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Physical Diagnostics > Neck > Flashcards

Neck Flashcards

1
Q

What does JVD stand for?

A

Jugular Venous Distention

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2
Q

JVD is an indirect measure of what?

A

CVP (Central Venous Pressure)

Pressure in the right atrium of the heart

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3
Q

What happens to the jugular vein in JVD?

A

Jugular vein distends/bulges

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4
Q

For a normal pt, if they turn their head to the right should you be able to see their jugular vein bulging?

A

no

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5
Q

What does it mean if CVP is elevated?

A

jugular vein is bulging, CVP is elevated, right atrium pressure is elevated

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6
Q

JVD may indicate…

A

heart disease or vascular disease

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7
Q

Where is the external/internal jugular vein emptying into?

A

jugular vein is emptying into the superior vena cava of the heart

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8
Q

Where does the superior vena cava empty into?

A

superior vena cava empties into the right atrium of the heart

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9
Q

What is hypervolemia?

A

increased blood volume

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10
Q

What does it mean if a pt has hypervolemia?

A

pt suffering with hypervolemia means that there is an increase of CVP, which indicates JVD

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11
Q

If the tricuspid valve is stenosed, what does this mean?

A

blood is having hard time to flow from right atrium to the right ventricle of the heart causing regurgitation into superior vena cava

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12
Q

What does it mean if the blood can not flow properly into the right atrium?

A

if blood cannot flow properly, blood will accumulate in the right atrium and will regurgitate back into the superior vena cava (JVD)

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13
Q

Can you see JVD in a pt if they’re laying down?

A

Rarely, if you’re doing something with the heart, the bed should always be at a 30-45 degree angle

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14
Q

What is the spurling test designed for?

A

designed to reproduce symptoms by compression of affected nerve root

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15
Q

How do you perform a spurling test?

A

press axially with both hands on the patient’s head (their head should be slightly tilted/rotated)

radiating neck pain is consistent with nerve root compression

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16
Q

What general assessments should you use on a carotid artery?

A

palpate and auscultate

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17
Q

What should you hear through a stethoscope for a normal carotid artery?

A

normal heart thumping sounds “lub dup”

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18
Q

What is an abnormal auscultation sound heard through stethoscope when examining the carotid artery or thyroid gland?

A

bruit

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19
Q

What does a bruit sound indicate?

A

a vascular problem

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20
Q

What is a bruit sound?

A

an abnormal sound through blood vessels that is indicating turbulent blood flow from plaque (atherosclerosis)

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21
Q

Bruit sound is more common in _______

A

Bruit sound is more common in elderly

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22
Q

T/F

If you’re examining left carotid artery, have pt turn head to right and vice versa

A

true

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23
Q

What imagining test should you refer a pt to if they have a bruit?

A

ultrasound, this may prevent a stroke

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24
Q

What does a bruit sound like?

A

blowing or swooshing noise

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25
Q

What is a thyroid bruit?

A

increased blood flow to thyroid gland

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26
Q

Which disease do you commonly see enlarged thyroid glands?

A

Grave’s disease

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27
Q

Define nuchal rigidity

A

neck is rigid, cannot flex neck

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28
Q

What does nuchal rigidity indicate?

A

meningitis

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29
Q

What is another name for the larynx?

A

voice box

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30
Q

What is another name for thyroid cartilage?

A

“adam’s apple”

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31
Q

If a pt experiences pain while you’re palpating their thyroid gland, it may indicate….

A

infection or a hemorrhage

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32
Q

What can make it easier for you while examining/palpating the thyroid gland?

Hint: there are 2 things

A

have pt sit up and extend their head

have pt swallow water/saliva and it’ll allow the thyroid gland to elevate

33
Q

Where should you start when you examine a patient’s thyroid gland?

A

start right under the chin

34
Q

Can you see the thyroid gland for all patients?

A

no, it is most commonly seen in patients who have a goiter

35
Q

The thyroid gland is made up of how many lobes? What is the structure called that joins the lobes?

A

2 lobes, isthmus joins them together

36
Q

inferior or superior?

Isthmus is _____ to the cricoid cartilage

A

Isthmus is inferior to the cricoid cartilage

37
Q

What should you first feel for when palpating the thyroid gland and surrounding structures?

A

you should first feel the thyroid cartilage (it’s the largest, and has a little notch at the top)

38
Q

What should you feel next if you move down from the thyroid cartilage?

A

cricoid cartilage

39
Q

What structure is below the cricoid cartilage?

A

the first tracheal ring

40
Q

After palpating the tracheal rings, which direction should you move your fingers? What are you palpating once you get there?

A

move fingers laterally from the tracheal rings, this is your thyroid gland

41
Q

What were the 2 types of goiters we learned in class?

A

1) goiter of graves disease (usually hyperthyroidism)

2) multinodular goiter (usually seen in thyroid cancers)

42
Q

What is lymphadenopathy?

