
B)false
A
A noticeable enlargement of the thyroid cartilage occurs, and with it, the voice deepens.
A)adolescents
B)school age
C)young adult
A
DEVELOPMENT COMPETENCE
The Pregnant Woman
.
The thyroid gland enlarges slightly during pregnancy as a result of hyperplasia of the tissue and increased vascularity.
A)true
B)false
A
The ________ gland enlarges slightly during pregnancy as a result of hyperplasia of the tissue and increased vascularity.
A)submandibular
B)thyroid
C)patroid
B
DEVELOPMENT COMPETENCE
The Aging Adult
.
The facial bones and orbits appear more prominent, and the facial skin sags as a result of decreased elasticity, decreased subcutaneous fat, and decreased moisture in the skin. The lower face may look smaller if teeth have been lost.
A)the pregnant women
B)aging adult
B
SUBJECTIVE DATA
.
- Headache
- Head injury
- Dizziness
- Neck pain, limitation of motion
- Lumps or swelling
- History of head or neck surgery
A)objective data
B)subjective data
B
HEADACHE
.
Any unusually frequent or unusually severe headaches?
A)This is a more meaningful question than “Do you ever have headaches?” because most people have had at least one headache. Because many conditions have a headache as a symptom, a detailed history is important.
B)false, do not answer
A
Ever had this kind of headache before?
A)A red flag is a severe headache in an adult or child who has never had it before.
B)Unilateral or bilateral (e.g., with cluster headaches, pain is always unilateral and always on the same side of the head).
A
Where do you feel it: frontal, temporal, behind your eyes, like a band around the head, in the sinus area, or in the occipital area?
A)Tension headaches tend to be occipital, frontal, or with bandlike tightness; migraines (vascular) tend to be supraorbital, retro-orbital, or frontotemporaL; cluster headaches (vascular) produce pain around the eye, temple, forehead, cheek.
B)false
A
Is pain localized on one side, or all over?
A)Unilateral or bilateral (e.g., with cluster headaches, pain is always unilateral and always on the same side of the head).
B)Character is typicaUy viselike with tension headache, throbbing with migraine or temporaJ arteritis.
A
Character. Throbbing (pounding, shooting) or aching (viselike, constant pressure, dull)?
A)Character is typically viselike with tension headache, throbbing with migraine or temporal arteritis.
B)false
A
Is it mild, moderate, or severe?
A)Pain is often severe with migraine, or excruciating with cluster headache.
B)false
A
Course and duration. What time of day do the headaches occur: morning, evening, awaken you from sleep?
A)Migraines occur about twice per month, each lasting 1 to 3 days; cluster headaches occur once or twice per day, each to 2 hours for 1 to 2 months, and remission may last for months or years.
B)false
A
Migraines occur about twice per month, each lasting 1 to 3 days;
A)true
B)false
A
cluster headaches occur once or twice per day, each to 2 hours for 1 to 2 months, and remission may last for months or years.
A)true
B)false
A
Precipitating factors. What brings it on: activity or exercise, work environment, emotional upset, anxiety, alcohol? (Also note signs of depression.)
A)Alcohol ingestion and daytime napping typically precipitate cluster headaches, whereas alcohol, letdown after stress, menstruation, and eating chocolate or cheese precipitate migraines.
B)false
A
Associated factors. Any relation to other symptoms: any nausea and vomiting? (Note which came first, headache or nausea.) Any vision changes, pain with bright lights, neck pain or stiffness, fever, weakness, moodiness, stomach problems?
A)Nausea, vomiting, and visual disturbances are associated with migraines; eye reddening and tearing, eyelid drooping, rhinorrhea, and nasal congestion are associated with cluster headaches; anxiety and stress are associated with tension headaches; nuchal rigidity and fever are associated with meningitis or encephalitis.
B)false,patient is okay
A
Do you have any other illness?
A)Hypertension, fever, hypothyroidism, and vasculitis produce headaches.
B)hypotension
A
Do you take any medications?
A)Oral contraceptives, bronchodilators, alcohol, nitrates, carbon monoxide inhalation produce headaches
B)weed smoking
A
What is the frequency of your headaches: once a week? Are your headaches occurring closer together?
A)Migraines are associated with family history of migraine
B)none
A
Effort to treat. What seems to help: going to sleep, medications, positions, rubbing the area?
A)With migraines, people lie down to feel better, whereas with cluster headaches they need to move-even to pace the floor-to feel better.
