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N112 > N112 Quiz 1: chapter 13 > Flashcards

N112 Quiz 1: chapter 13 Flashcards

1
Q

Name the skull bones and sutures needed for a head assessment.

A 
Frontal
Temporal
Parietal
Occipital
Coronal suture
Lambdoid suture
Sagittal suture
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2
Q

What are the 3 glands associated with the face?

A

parotid
submandibular
lingual

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3
Q 
Bleeding into the periosteum during birth is known as:
A.	caput succedaneum.
B.	craniosynostosis.
C.	molding.
D.	cephalhematoma.
A

D. cephalhematoma.

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4
Q

Craniosynostosis is a severe deformity caused by:
A. premature closure of the sutures.
B. increased intracranial pressure.
C. a localized bone disease that softens, thickens, and deforms bone.
D. excess growth hormone or a deficit in thyroid hormone.

A

A. premature closure of the sutures.

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5
Q 
Narrow palpebral fissures, epicanthal folds, and midfacial hypoplasia are characteristic of:
A.	Down syndrome.
B.	fetal alcohol syndrome.
C.	chronic childhood allergies.
D.	congenital hypothyroidism.
A

B. fetal alcohol syndrome.

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6
Q 
Kyphosis of the spine is common with aging. To compensate, older adults will:
A.	increase their center of gravity.
B.	extend their heads and jaws forward.
C.	stiffen their gait.
D.	shuffle.
A

B. extend their heads and jaws forward

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7
Q

Which statement is accurate related to aggravating symptoms or triggers of headaches?
A. Alcohol consumption may precipitate the onset of cluster or migraine headaches.
B. Certain foods such as chocolate or cheese may precipitate the onset of tension headaches.
C. Premenstrual hormonal fluctuations may precipitate the onset of cluster headaches.
D. Poor posture may trigger a migraine headache.

A

A. Alcohol consumption may precipitate the onset of cluster or migraine headaches

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8
Q 
Most facial bones articulate at a suture. Which facial bone articulates at a joint?
A.	Nasal bone
B.	Mandible
C.	Zygomatic bone
D.	Maxilla
A

B. Mandible

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9
Q 
A severe deficiency of thyroid hormone leading to nonpitting edema, coarse facial features, dry skin, and dry coarse hair is known as:
A.	congenital hypothyroidism.
B.	scleroderma.
C.	myxedema.
D.	Hashimoto thyroiditis.
A

C. myxedema.

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10
Q

Which of the following statements describing a headache would warrant an immediate referral?
A. “This is the worst migraine of my life.”
B. “This is the worst headache I’ve had since puberty.”
C. “I have never had a headache like this before; it is so bad I can’t function.”
D. “I have had daily headaches for years.”

A

C. “I have never had a headache like this before; it is so bad I can’t function.”

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11
Q 
What disease is characterized by a flat, expressionless, or mask-like face, a staring gaze, oily skin, and elevated eyebrows?
A.	Acromegaly
B.	Scleroderma
C.	Cushing syndrome
D.	Parkinson disease
A

D. Parkinson disease

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12
Q 
A patient is admitted to the emergency room after a motor vehicle accident. The trachea is deviated to the left side. This finding is characteristic of:
A.	right pneumothorax.
B.	aortic arch aneurysm.
C.	right pleural adhesion.
D.	right sided atelectasis.
A

A. right pneumothorax.

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13
Q

What are the major neck muscles included in a neck, thyroid assessment? Which nerve innervates them?

A

sternomastoid
trapezius
spinal accessory (cranial nerve XI)

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14
Q

Describe the thyroid gland locationand function.

A

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.

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15
Q

Name the arteries and veins of the neck.

A

Internal and external jugular veins.
Temporal artery
External and Internal carotid artery
Common carotid artery

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16
Q

Name and locate the 10 lymph nodes associated with the neck.

A
  1. Preauricular, in front of the ear
  2. Posterior auricular (mastoid), superficial to the mastoid process
  3. Occipital, at the base of the skull
  4. Submental, midline, behind the tip of the mandible
  5. Submandibular, halfway between the angle and the tip of the mandible
  6. Jugulodigastric (tonsilar), under the angle of the mandible
  7. Superficial cervical, overlying the sternomastoid muscle
  8. Deep cervical, deep under the sternomastoid muscle
  9. Posterior cervical, in the posterior triangle along the edge of the trapezius muscle
  10. Supraclavicular, just above and behind the clavicle, at the sternomastoid muscle
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17
Q

dysphagia

A

difficulty swallowing

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18
Q

What health history questions are associated with the head and neck?

A 
Headache not just “do you have headaches” ask if “severe” or “frequent”, where, how long, what brings it on, other symptoms
Head injury concussion
Dizziness
Neck pain and/or limitation of motion
Lumps or swelling
History of head or neck surgery
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19
Q

What are the 3 types of headaches?

