Module 9: Pt.1 Head and Neck assessment Flashcards
Where are the lymph nodes in the head and neck
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
What do lymph nodes do
Filter the lymph and engulf pathogens, preventing harmful things from entering circulation
What are the 4 main areas where lymph nodes are accessible
1) head and neck
2) arms
3) Axillae
4) inguinal region
what are fontanelles
spaces in infants where sutures intersect
allow for brain growth during first year
What predominates (grows most) during the fetal period
Head growth
What predominates during infancy
trunk growth predominates so that the proportion of head size to body height changes
by age 6 the head is …. of full size
90%
What subjective data for head and neck assessment
1) headache
2) head injury
3) dizziness
4) neck pain, limitation of motion
5) lumps or swelling
6) history of head or neck surgery
Objective data to note for head and neck
-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
-
Normocephalic skull
Normal sized skull
What is lymphadenopathy
enlargement of lymph nodes
Why might the lymph nodes be swollen
- Acute infection
- chronic inflammation
- Cancerous nodes
- HIV
What is Caput succedaneum
Edematous swelling and ecchymosis of the head caused by birth trauma
What is cephalohematoma
Hemorrhage from birth trauma on head
Chloasma (in pregnant lady)
Blotchy/ hyper pigmentation over cheeks and forehead
senile tremors
Noding and tongue protrusion, common in elderly
Eyeball developmental considerations for kids
macula isn’t fully developed yet
most are born farsighted but lens will reach maturity by 8years
Eyeball developmental considerations for older adults
Skin loses elasticity decreased tears pupil size decreases lens loses elasticity -thick yellow lens (senile cataract) -poor night vision
Subjective data for eye exam
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
Additional eye history for infants and children
1) delivery
2) developement
3) Vision testing
4) Safety
Additional eye history for older adults
1) movement
2) glaucoma testing
3) catarcts
4) dryness
5) activities
Objective data for eye test
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
Visual tests for newborns
- If infant blinks from light
- pupillary response
- should fixate on object, reaching for it by month 3-4,
- Allen chart
- snellen E chart
What is pinguecula
yellowish elevated nodules on the sclera
What is acres senilis
Grey, white arc usually around ornea
Xanthelasma
Raised soft yellow plaques on eyelid at inner corner
What is otitis media
obstruction of auditory tube by nasopharyngeal secretions
Romberg test
assessment of ability of vestibular apparatus in the middle ear to maintain balance
Subjective data for ear
- Any earache, pain pressure, trauma
- any infections
- any discharge (Otorrhea)
- any hearing loss
- occupational hazards
- tinnitus
- vertigo
- self care
Clues that someones has hearing loss
- lip reading
- straining
- misunderstanding or needs repeating
- flat voice
- startled
Objective data for the ear
- size and shape (Mirotia =smaller than 4cm vertically)
- skin condition
- tenderness
- swelling discharge redness
- pearly tympanic canal
For infants hearing….
Use parents developmental milestones
-make loud noise and see how they react
Epitaxis
nose bleeds
Subjective info for the nose
1) Discharge
2) frequent colds?
3) Sinus pain?
4) Trauma
5) Epistaxis (nose bleeds)
6) allergies
7) Altered smell
Subjective for mouth and throat
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
Additional mouth and throat for infants and children
1) Mouth disease
2) Throat soars/disease
3) Tooth development
4) self care
Additional mouth and throat questions for older adults
1) dryness
2) teeth fallen out
3) mouth care
4) taste and smell
When should children have teeth by
At least 1 tooth by 1
