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Health Assessment > Quiz #2: Head/Neck, Eyes > Flashcards

Quiz #2: Head/Neck, Eyes Flashcards

1
Q

4 Places in the Body Lymph Nodes are Accessible

A

Head and Neck
Arms
Axillae
Inguinal

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2
Q

Lymphadenopathy indicates…

A

Infection, allergy, or Neoplasm

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3
Q

Lymphadenopathy

A

Increased size of lymph nodes, >1cm

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4
Q

When do posterior and anterior fontanels close?

A

Posterior- 1-2 months

Anterior- 9 months-2 years

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5
Q

Thyroid gland changes in pregnancy

A

Gland enlarges slightly due to hyperplasia of the neck and increase in vascularity

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6
Q

Factors associated with head injury

A

Neck pain, visual changes, nasal/ear discharge

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7
Q

Most important info in evaluating head injury/neurologic deficit

A

Change in consciousness

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8
Q

What to ask a patient about dizziness

A

Fluid/food intake, vomiting, bloody or black stools, occupation, falls

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9
Q

Presyncope

A

Feeling of lightheadedness, fainting/falling, or swimming. Caused by decreased blood flow to the brain or decreased cardiac output.

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10
Q

What to ask about neck pain

A

PQRSTU, hx of injury, occupation/home lifting, stress, limits to ROM

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11
Q

6 Categories for Subjective Head, Neck, and Regional Lymphatics Assessment

A

Headache, Head Injury, Dizziness, Neck Pain, Lumps or Swelling, Head and Neck Surgery Hx

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12
Q

Additional head, face, neck hx for infants and children

A
  1. Alcohol or drug use in pregnancy
  2. Vaginal, c-section, forceps? Any issues in birth?
  3. Has development been normal? fontanels closed? What age did pt gain head control?
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13
Q

What can cause asymmetry in the face?

A

Damage to cranial nerve VII, which can cause Bell’s Palsy, or stroke.

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14
Q

Objective Data for Head/Face (6)

A
  1. Size
  2. shape
  3. symmetry
  4. skin
  5. muscle tone
  6. CN VIII
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15
Q

Objective Data for the Neck

A
  1. General Swelling
  2. ROM
  3. carotid pulsation
  4. lymph node enlargement
  5. CN XI
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16
Q

Assessment for CN XI

A

Have pt move head back and forth and shrug shoulder with you resisting

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17
Q

Why would trachea not be in the midline?

A

Trachea pushed to the healthy side with aortic aneurysm, tumor, unilater thyroid gland enlargement, or pneumothorax

Trachea pulled to the diseased side with fibrosis, atelectasis, or pleural adhesions

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18
Q

Tracheal Tug

A

Rhythmic downward movement of the trachea with systole that occurs as a result of aortic arch aneurysm.

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19
Q

bruit

A

soft, pulsatile, whooshing sound in the thyroid heard with the bell of the stethoscope. Indicates increased/turbulent blood flood and hyperplasia of the thyroid, as in hyperthyroidism.

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20
Q

When to measure head diameter

A

Each visit up to age 2, then annually up to age 6.

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21
Q

caput succedaneum

A

edematous swelling and ecchymosis of presenting part of head, may be along suture lines, resolves during the first few days of life without treatment

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22
Q

cephalhematoma

A

subperiostal hemmorhage causing soft, fluctuant hematoma over one cranial bone. Resorbed during first few weeks of life, large may take up to 3 months. Increases infant risk of jaundice.

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23
Q

molding

A

Overriding of cranial bones due to passage through the birth canal. Lasts only a few days or a week.

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24
Q

craniosynostosis

A

Severe deformity due to premature closure of the sutures.

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25
Q

When can infant turn head side to side

A

2 weeks

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26
Q

When does infant have head control

A

4 months

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27
Q

What is Nuchal Rigidity and what does it indicate?

A

Nuchal rigidity is resistance to neck flexion. It may indicate meningeal irritation or meningitis.

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28
Q

Senile Tremors

A

benign. Head nodding, tongue protrusion

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29
Q

What protects the eye?

A

Bony orbital cavity, cushion of fat, eyelids, lacrimal apparatus

30
Q

What do the eyelids protect the eye from?

A

injury, strong light, and dust.

31
Q

3 Layers of the Eye

A

Sclera, choroid, retina

32
Q

Sclera

A

Tough, protective white coating

Continuous anteriorly as the cornea

33
Q

Cornea

A

Thin, transparent, and sensitive to the touch. Part of the refracting media of the eye- bends incoming light rays to focus them on the inner retina.

34
Q

Corneal reflex

A

Stimulation of the cornea with a wisp of cotton causes blinking in both eyes.

