Head, face, neck, and lymph nodes

preauricular lymph nodes

front of ear

posterior auricular lymph nodes

superficial to the mastoid process

occipital lymph node

base of the skull

submental lymph node

midline, behind the tip of the mandible

submandibular lymph nodes

halfway between the angle and the tip of the mandible

jugulodigastric lymph nodes

angle of the mandible

superficial cervical lymph nodes

overlying the sternomastoid muscle

deep cervical lymph node

deep under the sternomastoid muscle

posterior cervical lymph node

in the posterior triangle along the edge of the trapezius muscle

supraclavicular lymph nodes

just above and behind the clavicle, at the sternomastoid muscle

what are primary headaches

tension, migraine, cluster

what are secondary headaches

result from trauma or injury, substance use or withdrawal, infection, cranial or intercranial disorders, neuropathies and cranial nerve injuries, mental health disorders

6 subjective data for head

headache, head injury, dizziness, neck pain (limitation of motion), lumps/swelling, hx of head/neck surgery

thunderclap headache

severe, reaching maximum intensity in minutes

where are tension headahces

occpital, frontal, or with band like tightness

where are migraines

supraorbital, retro-orbital, or frontotemporal

where are sinus headaches

produce pain around the eye or cheek

concussion

direct blow to the skull causes the brain to shift rapidly back and forth inside

presyncope

light-headed, swimming sensation or feeling of fainting or falling caused by decreased blood flow to brain or heart irregularity causing decreased cardiac output

vertigo

true rotational spinning often from labyrintheine-vesibular disorder in inner ear

objective vertigo

person feels like the room is spinning

subjective vertigo

person feels like he or she is spinning

disequilibrium

shakiness or instability when walking related to musculoskeletal or multisensory deficits

dysphagua

difficulty swallowing

what three disorders can increase the risk of with forceps

succedaneum, cephalhematoma, Bell palsy

normocephalic

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

microcephaly

abnormally small head

macrocephaly

abnormally large head

what do normal lymph nodes feel like

movable, discrete, soft, and nontender

lymphadenopathy

enlargement of the lymph nodes (more than 1 cm)

what do lymph nodes feel like in an acute infection

bilateral, enlarged, warm, tender, and firm but freely movable

what do lymph nodes feel like in chronic inflammation

nodes are clumped

what do cancerous lymph nodes feel like

hard, bigger than 3 cm, unilateral, nontender, matted, and fixed to adjacent structures

what do lymph nodes in HIV feel like

enlarged, firm, nontender, and mobile

4 reasons trachea is pushed to unaffected side

aortic aneurysm, tumor, unilateral thyroid lobe, enlargement, and pneumothroax

3 reasons trachea goes toward affected side

large atelectasis, pleural adhesions, or fibrosis

trachea tug

rhythmic down ward pull that is synchronous with systole and occurs with aortic arch aneurysm

caput succedaneum

edematous swelling and ecchymosis of the presenting part of the head caused by birth trauma, feels soft, may extend across suture lines

cephalhematoma

subperiosteal hemorrhage, soft, fluctuant, and well defined over one cranial bone because the periosteum holds the bleeding in place

craniosynostosis

severe deformity caused by premature closure of the sutures

positional plagiocephaly

happens as the infant continually sleeps in the recommended position on the back to decrease the incidence of SIDS, flattening of the dependent occiput

marked plagiocephaly

requires custom-shaped helmet to afford room for brain growth in the flat area while moderating growth in other areas

what can infants do with their head by 2 weeks

turn their head side to side

tonic neck reflex

supine and head is turned to one side (extension of same arm and leg, flexion of opposite arm and leg)

when does the tonic neck reflex disappear

3 to 4 months

when percussing, what condition happens with a resonant sound

hydrocephalus

when are bruits common

common in the skull in children younger than 4 to 5 years, heard over the temporal area

what do bruits indicate after 5 years of age

increased intracranial pressure, aneurysm, or anteriovenous shunt

isolated head tremors

benign and include head nodding and tongue protrusion

what will the neck look like

increased anterior cervical concave curve when the head and jaw are extended forward to compensate for kyphosis of the spine

