Ch 14 - Head, Face, and Neck, Including Regional Lymphatic System

Head - Structure and Function

• Cranial & Facial Bones - frontal, occipital, sphenoid, ethmoid, 2 parietal, 2 temporal, 2 nasal, 2 lacrimal, 2 maxilla, 2 zygomatic, 2 vomer, and mandible

• Sutures - (immovable joints where the bones joined together) lambdoid, sagittal, coronal

• Facial Muscles

• Salivary Glands - parotid glands and cheeks over mandible, submandibular glands beneath mandible at the angle of the jaw, sublingual glands are under the tongue, floor of the mouth

These facial structure should appear symmetrical when assessing the patient

Neck - Structure and Function

• 2 Major Muscles of the Neck

  • Sternocleidomastoid Muscle

  • Trapezius Muscle

• Sternocleidomastoid Muscle

  • Two headed neck muscle, attachments to the manubrium of the sternum, the clavicle, and the mastoid process of the temporal bone

• Many major blood vessels, nerves, and lymphatic vessels also passed through the neck

• Thyroid Gland

  • Straddles the trachea in the middle of the neck

  • Butterfly shaped organ on either side of the trachea

Neck Triangles

• Anterior Triangle

  • Lies in front, between the sternomastoid and the midline of the body

  • It's base is up along the lower border of the mandible and it's Apex is down

• Posterior Triangle

  • Lie behind this sternocleidomastoid muscle with the trapezius muscle on the other side and it's base along the clavicle bone

Lyphatics - Structure and Function

• Lymphatic system includes tissues, organs, and vessels that fight infection and maintain fluid balance

• The lymph nodes located in the head and neck are:

  • Preauricular - in front of ear

  • Posterior auricular - superficial to the mastoid process

  • Occipital - at the base of the skull

  • Submental - midline behind the top of the mandible

  • Submandibular - halfway between the angle and the tip of the mandible

  • Tonsillar

  • Superficial cervical

  • Deep cervical

  • Posterior cervical

  • Supraclavicular

Subjective Data: Health History

• Headache

• Head injury

• Dizziness

• Neck pain or limitation of motion

• Lumps or swelling

• History of head or neck surgery

Objective Data: Physical Exam

• Head - inspect and palpate the skull

• Size and shape

• Temporal area

  • Temporal artery

  • Temporomandibular joint

• Head- inspect the face

• Facial structures

Objective Data: Physical Exam - The Neck & Lymph Nodes

• Inspect and Palpate

  • Symmetry

  • Range of motion

  • Lymph nodes (if palpable, note, location, size, shape, delimination, mobility, consistency, and tenderness)

• Trachea

• Thyroid gland

  • Palpate the thyroid gland (posterior approach, anterior approach, auscultate for the present of bruit)