A

Tension
migraine
cluster

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20
Q

Describe symptoms, duration, location and releiving factors of pain associated with a tension headache.

A

viselike, “stress” headache, ask about anxiety or stress
Location: Occipital/Frontal
Character: viselike, bandlike tightness
Environmental factors: stress
Other symptoms: anxiety and stress, poor posture
Gradual onset, lasts 30 minutes to days
Relief: rest, massage, NSAID

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21
Q

Describe symptoms, occurranc, pain location and relieving factors associated with a migraine headache.

A

Location: supra orbital/retro orbital
Character: throbbing/severe
Cause: food (chocolate and cheese), menses, alcohol letdown, family history
Symptoms: nausea, vomiting, visual disturbances
Migraines occur about twice per month, each lasting 1 to 3 days
Relief: lie down in dark room, NSAID

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22
Q

Describe symptoms, pain location, occurance, relieving factors associated with cluster headaches.

A

Location: temple, forehead, cheeks, pain around eyes (not behind)
Character: unilateral pain, always same side
Causes: alcohol Ingestion, day time napping, wind or heat exposure
Other symptoms: eye drooping, red eyes, tearing, nasal congestion
Occurrence: cluster headaches occur once or twice per day,lasts 30 min to 2 hours for 1 to 2 months, and remission may last for months or years.
Relief: Need to move, pace

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23
Q

What objective data should be gathered for a head/face/neck physical assessment?

A 
Head  
Size / Shape
Erect / Midline
Scalp
Facial structures
Inspect face, noting facial expression and its appropriateness to behavior or reported mood.
Note symmetry of eyebrows, nasolabial folds, and sides of the mouth. 
Neck 
ROM
Enlargement of glands
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24
Q

Normocephalic

A

a round symmetric skull that is appropriately related to body size.

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25
Q

What other illness or medications can cause headaches?

A

Hypertension, fever, hypothyroidism, and vasculitis produce headaches.
Oral contraceptives, bronchodilators, alcohol, nitrates, carbon monoxide inhalation produce headaches.

26
Q

Describe subjective and objective perception with true vertigo.

A

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.

27
Q

lymphadenopathy

A

Lymphadenopathy is enlargement of the lymph nodes (>1 cm) from infection, allergy, or neoplasm.

28
Q

What would lymph nodes that are bilateral, enlarged, warm, tender, and firm but freely movable indicate?

A

Acute infection—acute onset, <14 days’ duration

29
Q

With chronic inflammation, how would the lymph nodes feel?

A

e.g., in tuberculosis the nodes are clumped.

30
Q

what would lymph nodes described as hard, >3 cm, unilateral, nontender, matted, and fixed indicate?

A

Cancerous

31
Q

What would the lymph nodes of a patient with HIV feel like?

A

Nodes with HIV infection are enlarged, firm, nontender, and mobile. Occipital node enlargement is common with HIV infection.

32
Q

What would a single enlarged, nontender, hard, left supraclavicular node (Virchow’s node) indicate?

A

neoplasm in thorax or abdomen.

•

33
Q

What disease would be indicated with painless, rubbery, discrete nodes that gradually appear?

A

Hodgkin’s lymphoma.

34
Q

With tracheal shift, if the trachea is pushed to the unaffected (or healthy) side, what is indicated?

A

aortic aneurysm, a tumor, unilateral thyroid lobe enlargement, and pneumothorax.

35
Q

With tracheal shift, if the trachea is pulled toward the affected (diseased) side what is indicated?
• Tracheal tug is a rhythmic downward pull that is synchronous with systole and that occurs with aortic arch aneurysm.

A

large atelectasis, pleural adhesions, or fibrosis.

36
Q

What is Tracheal tug?

A

a rhythmic downward pull that is synchronous with systole and that occurs with aortic arch aneurysm.

37
Q

What does a Bruit indicate when palpating the thyroid?

A

A bruit occurs with accelerated or turbulent blood flow, indicating hyperplasia of the thyroid (e.g., hyperthyroidism).

38
Q

caput succedaneum

A

edematous swelling and ecchymosis of the presenting part of the head caused by birth trauma

39
Q

cephalhematoma

A

a subperiosteal hemorrhage, which is also a result of birth trauma. An infant with cephalhematoma is at greater risk for jaundice as the red blood cells within the hematoma are broken down and reabsorbed

40
Q

If an infant has a short neck or webbing (loose fanlike folds) what can it indicate?

A

may indicate congenital abnormality (e.g., Down or Turner syndrome), or it may occur alone.

41
Q

Hydorcephalus

A

Obstruction of drainage of cerebrospinal fluid results in excessive accumulation, increasing intracranial pressure, and enlargement of the head. The face looks small compared with the enlarged cranium. The increasing pressure also produces dilated scalp veins, frontal bossing, and downcast or “setting sun” eyes (sclera visible above iris).