why are young adults susceptible to concussion

thinner cranial bones, larger head-to-body ration, immature CNS, and larger subarachnoid space in which the brain can rattle

what is the mnemonic for stages of increasing exercise levels after a concussion

BRAIN

what is the B in brain

stationary bike

what is the R in BRAIN

running

what is the A in BRAIN

agility

what is the I in brain

full contact controlled practice after med clearance

what is the N in BRAIN

no restrictions

what do tension HA originate

musculoskeletal, most common type is stress HA

where are the 3 categories of tension headaches

episodic infrequent, episodic frequent, and chronic

how often are episodic infrequent

less than a day a month

how often are episodic frequent

less than 15 days a month for 3 months

how often are chronic tension headaches

more than 15 days a month for 3 months

where are tension HA usually

bilateral, across frontal, temporal, and/or occipital region of head

how are tension HA usually described

bandlike tightness, viselike, nonthrobbing, nonpulsatile

how long do tension HA last

gradual onset, lasts 30 min to 7 days

quantity and severity of tension HA

diffuse, dull aching pain, mild-to-moderate pain

when do tension HA usually happen

situational, in response to overwork, posture

what usually help relieve tension HA

abortive meds, preventive meds, and nonpharmacologic aids

what usually helps relieve migraines

lie down, darken room, abortive therapies, preventive meds, alternative therapies, and lifestyle changes

what happens in the prodrome stage of a migraine

hours to days before migraine, change in mood, behavior

what happens in the aura stage of a migraine

visual changes, tingling in arms or legs

how long does the migraine attack stage of a migraine last

4-72 hrs

what happens in the postdrome stage of a migraine

24-48 hrs, irritability

quantity and severity of a migraine

moderate-to-severe pain

what is a migraine usually described as

throbbing, pulsating

where are migraines usually located

usually one-sided, pain is behind the eyes, temples, or forehead

where do migraines usually originate

trigeminal nerve or vascular origin

where is a brief overview of a cluster HA

intermittent, excruciating, unilateral, with autonomic signs

where do cluster HA usually happen

always one-sided, behind or around the eye, temple

where are cluster HA usually described as

continuous, sharp, burning, piercing

how long do cluster HA usually last

abrupt onset, peaks in minutes, lasts 15-180 min

quantity and severity of cluster HA

can occur multiple times a day, in “clusters”, very severe pain

how often do cluster HA usually happen

1-2/day up to 8/day for weeka or months

relieving factors of cluster HA

aborptive therapies, preventive meds

hydrocephalus

obstruction of drainge of CSF results in excessive accumulation, increasing intracranial pressure, and enlargement of the head

what is the cracked pot sound known as

Macewen sign

plagiocephaly

asymmetry of the cranium when seen from the top caused by positional preference

what can mitigate plagiocephaly

tummy time, PT, and corrective therapies

craniosynostosis

premature closing of one or multiple cranial sutures results in malformed head and a cosmetic deformity

5 characteristics of atopic (allergic) facies

exhausted face, blue shadows below the eye from sluggist venous return, crease on lower eyelids (morgan lines), central facial palloar and open mouth breathing

allergic salute and crease

child uses the hand to push the nose up and back to relieve itching and free swollen turbinates

4 characteristics of fetal alcohol spectrium disorders

narrow palpebral fissures, smooth philtrum, thin upper tip, and micfacial hypoplasia

5 characteristics of down syndrome

upslanting eyes with inner epicanthal folds, flat nasal bridge, small, broad, flat nose, protruding thick tongue, ear dysplasia, and short, broad neck with nuchal folds

congenital torticollis

hematoma in one sternomastoid muscle, results in head tilt to one side and limited neck ROM to the other side

simple diffuse goiter

endemic goiter, low iodine

multinodular goiter

indicate inflammation rather than neoplasm

graves disease

goiter, eyelid retraction, exophthalmos, forceful tachycardia

myxedema

puffy edematous face around eyes, cool dry skin, slowed reflexes

acromegaly

too much GH after puberty, enlarged skull and thick cranial bones

cushing syndrome

“moonlike” face, prominent jowls, red cheeks, hirsutism on upper lips, lower cheeks, and chin with acneiform rash on chest