Jarvis Chapter 13 Head, face, Neck and Lymphs Flashcards
Rigid bony box that protects the brain and special sense organs it includes the bones of the cranium and the face.
Skull
Cranial Bones
- Frontal
- Parietal
- Occipital
- Temporal
Immovable joints where adjacent and cranial bones unite
Suture
Crowns the head from ear to ear at the union of the frontal and parietal bones
Coronal sutures
Separates the head lengthwise between the two parietal bones
Sagittal Sutures
Separates the paretal bones crosswise from the occipital bone
Lamboid Sutures
Palpable spinous process of C7
Vertebra prominens
Opening between eyelids- are equally bilateral.
Palpebral fissures
The creases extending from the nose to each corner of the mouth, should look symmetrical.
Nasolabial folds
Facial nerve. mediates the facial muscles.
Cranial nerve VII
Trigeminal nerve. mediates the facial sensations of pain or touch
Cranial nerve V
Cranial Nerve V
Trigeminal
Cranial nerve VII
Facial
Salivary glands in the cheeks over the mandible, anterior to and below the ear. largest of the salivary glands but are not normally palpable. enlarged with mumps and AIDS
Parotid glands
Salivary glands beneath the mandible at the angle of the jaw
Submandibular glands
Salivary glands. in the floor of the mouth
Sublingual glands
Lies superior to the temporalis muscle. its pulsation is palpable anterior to the ear
Temporal artery
Branches off common carotid and runs inward and upward to supply the brain
Internal carotid
Supplies the face, salivary glands, and superficial temporal area
External Carotid
Innervatd by cranial nerve XI. arises from the sternum and clavicle and extends diagonally across the neck to the mastid process behind the ear. accomplishes head rotation and head flexion
Sternomastoid muscle
Move shoulders and extend and turn the head
Trapezius
AKA upper trachial ring. just above the thyroid isthmus
Cricoid cartilage
Above cricoid cartilage. Adam’s apple
Thyroid cartilage
Above thyroid cartilage. At level of the floor of the mouth
Hyoid bone
Lymph node located in front of the ears.
Preauricular
Lymph node located superficial to the mastoid process
Postauricular
Lymph node located at the base of the skull.
Occipital
Lymph node located midline, behind the tip of the mandible.
Submental
Lymph node located halfway between the angle and the tip of the mandible
Submandibular
Limph node located under the angle of the mandible
Jugolodigastric
Lymph node overlying the sternomastoid muscle
Superficial cervical
Lymph node deep under the sternomastoid muscle
Deep cervical chain
Lymph node located in the posterior triangle along the edge of the trapezius muscle
Posterior cervical
Lymph node located just above and behind the clavicle, at the sternomastoid muscle
Supraclavicular
Spaces where sutures intersect. aka soft spots. allow for growth of brain during the first year
Fontanels
Tend to be occipital, frontal, or with bandlike tightness. Associated with anxiety and stress
Tension headache
Aka vascular. tend to be supraorbital, retro-orbital, or frontotemporal. pain is throbbing and severe. occur about twice per month, each lasting 1 to 3 days. associated with nasea, vomiting, and visual disturbances. precipitated by alcohol, letdown after stress, menstruation, and eating chocolate or cheese. associated with family history of migraines. lying down helps relieve pain
Migraine
Produce pain around the eye, temple, forehead, cheek. pain is always unilateral. excrutiating. occur twice per day, each lasting 1/2 to 2 hours for 1 to 2 months. remission may last for months or years. precipitated by alcohol ingestion or daytime napping. associated with eye reddening and tearing, eyelid drooping, rhinorrhea, and nasal congestion. moving around helps pain.
Cluster headache
Rotational spinning from neurologic disease
Vertigo
Person feels like the room spins
Objective vertigo
Perception that person is spinning
Subjective vertigo
Acute onset of neck stiffness with headache and fever
Menigeal inflmmation
Difficulting swallowing
Dysphagia
Form of facial paralysis resulting from a dysfunction of the cranial nerve VII
Bell’s Palsy
Edematous swelling and ecchymosis of the presenting part of the head caused by birth trauma.
Caput succedaneum
Abnormaly small head
Microcephaly
Abnormaly large head
Macrocephaly
Enlargement of the lympth nodes (>1cm) from infection, allergy, or neoplasm
Lymphadenopaty
Benign and include head nodding (as if saying yes or no) and tongue protrusion. If some teeth have been lost, the lower face looks unusually small, with the mouth sunken in.
Senile tremors
Curving of the spine
Kyphosis
Askeletal disease of increased bone resorption and formation, which softens, thickens, and deforms bone. It affects 10% of those older than 80 years and occurs more often in males.
Paget’s diseases
The disease is characterized by bowed long bones, sudden fractures, frontal bossing, and enlarging skull bones that form an acorn-shaped cranium. Enlarging skull bones press on cranial nerves, causing symptoms of headache, vertigo, tinnitus, progressive deafness, and optic atrophy and compression of the spinal cord.