B)head injury
A
HEAD INJURY
.
Lose consciousness and then fall?
A)Loss of consciousness before a fall may have a cardiac cause (e.g., heart block)
B)no change
A
Duration. How long were you unconscious? Any symptoms afterward-headache, vomiting, projectile vomiting? Any change in level of consciousness nfter injury: dazed or sleepy?
A)a change in level of consciousness is most important in evaluating a neurologic deficit.
B)no change noted
A
Associated symptoms. Any pain in the head or the neck, vision change, discharge from ear or nose-is it bloody or watery? Are you able to move all extremities? Any tremors, staggered walk, numbness and tingling
A)true
B)fase
A
DIZZINESS
.
Experienced any dizziness? (Determine exactly what the person means by dizziness.) Was it a feeling of light-headedness or of falling? Or was it a spinning sensation?
A)Dizziness is a light-headed, swimming sensation, feeling of falling. True vertigo is true rotational spinning from neurologic disease (labyrinthine-vestibular apparatus, vestibular nuclei in brainstem). When vertigo is objective, the person feels like the room spins. When vertigo is subjective, the perception is that the person spins.
B)person affect is cooperative
A
Dizziness is a light-headed, swimming sensation, feeling of falling. True vertigo is true rotational spinning from neurologic disease (labyrinthine-vestibular apparatus, vestibular nuclei in brainstem).
A)true
B)false
A
When vertigo is__________, the person feels like the room spins. .
A)subjective
B)objective
B
When vertigo is_______, the perception is that the person spins.
A)subjective
B)objective
A
Onset. Abrupt or gradual? After a change in position, such as sudden standing?
A)dizziness
B)headache
A
Associated factors. Any nausea and vomiting, pallor, immobility, decreased hearing acuity, or tinnitus along with the dizziness?
A) true
B) false
A
NECK PAIN
.
Any neck pain?
A)Acute onset of neck stiffness with headache and fever occurs with meningeal inflammation
B)false,
A
Associated symptoms. Any limitations to range of motion (ROM), numbness or tingling in shoulders, arms, or hands?
A)true
B)false
A
Pain creates a VICIOUS circle. Tension increases pain and disability, which produces more anxiety.
A)true
B)false
True
LUMPS OR SWELLING
.
? Any recent infection? Any tenderness?
A)Tenderness suggests acute infection
B)check hands
A
For a lump that persists, how long have you had it? Has it changed in size?
A)A persistent lump arouses suspicion of malignancy. For people older than 40 years, suspect malignancy until proven otherwise.
B)Any history of prior irradiation of head, neck, upper chest?
A
Any history of prior irradiation of head, neck, upper chest?
A)Increased risk for salivary and thyroid tumors.
B)decrease risk of salivary tumors
A
Any difficulty swallowing?
A)Dysphagia.
B)mouthphagis
A
Do you smoke? For how long? How many packs a day? Do you chew tobacco?
A)Smoking and chewing tobacco increase risk for oral and respiratory cancer.
B)false
A
When was your last alcohol drink? How much alcohol do you drink a day?
A)Smoking and large alcohol consumption together increase the risk for cancer.
B)Smoking and large alcohol consumption together increase of no cancer.
A
HISTORY OF HEAD OR NECK SURGERY
.
had surgery of the head or neck? For what condition? When did the surgery occur? How do you feel about results?
A)Surgery for head and neck cancer often is disfiguring and increases risk for body image disturbance.
B)no, fase question
A
Additional History for Infants and Children
.
Did the mother use alcohol or street drugs during pregnancy? How often? How much was used per episode?
A)Alcohol increases the risk for fetal alcohol syndrome, with distinctive facial features (see Table 13-4, Pediatric Facial Abnormalities, p. 274). Cocaine use causes neurologic, developmental, and emotional problems
B)none
A
Was delivery vaginal or by cesarean section? Any difficulty? Use of forceps?
A)Forceps may increase the risk for caput succedaneum, cephalhematoma, and Bell’s palsy.
B)Additional History for the Aging Adult
A
Additional History for the Aging Adult
.
If dizziness is a problem, how does this affect your daily activities? Are you able to drive safely, maneuver about the house safely?
A)Assess self-care. Assess potential for injury
B)false
A
OBJECTIVE DATA
.
Inspect and Palpate the Skull
.
Normocephalic is the term that denotes a round symmetric skull that is appropriately related to body size. Be aware that “normal” includes a wide range of sizes.