42
Q

Paget’s Disease (Osteitis Deformans)

A

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. 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.

43
Q

Acromegaly

A

Excessive secretion of growth hormone from the pituitary gland after puberty creates an enlarged skull and thickened cranial bones. Elongated head, massive face, prominent nose and lower jaw, heavy eyebrow ridge, and coarse facial features.

44
Q

Torticollis (Wryneck)

A

A hematoma in one sternomastoid muscle, probably injured by intrauterine malposition, results in head tilt to one side and limited neck ROM to the opposite side.

45
Q

Goiter

A

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.

46
Q

Pilar Cyst (Wen)

A

Smooth, firm, fluctuant swelling on the scalp that contains sebum and keratin. Tense pressure of the contents causes overlying skin to be shiny and taut. It is a benign growth.

47
Q

Fetal Alcohol Syndrome

A

Face characteristics include narrow palpebral fissures, epicanthal folds, and midfacial hypoplasia.

48
Q

congenital hypothyroidism

A

low hairline, hirsute forehead, swollen eyelids, narrow palpebral fissures, widely spaced eyes, depressed nasal bridge, puffy face, thick tongue protruding through an open mouth, and a dull expression. Head size is normal, but the anterior and posterior fontanels are wide open.

49
Q

Down syndrome

A

Chromosomal aberration (trisomy 21). Head and face characteristics may include upslanting eyes with inner epicanthal folds; flat nasal bridge; small, broad, flat nose; protruding, thick tongue; ear dysplasia; short, broad neck with webbing; and small hands with single palmar crease.

50
Q

Parkinson Syndrome

A

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.

51
Q

Cushing syndrome

A

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.

52
Q

Hyperthyroidism

A

Goiter is an increase in the size of the thyroid gland and occurs with hyperthyroidism, Hashimoto’s thyroiditis, and hypothyroidism. Graves’ disease is the most common cause of hyperthyroidism, manifested by goiter and exophthalmos (bulging eyeballs). Symptoms include nervousness, fatigue, weight loss, muscle cramps, and heat intolerance; signs include tachycardia, shortness of breath, excessive sweating, fine muscle tremor, thin silky hair and skin, infrequent blinking, and a staring appearance.

53
Q

Myxedema (hypothyroidism)

A

A deficiency of thyroid hormone, when severe, causes a nonpitting edema or myxedema. Note puffy, edematous face, especially around eyes (periorbital edema), coarse facial features, dry skin, and dry, coarse hair and eyebrows.

54
Q

Bells palsy

A

A lower motor neuron lesion (peripheral), producing cranial nerve VII paralysis, which is almost always unilateral. It has a rapid onset, and its cause is currently thought to be herpes simplex virus (HSV). Note complete paralysis of one half of the face; the person cannot wrinkle forehead, raise eyebrow, close eye, whistle, or show teeth on the right side. Usually presents with smooth forehead, wide palpebral fissure, flat nasolabial fold, drooling, and pain behind the ear.

55
Q

Stroke or cerebrovascular accident

A

An upper motor neuron lesion (central). A stroke (or brain attack) is an acute neurologic deficit caused by an obstruction of a cerebral vessel, as in atherosclerosis, or a rupture in a cerebral vessel. If you suspect a stroke, ask if the person can smile. Note paralysis of the lower facial muscles, but also note that the upper half of face is not affected because of the intact nerve from the unaffected hemisphere. The person is still able to wrinkle the forehead and close the eyes.

56
Q

Cathectic appearance

A

Accompanies chronic wasting diseases such as cancer, dehydration, and starvation. Features include sunken eyes; hollow cheeks; and exhausted, defeated expression.

57
Q

Scleroderma

A

Literally, “hard skin,” this 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. Characteristic facies: hard, shiny skin on forehead and cheeks; thin, pursed lips with radial furrowing; absent skinfolds; muscle atrophy on face and neck; absence of expression.

58
Q

Describe how you would palpate the trachea.

A

Palpate trachea checking that it is midline and there is no tracheal shift.
Place index finger on trachea in sternal notch, and slip it off to each side. The space should be symmetric on both sides
WHEN DRINKING, should move up and down “midline and no tracheal shift (if normal)

59
Q

Describe how you would palpate the thyroid.

A

Inspect neck as person takes a sip of water and swallows. Thyroid tissue should move up with a swallow.
Posterior Approach: Palpate thyroid by moving behind person. Person to sit straight and bend head slightly forward and to the right. Use fingers of left hand to push trachea slightly to right. Curve right fingers between trachea and sternomastoid muscle, retracting it slightly, person swallows. Thyroid moves up under examiner’s fingers. Reverse procedure for left side

60
Q

Parotid gland enlargement is caused by…

A

mumps or dehydration

N112 (6 decks)

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