A

abnormality of size or inconsistency on the lymph nodes that you can palpate for

43
Q

Name the triangles of the neck

A

anterior and posterior triangles

44
Q

What is the anterior triangle bounded by?

A

mandible, midline of neck, and sternocleidomastoid muscle (SCM)

45
Q

What does SCM stand for?

A

sternocleidomastoid muscle

46
Q

What is the posterior triangle bounded by?

A

sternocleidomastoid muscle (SCM), trapezius muscle, and the clavicle

47
Q

In simplest terms, what do lymph nodes do?

A

exchange fluid through vessels

drain lymphatic capillaries

48
Q

How much fluid remains in blood capillaries?

A

15%

49
Q

What happens to the “leftover” fluid in the blood capillaries?

A

that 15% will be exchanged through lymphatic capillaries

50
Q

Describe lymphatic capillaries permeability

A

EXTREMELY permeable, everything is allowed in/out

Can easily result in cancer

51
Q

What percent of blood is returned to a normal heart through blood vessels?

A

85%

52
Q

What does it mean if lymph nodes are swollen/inflamed?

A

there is an infectious process present = infection

53
Q

What does it mean if lymph nodes feel hard when you palpate?

A

often indicates malignancy

54
Q

Where are lymph nodes typically?

A

everywhere, all over the body

55
Q

When examining the head/neck should you assess one side at a time or both simultaneously?

A

both sides simultaneously so you can compare symmetry, size, misalignment, etc.

56
Q

What does URT stand for?

A

upper respiratory tract

57
Q

What does mental mean in a medical setting?

A

chin

58
Q

List the 9 lymph node locations for the neck

A

1) anterior auricular
2) posterior auricular
3) occipital
4) tonsillar
5) submandibular
6) submental
7) superficial and deep cervical
8) posterior cervical
9) supraclavicular

59
Q

Which lymph node location should you start with when inspecting/palpating the neck/head

A

anterior auricular

60
Q

Where is anterior auricular lymph node? How many fingers should you use to palpate here?

A

in front of the ear, use 2 fingers in a circular motion

61
Q

An enlarged/inflamed anterior auricular lymph node indicates….

A

external ear infection

62
Q

Where is the posterior auricular lymph node? How many fingers should you use to palpate here?

A

at the mastoid process, use 2 fingers

63
Q

Where is the tonsillar lymph node? What does it drain?

A

beneath the mandible

drains tonsils and posterior pharynx

64
Q

Where is the submandibular lymph node? What does it drain?

A

under mandible

drains the floor of the mouth and the salivary glands

65
Q

Where is the submental lymph node? What does it drain?

A

under chin

drains the entire oral cavity

66
Q

Where is the superficial and deep cervical lymph nodes? What does it drain?

A

superficial and deep to the sternocleidomastoid muscle (SCM)

they drain the thyroid gland, tonsils, and the pharynx

67
Q

Where is the posterior cervical lymph node? How many fingers should you use here? What does it drain?

A

posterior to the sternocleidomastoid muscle (SCM)

anterior to the trapezius muscle

use 4 fingers here

drains the skin on the back of the head and neck

68
Q

What does an enlarged posterior cervical lymph node mean?

A

Upper Respiratory Infection (URI)

69
Q

What is the last lymph node you should look at on the neck?

A

supraclavicular, it is the deepest lymph node on the neck/head

70
Q

Where is the supraclavicular lymph node? How hard should you push here? What does it drain?

A

the deepest lymph node on the neck/head

really push down here, it is on the anterior triangle of the neck

drains part of the thoracic cavity and abdomen

71
Q

What are 2 tests you can do in office if a pt have nuchal rigidity and you suspect they have meningitis?

A

1) brudzinski test

2) kernig test

72
Q

What is meningitis?

A

inflammation of meninges

73
Q

If either/both brudzinski and kernig test give a negative test result should you still write it in the SOAP note?

A

no, only record in SOAP if brudzinski and/or kernig test is positive test result

74
Q

If pt has nuchal rigidity and you suspect they have meningitis what should you do besides the brudzinski and kernig tests?

A

refer them out for lab work

75
Q

Describe brudzinski test

A

have pt lay flat and flex their neck/head

as the pt does this, you will stretch their meninges

if they feel pain, then that is a positive test result

if they put their legs up/bend them it will help alleviate some of that pain

76
Q

Describe kernig test

A

pt is supine

flex the patient’s knees to 90 degrees and try to extend the legs

this stretches the meninges, if it causes pain then its a positive test result

pt can sit up to help alleviate pain

77
Q

When palpating the patient’s cervical spinous processes, what should you pay attention to?

A

pt facial expression –> they may not tell you if its slightly painful, stiff, or tender

78
Q

Where should the trachea be?

A

midline

Physical Diagnostics (13 decks)

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