Module 9: Pt.1 Head and Neck assessment

Question 1

Where are the lymph nodes in the head and neck

Answer 1

1) Preauricular (front of ear)
2) Posterior auricular (Mastoid)
3) Occipital (base of skull)
4) Submental (behind tip of mandible)
5) Tonsillar (under the angle of the mandible
6) Jugulodiagastric (internal jugular vein)
7) superficial cervical
8) Deep cervical
9) Posterior cervical
10) Supra clavicle

Question 2

What do lymph nodes do

Answer 2

Filter the lymph and engulf pathogens, preventing harmful things from entering circulation

Question 3

What are the 4 main areas where lymph nodes are accessible

Answer 3

1) head and neck
2) arms
3) Axillae
4) inguinal region

Question 4

what are fontanelles

Answer 4

spaces in infants where sutures intersect

allow for brain growth during first year

Question 5

What predominates (grows most) during the fetal period

Answer 5

Head growth

Question 6

What predominates during infancy

Answer 6

trunk growth predominates so that the proportion of head size to body height changes

Question 7

by age 6 the head is …. of full size

Answer 7

90%

Question 8

What subjective data for head and neck assessment

Answer 8

1) headache
2) head injury
3) dizziness
4) neck pain, limitation of motion
5) lumps or swelling
6) history of head or neck surgery

Question 9

Objective data to note for head and neck

Answer 9

-Note general size and shape of skull
-palpate temporal artery and temporomandibular joint
-Inspect facial features, symmetry, changes in pigment, swelling, excessive blinking
-any involuntary tics
-any neck rigidity
-any head tilt with muscle spasm
-limitation of ROM
Trachea: Palpate for shift
-note thyroid swelling
-

Question 10

Normocephalic skull

Answer 10

Normal sized skull

Question 11

What is lymphadenopathy

Answer 11

enlargement of lymph nodes

Question 12

Why might the lymph nodes be swollen

Answer 12

• Acute infection
• chronic inflammation
• Cancerous nodes
• HIV

Question 13

What is Caput succedaneum

Answer 13

Edematous swelling and ecchymosis of the head caused by birth trauma

Question 14

What is cephalohematoma

Answer 14

Hemorrhage from birth trauma on head

Question 15

Chloasma (in pregnant lady)

Answer 15

Blotchy/ hyper pigmentation over cheeks and forehead

Question 16

senile tremors

Answer 16

Noding and tongue protrusion, common in elderly

Question 17

Eyeball developmental considerations for kids

Answer 17

macula isn’t fully developed yet

most are born farsighted but lens will reach maturity by 8years

Question 18

Eyeball developmental considerations for older adults

Answer 18

Skin loses elasticity 
decreased tears
pupil size decreases
lens loses elasticity 
-thick yellow lens (senile cataract)
-poor night vision

Question 19

Subjective data for eye exam

Answer 19

1) Vision difficulty
2) Pain in eye
3) Strabismus, diplopia
4) Redness, swelling
5) watering, discharge
6) History of ocular problems
7) Use of glasses or contact lens
8) Self care behaviour
9) Meidcations
10) Glaucoma
11) coping with vision loss

Question 20

Additional eye history for infants and children

Answer 20

1) delivery
2) developement
3) Vision testing
4) Safety

Question 21

Additional eye history for older adults

Answer 21

1) movement
2) glaucoma testing
3) catarcts
4) dryness
5) activities

Question 22

Objective data for eye test

Answer 22

1) Test visual acuity:
- Snellen eye chart
- near vision stick test
2) Test visual fields
- controntation test (measures periphery)
3) Inspect extra ocular muscle function
- Corneal light reflex/ hirschberg test
- cover uncover test (if their eyes readjust when they cover with card they could have phoria or tropia)
- Diagnostic position tests (6 positions of gaze)
4) Inspect external ocular structures
5) inspect anterior eyeball structure
6) inspect ocular funds
- ophalamoscope so you can see more

Question 23

Visual tests for newborns

Answer 23

• If infant blinks from light
• pupillary response
• should fixate on object, reaching for it by month 3-4,
• Allen chart
• snellen E chart

Question 24

What is pinguecula

Answer 24

yellowish elevated nodules on the sclera

Question 25

What is acres senilis

Answer 25

Grey, white arc usually around ornea

Question 26

Xanthelasma

Answer 26

Raised soft yellow plaques on eyelid at inner corner

Question 27

What is otitis media

Answer 27

obstruction of auditory tube by nasopharyngeal secretions

Question 28

Romberg test

Answer 28

assessment of ability of vestibular apparatus in the middle ear to maintain balance

Question 29

Subjective data for ear

Answer 29

• Any earache, pain pressure, trauma
• any infections
• any discharge (Otorrhea)
• any hearing loss
• occupational hazards
• tinnitus
• vertigo
• self care

Question 30

Clues that someones has hearing loss

Answer 30

• lip reading
• straining
• misunderstanding or needs repeating
• flat voice
• startled

Question 31

Objective data for the ear

Answer 31

• size and shape (Mirotia =smaller than 4cm vertically)
• skin condition
• tenderness
• swelling discharge redness
• pearly tympanic canal

Question 32

For infants hearing….

Answer 32

Use parents developmental milestones

-make loud noise and see how they react

Question 33

Epitaxis

Answer 33

nose bleeds

Question 34

Subjective info for the nose

Answer 34

1) Discharge
2) frequent colds?
3) Sinus pain?
4) Trauma
5) Epistaxis (nose bleeds)
6) allergies
7) Altered smell

Question 35

Subjective for mouth and throat

Answer 35

1) Sores or lesion
2) Sore throat
3) Bleeding gums
4) Toothache
5) Hoarseness
6) Dyphagia (difficulty/ discomfort swallowing)
7) altered taste
8) Smoking and alcohol consumption
9) Self care behaviour
10) dentures or other

Question 36

Additional mouth and throat for infants and children

Answer 36

1) Mouth disease
2) Throat soars/disease
3) Tooth development
4) self care

Question 37

Additional mouth and throat questions for older adults

Answer 37

1) dryness
2) teeth fallen out
3) mouth care
4) taste and smell

Question 38

When should children have teeth by

Answer 38

At least 1 tooth by 1