module 7 head and neck 1

Question 1

Endocrine glands in the head and neck

Answer 1

pineal
pituitary
hypothalamus
thyroid
parathyroid

Question 2

exocrine glands in the head and neck

Answer 2

salivary
sweat
ceruminous
mucous
sebaceous

Question 3

5 layers of scalp. SCALP

Answer 3

S: skin: large number of sebaceous glands
C: connective tissue, passageway for nerves and vessels
A: apicranial aponeurosis: insertion point for occipital-frontalis muscles.
L: loose areolar tissue: allows the 3 above layers to move
P: pericranium, periosteum of cranial bones

Question 4

arteries and veins of the scalp

Answer 4

supratroclear and supraorbital 
- both frontal above eyes. 
superficial temporal
- in front of ear
posterior auricular
- behind ear and up occipital 
Occipital

Question 5

anterior lymphatic drainage of scalp

Answer 5

lymph nodes

• parotid
• submandibular
• cervical

Question 6

posterior lymphatic drainage of scalp

Answer 6

lymph nodes

• posterior auricular
• occipital

Question 7

Sagittal suture

Answer 7

between the parietal bones

Question 8

coronal suture

Answer 8

between frontal and parietal bones

Question 9

lambdoid suture

Answer 9

between parietal and occipital bones

Question 10

posterior fontanelle closes

Answer 10

2-3 months

Question 11

sphenoidal fontanelle closes

Answer 11

6 months

Question 12

mastoid fontanelle closes

Answer 12

6-18 months

Question 13

anterior fontanelle closes

Answer 13

12-15 months

Question 14

salivary glands

Answer 14

parotid: anterior to the ear, above the mandible
submandibular: medial to mandible at the angle of the jaw
sublingual: anterior floor of mouth

Question 15

thyroid location

Answer 15

isthmus lies over tracheal rings 2-4

- should move with swallowing.

Question 16

thyroid enlargement

Answer 16

bruit may be heard

Question 17

assess CNVII by asking pt to

Answer 17

smile
frown
wrinkle forehead
puff out cheeks

Question 18

assess strength of muscles CNV

Answer 18

have pt clench teeth

try to open pt mouth, have them resist.

Question 19

assess sensation CNV

Answer 19

assess bilaterally on
forehead
cheeks
chin

Question 20

cardarelli’s sign

Answer 20

palpable pulsations with displacement of thyroid cartilage to the left
- s/s of aneurysm

Question 21

oliver’s sign

Answer 21

downward tug with upward displacement of cricoid cartilage

Question 22

ROM in neck

Answer 22

6 directions

• flexion: chin down
• extension: head back
• right lateral
• left lateral
• left rotation
• right rotation

Question 23

6 steps to feel for nodes of head

Answer 23

1. occipital nodes at base of skull
2. postauricular: superficial to the mastoid process
3. preauricular: just in front of ear
4. parotid and retopharyngeal: angle of the mandible
5. submandibular: halfway between the angle and the tip of mandible
6. submental: midline behind tip of mandible

Question 24

4 steps to feel for nodes of neck

Answer 24

1. superficial cervical: sternocleidomastoid muscle
2. posterior cervical: along the anterior border of the trapezius muscle
3. deep cervical: deep to the sternocleidomastoid
4. supraclavicular: probing deeply in the angle formed by the clavicle and the sternocleidomastoid muscle.

Question 25

headaches patho

Answer 25

pain in the head

common concern

Question 26

headaches subjective

Answer 26

description: constant, severe, recurrent
associated: tearing
exposures: meds?

Question 27

headaches objective

Answer 27

no physical findings in many cases
neurologic deficits in some cases
abnormal gait
papiledema
nystagmus

Question 28

salivary gland tumor patho

Answer 28

tumor in any of the salivary glands, but most commonly in the parotid

Question 29

salivary gland tumor subjective

Answer 29

slow growing painless lumps, either in front of ear or under jaw
difficulty opening the mouth
tongue numbness or weakness

Question 30

salivary gland tumor objective

Answer 30

benign tumors usually smooth, malignant often irregular 
facial weakness
fixation of the lump
sensory loss
ulceration

Question 31

primary hypothyroidism

Answer 31

thyroid gland produces insufficient amounts of thyroid hormone

Question 32

secondary hypothyroidism

Answer 32

insufficient TH secretion due to inadequate secretion of either TSH from the pituitary gland or TRH from th hypothalamus

Question 33

myxedema patho

Answer 33

skin and tissue disorder usually due to severe prolong hypothyroidism

• dec metabolic rate
• > accumulation of hyaluronic acid and chondroitin sulfate in dermis
• deposition of glycosaminoglycan leads to mucinous edema of facial features

Question 34

myxedema subjective

Answer 34

cognitive impairment, slowed mentation, poor concentration, dec. short term memory, depressed mood
constipation
muscle pain
hearing problems, deafness

Question 35

myxedema objective

Answer 35

coarse thick skin, thickening nose, swollen lips, puffy eyes.
slow speech
mental dullness, lethargy, mental problems
weight gain
thin brittle hair, with bald patches

Question 36

graves disease patho

Answer 36

overactive thyroid caused by autoimmune antibodies to TSH receptor

Question 37

graves disease subjective

Answer 37

palpitations 
heat intolerance 
wt loss
fatigue
inc. appetite, tachycardia

Question 38

graves disease objective

Answer 38

diffuse thyroid enlargement, prominent eyes

Question 39

hashimoto disease patho

Answer 39

underactive thyroid caused by autoimmune antibodies against thyroid gland

Question 40

hashimoto disease subjective

Answer 40

wt gain
nausea
fatigue

Question 41

hashimoto objective

Answer 41

enlarged nontender smooth thyroid