Paget’s diseases
Excessive secretion of growth hormone from the pituitary gland after puberty creates an enlarged skull and thickened cranial bones.
Acromegaly
A chronic enlargement of the thyroid gland that occurs in some regions of the world where the soil is low in iodine. Not due to a neoplasm.
Goiter
Smooth, firm, fluctuant swelling on the scalp that contains sebum and keratin.
Pilar Cyst (Wen)
Mumps, Blockage of ducts, abcess or tumor.
Parotid gland enlargment
aging adults dehydrated from diuretics or anticholinergics causing?
Stensen duct obstruction
A deficiency of the neurotransmitter dopamine and degeneration of the basal ganglia in the brain. The immobility of features produces a face that is flat and expressionless, “masklike,” with elevated eyebrows, staring gaze, oily skin, and drooling.
Parkinson syndrome
With excessive secretion of corticotropin hormone (ACTH) and chronic steroid use, the person develops a plethoric, rounded, “moonlike” face; prominent jowls; red cheeks; hirsutism on the upper lip, lower cheeks, and chin; and acneiform rash on the chest.
Cushing syndrome
Myxedema
Hypothyroidism
acute neurologic deficit caused by an obstruction of a cerebral vessel, as in atherosclerosis, or a rupture in a cerebral vessel.
Stroke
Brain attack or Cerebral Vascular accident
Stroke
Loss of weight, muscle atrophy, fatigue, weakness
Cachexia
Accompanies chronic wasting diseases such as cancer, dehydration, and starvation. Features include sunken eyes; hollow cheeks; and exhausted, defeated expression.
Cachectic apperance
rare connective tissue disease is characterized by chronic hardening and shrinking degenerative changes in the skin, blood vessels, synovium, and skeletal muscles. Changes can occur in the skin, heart, esophagus, kidney, lung.
Scleroderma
Bleeding into the periosteum during birth is known as?
Celphahematoma
Craniosynostosis
Premature closure of the cranial sutures
Kyphosis of the spine is common with aging. To compensate, older adults will:
Extend their head and jaw foward
Most facial bones articulate at a suture. Which facial bone articulates at a joint?
Mandible
Excess thyroid hormone production
Hashimoto thyroiditis
Nononpitting edema, coarse facial features, dry skin, and dry coarse hair
Myxedema
What could indicate a A sudden severe headache
Subarachnoid hemorrhage
Endocrine gland, straddles trachea, cell metabolism
Thyroid
Trachea Shift - Unaffected Side
Pneumothorax
Unilateral Thyroid Englargement
Tumor
Aortic Aneurysm
Trachea Shift - Affected Side
Atelectasis
Fibrosis
Pleural Adhesions
Bulging eyes
Exopthalmos
Major Neck Muscles
Sternomastoid
Trapezius
Subjective Data: Head, Face, & Neck, Incl Regional Lymphatics
- Headache
- Head Injury
- Dizziness
- Neck Pain, Limitation of Motion
- Lumps or Swelling
- History of Head or Neck Injury
Filters
Lymph nodes
Anterior triangle
Neck landmark
A conduit for the passage of multiple structures
Neck
Which diseases can cause dysphagia?
- Pharangitis
- Gastroesophageal reflux
- Sroke
- Esophageal Cancer
- Some neurological diseases
People lie down to feel better
Migraine
People need to move to feel better
Cluster headaches
Commonly one side bit can occur in both sides
Migraines
Always one side
Cluster headaches
Trubbing, pulsating
Migraines
Continuos, piercing, excruciating
Cluster headache
Rapid onset, peaks 1-2 hr, lasts 4hr to 72hr, sometimes longer
Migraines
Abrupt onset, peaks in minutes, lasts 45-90min
Cluster headaches
Exacerbated by alcohol, stress, wind or heat exposure
Cluster headaches
Hormonal fluctuations (premenstrual)
Foods (e.g., alcohol, caffeine, MSG, nitrates, chocolate, cheese)
Letdown after stress
Changes in sleep pattern
Sensory stimuli (e.g., flashing lights or perfumes)
Changes in weather
Physical activity
Migraines
Chewing tabacco
Risk for oral cancer
Early signs of Oral cancer
- A sore that does not seem to heal
- A smooth or leathery white patch or lump
- A prolonged sore throat or feeling that something is in the throat
- Difficulty chewing
- Restricted movement of the tongue or jaw
Lymph nodes assessment
- Location
- Size
- Shape
- Delimination
- Mobility
- Consistency
- Tenderness
Infected lymph nodes s/s
- Acute infection—acute onset, 3cm, unilateral, nontender, matted, and fixed.
- Nodes with HIV infection are enlarged, firm, nontender, and mobile. Occipital node enlargement is common with HIV infection.
- A single enlarged, nontender, hard, left supraclavicular node (Virchow’s node) may indicate neoplasm in thorax or abdomen.
- Painless, rubbery, discrete nodes that gradually appear occur with Hodgkin’s lymphoma.