Ch 14. Head, face, and neck, including regional lymphatics

What is the function of the skull?

The skull is a rigid box that protects the brain.

What does the skull include?

The skull includes the bones of the cranium and face

What supports the skull?

The skull is supported by the cervical vertebra.

Name the cranial bones.

Frontal, Parietal, Occipital, Temporal.

What forms facial expressions?

Facial expressions are formed by facial muscles, which are mediated by cranial nerve VII, the facial nerve.

Where is the temporal artery located and what can be felt?

The temporal artery lies superior to the temporalis muscle, and its pulsation is palpable anterior to the ear.

What is the major role of the lymphatic system?

The lymphatic system is a major part of the immune system.

What is the purpose of lymphatic drainage

Lymphatic drainage helps prevent potentially harmful substances from entering the circulation.

What are lymph nodes?

Lymph nodes are small, oval clusters of lymphatic tissue that filter lymph and engulf pathogens.

How do facial bones and orbits appear in aging adults?

Facial bones and orbits appear more prominent in aging adults.

What happens to facial skin in aging adults?

Facial skin sags in aging adults.

• less elastic

What is the leading cause of acute pain and lost productivity?

Headache is the leading cause of acute pain and lost productivity.

• define it

What is the most common type of headache?

Tension-type headache is the most common.

• The most common type, caused by stress, muscle tension, or poor posture. Feels like a tight band around the head.

What is the second most common type of headache?

Migraine is the second most common type of headache.

• Intense, throbbing pain, often on one side of the head. Can come with nausea, sensitivity to light/sound, and visual disturbances (aura).

What are the two categories of migraines?

Migraines are categorized as episodic and chronic.

• Chronic Migraine – Occurs 15 or more days per month for at least 3 months. Symptoms are more frequent and can be more disabling.

• Episodic Migraine – Occurs less than 15 days per month. Symptoms come and go, with pain-free periods in between.

Why is it important to identify triggers for headaches?

Identifying triggers helps in managing headaches and reducing their frequency or severity.

What is important to understand regarding headaches and daily activities?

It’s important to understand the impact of headaches on activities of daily living (ADLs).

Subjective data

• headache

• head injury

• dizziness

• neck pain

• lumps or swelling

• history of head or neck surgery

What does "normocephalic" mean when assessing the skull?

Normocephalic means the skull is round and symmetric.

How do you assess the shape of the skull?

To assess the shape, place fingers in the person's hair and palpate the scalp.

What should you note when inspecting facial structures?

Note the facial expression and any involuntary movements.

What should you assess for head and neck symmetry?

• The head position should be centered in midline, and accessory neck muscles should be symmetric. The head should be held erect and still.

What should you note when assessing range of motion in the neck?

• Note any limitations in the range of motion.

How do you test muscle strength in the neck?

Test muscle strength by asking the person to resist pressure while turning their head against your hand or shrugging their shoulders against resistance.

How should you palpate lymph nodes in the neck?

• Palpate nodes noting location, size, shape, delimitation, mobility, consistency, and tenderness.

• THEY SHOULD BE NON PALPABLE, NOT MOVEABLE, AND NOT TENDER

How should you palpate lymph nodes?

Use a gentle circular motion of finger pads to palpate the lymph nodes.

Which lymph nodes should you start with when palpating?

Begin with the preauricular lymph nodes in front of the ear.

How many groups of lymph nodes should you palpate?

You should palpate the 10 groups of lymph nodes in routine order.

Why should you not vary the sequence when palpating lymph nodes?

Varying the sequence may cause you to miss some small nodes.

What may happen to temporal arteries in aging adults?

Temporal arteries may look twisted and prominent.

Is a mild rhythmic tremor of the head normal in aging adults?

Yes, in some aging adults, a mild rhythmic tremor of the head may be normal.

What are senile tremors?

Senile tremors are benign and include head nodding and tongue protrusion.

What are the signs of Cushing syndrome?

Classic "moonlike" face, red cheeks, and hirsutism.

What is Bell's palsy and its effect on the face?

Paralysis on one side of the face due to a lower motor neuron lesion.

How does a stroke or brain attack affect facial appearance?

It leads to paralysis of the lower facial muscles due to an upper motor neuron lesion.

What is the classic facial appearance of Parkinson syndrome?

• "Masklike" appearance, elevated eyebrows, staring gaze, oily skin, and drooling due to dopamine deficiency.

What is the cachectic appearance and what causes it?

Sunken eyes, hollow cheeks, and a defeated expression, typically seen in chronic wasting diseases.

• extreme weight loss