A)true
B)false
A
Deformities: microcephaly, abnormally small head; macrocephaly, abnormally large head (hydrocephaly, acromegaly, Paget’s disease)
A)TURE for skull
B)false for skull
A
microcephaly,
A)abnormally small head
B)abnormally large head
A
macrocephaly,
A)abnormally small head;
B)abnormally large head
B
macrocephaly, abnormally large head are associated with which of the following diseases A)hydrocephaly B) acromegaly C)Paget's disease D)all the above
D
The skull normally feels symmetric and smooth. Cranial bones that have normal protrusions are the forehead, the side of each parietal bone, the occipital bone, and the mastoid process behind each ear. There is no tenderness to palpation
A)true
B)false
True
Note lumps, depressions, or abnormal protrusions
A)abnormal finding of the skull
B)abnormal finding of the hand
A
Palpate the temporal artery above the zygomatic (cheek) bone between the eye and top of the ear.
A)true
B)false
A
The artery looks tortuous, feels hardened and tender with temporal arteritis.
A)abnormal finding of temporal artery
B)normal finding
A
The temporomandibular joint is just below the temporal artery and anterior to the tragus. Palpate the joint as the person opens the mouth, and note normally smooth movement with no limitation or tenderness
A)true
B)false
A
Crepitation, limited ROM, or tenderness.
A)normal finding
B)abnormal finding of the TMJ
B
Inspect the Face
.
Anxiety is common in the hospitalized or ill person.
A)true
B)fase
A
Hostility or aggression. Tense, rigid muscles may indicate anxiety or pain; a flat affect may indicate depression.
A)abnormal finding in the face
B)normal finding
A
Note symmetry of eyebrows, palpebral fissures, nasolabial folds, and sides of the mouth.
A)true
B)false
A
Marked asymmetry with central brain lesion (e.g., stroke) or with peripheral cranial nerve Vll damage (Bell’s palsy).
A)abnormal vision the face
B)normal vision
A
Note any abnormal facial structures (coarse facial features, exophthalmos, changes in skin color or pigmentation) or any abnormal swelling. Also note any involuntary movements (tics) in the facial muscles. Normally none occur.
A)true,normal for face
B)false
A
Edema in the face occurs first around the eyes (periorbital) and the cheeks where the subcutaneous tissue is relatively loose. Note grinding of jaws, tics, fasciculations, or excessive blinking.
A)abnormal finding of the face
B)normal finding
A
A habitual spasmodic contraction of the muscles in the face
A)tics
B)nicks
A
Inspect and Palpate the Neck
.
The head should be held erect and still.
A)normal finding
B)abnormal finding
A
Head tilt occurs with muscle spasm. Rigid head and neck occur with arthritis.
A)abnormal finding of the neck
B)normal finding of the neck
A
Note any limitation of movement during active motion. Ask the person to touch the chin to the chest, to turn the head to the right and left, to try to touch each ear to the shoulder (without elevating shoulders), and to extend the head backward. When the neck is supple, motion is smooth and controlled
A)normal finding
B)abnormal finding
A
Note pain at any particular movement. Note ratchety or limited movement from cervical arthritis or inflammation of neck muscles. The arthritic neck is rigid; the person turns at the shoulders rather than at the neck.
A)normal findings in ROM in the neck
B)abnormal findings in ROM in the neck
B
Test muscle strength and the status of cranial nerve Xl by trying to resist the person’s movements with your hands as the person shrugs the shoulders and turns the head to each side
A)true, neck strength
B) false.shoulder workout
A
As the person moves the head, note enlargement of the salivary glands and lymph glands. Normally no enlargement is present. Note a swollen parotid gland when the head is extended; look for swelling below the angle of the jaw. Also, note thyroid gland enlargement. Normally none is present
A)true, normal finding
B)false, abnormal finding
A
Thyroid enlargement may be a unilateral lump, or it may be diffuse and look like a doughnut lying across the lower neck
A)abnormal finding of the eek
B) normal finding of the ECM
A
Also note any obvious pulsations. The carotid artery runs medial to the sternomastoid muscle, and it creates a brisk localized pulsation just below the angle of the jaw. Normally, there are no other pulsations while the person is in the sitting position
A)true, normal finding of the neck
B)false abnormal finding of the neck
A
INSPECT and PALPATE THE NECK
Lymph Nodes
.
Using a gentle circular motion of your fingerpads, palpate the lymph nodes
A)true
B)false
A