35
Q

CN V

A

Trigeminal nerve- carries afferent sensation into brain

36
Q

CN VII

A

Facial nerve- Carries the efferent messages that signal blinking.

37
Q

Extraocular muscles

A

Give the eye straight and rotary movement. Conjugate movement- axes of both eyes always remain parallel.
Movement stimulated by cranial nerves.

38
Q

CN VI

A

abducens nerve

innervates lateral rectus muscle, abducts the eye

39
Q

CN IV

A

trochlear nerve

innervates superior oblique muscle, moves eye down and in.

40
Q

CN III

A

oculomotor nerve

innervates superior, inferior, and medial rectus and inferior oblique muscles.

Moves eyes inward, up/in, up/out, down/out.

41
Q

Choroid

A

Middle layer with dark pigmentation to prevent light from reflecting internally
Heavily vascularized to deliver blood to the retina
Continuous with the ciliary body and the iris

42
Q

Iris

A

controls the amount of light admitted to the retina

43
Q

Pupil size

A

determined by balance of PNS and SNS. CN III stimulation causes pupil to constrict. SNS causes pupil to dilate and eyelid to elevate.

44
Q

Lens

A

Biconvex disc posterior to pupil, Serves as refractory medium. Bulges for focusing on near objects, flattens for far objects. Middle layer of the eye.

45
Q

Vision at birth

A

Keenest vision in macula absent at birth. Mature by 8 months.

Eye movements poorly coordinated at birth, binocularity established by 3-4 months

80% of babies are born farsighted- decreases by age 7-8

46
Q

Lens in the aging adult

A

Looses elasticity- becomes hard and glass-like

47
Q

Accommodation in the aging adult

A

Decreased ability to accommodate near vision- presbyopia

48
Q

Percentage of people with presbyopia at age 40

A

50%

49
Q

Cataract

A

Normally transparent fibers of the lens begin to thicken and yellow. Clumping of proteins that causes clouding. By age 80, >50% of adults have cataracts. Women have a higher risk.

50
Q

Arcus senilis

A

Circle or arch around the cornea (limbus) due to the accumulation of lipid material. No effect on vision.

51
Q

Four most common causes of decreased visual functioning in the older adult

A
  1. Cataract formation
  2. Glaucoma
  3. Age-related macular degeneration
  4. Diabetic retinopathy
52
Q

Age related macular degeneration

A

Yellow deposits (drusen) and neovascularity in the macula. Loss of central vision. Difficulty with tasks, reading, and recognizing faces. Peripheral vision is not affected.

53
Q

Subjective Data for Eyes Categories

A

Vision changes, pain, strabismus/diplopia, redness/swelling, watering/discharge, hx of ocular problems, glaucoma, glasses/contacts, patient centered care

54
Q

Vision changes to ask about in subjective interview

A

Floaters, halos around lights, loss of peripheral vision, blind spots

55
Q

When to refer a pt to provider after a snellen test?

A

If vision is poorer than 20/30

56
Q

Why does impaired vision occur in the Snellen test?

A

Refractive error, opacity in the media, or a disorder in the retina or optic pathway.

57
Q

What test assesses peripheral vision?

A

Confrontation test- screens for glaucoma in the older adult. May also test for diseases of the retina and stroke.

58
Q

Diagnostic positions test

A

Lead eyes through 6 Cardinal movements. Tests EOM and cranial nerve function.

59
Q

What does nystagmus indicate?

A

Ear or eye disease, MS, brain lesions, paretic eye muscle, or phenytoin overdose

60
Q

Scleral icterus

A

Even yellowing of the sclera that indicates jaundice.

61
Q

What does pallor in the lateral canthus indicate?

A

Anemia

62
Q

Aniscoria

A

Difference in size of pupils. Occurs normally in 5% of people.

63
Q

retina

A

Visual receptive layer of the eye in which light waves are changed into nerve impulses.

64
Q

How to view retinal structures?

A

with opthamoloscope.

65
Q

Which retinal structures are viewed through the opthamaloscope?

A

optic disc, retinal vessels, general background, macula

66
Q

What determines intraocular pressure?

A

the balance of the amount of aqueous humor produced by the ciliary body and the outflow at the angle of the anterior chamber

67
Q

What does the aqueous humor do?

A

Delivers nutrients to surrounding tissue and drains metabolic waste.

68
Q

pupillary light reflex

A

normal constriction of the pupil when light hits the retina

69
Q

Cranial nerves in the pupillary light reflex

A

CN II- Optic nerve- sensory afferent link

CN III- oculuomotor nerve- motor efferent path

70
Q

consensual light reflex

A

simultaneous constriction of one pupil when light hits the other pupil

71
Q

Accomodation

A

Adaptation of the eye for near vision. Convergence of the axes of the eyes when changing from far to near vision.

Health Assessment (20 decks)

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