health module: head and neck

what do you record in hair?

• quantity

• distribution

• texture of the hair

• pattern of hair loss

what do you record when inspecting the scalp?

• scaliness

• lumps

• nevi

• lesions

when inspecting the head what do you record?

• size

• shape

• configuration

what do you observe and document when inspecting the face?

• skin color

• pigmentation

• texture

• thickness

• hair distribution

• lesions

always ______ the patient before palpating, and ask them for their ________ first

inform; permission

use the _____ of your index and middle fingers, move the skin over the underlying tissues in each area in a circular motion when palpating the lymph nodes

pads

what is the correct sequence of the head inspection?

1. hair

2. scalp

3. head as a whole

4. face

5. skin

hyperthyroidism

overly fine hair

hypothyroidism

dry or coarse hair

scalp

• seborrheic dermatitis, psoriasis, redness, and scaling

• soft lumps of pilar cysts

• pigmented nevi

skin

• acne

• hirsutism - overproduction of facial hair

• nephrotic syndrome - pale, swollen face

what are the types of assymetry in the head?

1. microcephaly: abnormally small head

2. acromegaly: skull and facial bones → larger & thicker

3. paget’s disease: acorn-shaped, enlarged skull bones

what are the types of inconsistencies in the head?

• deformities

• depressions

• lumps

• tenderness

• signs of recent trauma or cancer

what are the types of involuntary movements of the head?

• neurologic disorders: horizontal jerking movement

• nodding: aortic sufficiency

• tilted to 1 side: unilateral vision or hearing deficiency, shortening of sternomastoid muscle

what are the signs of irregularities to look for in the head?

temporomandibular joint dysfunction (TMJ)

what are the abnormal findings to look for in a patient’s face?

• edema (periorbital edema)

• involuntary facial movements (tics, fasciculations, tremors)

• masses

• temporal arteries (hard, thick, tender w/ inflammation; can lead to inflammation)

• abnormal face shape

what are the signs of abnormal face shapes to look out for?

• asymmetry in front of earlobes → parotid gland enlargement from abscess or tumor

• unusual/asymmetric orofacial movements → organic disease or neurologic problem

• bell’s palsy → drooping, weakness, paralysis on one side of face

• CVA → drooping, weakness, paralysis on one side of face & paralysis / weakness on other side of body

• parkinson’s disease → “mask-like” face

• cachexia → “sunken” face

bell’s palsy

drooping, weakness, paralysis on one side of face

CVA

drooping, weakness, paralysis on one side of face & paralysis / weakness on other side of body

parkinson’s disease

“mask-like” face

cachexia

sunken face

what are the 5 different types of headache?

1. sinus

2. cluster

3. tension

4. migraine

5. tumor related

headaches can be warning signs of conditions such as:

1. elevated blood pressure as an acute onset

2. photophobia: sensitivity to light or sound

3. rash or signs of infection

4. cancer, HIV, or pregnancy

characteristics of head injury include:

• concussions

• deformities

• depressions

• lumps

• tenderness

• suture line

potential causes of head injury include:

• transportation accidents

• violence

• falling

• excessive alcohol ingestion

• infants & elderly being cared for by caregivers

• abuse - domestic, infants or elderly being cared for

• blow to head

• piercing head injury

what conditions may be a reason for head or neck surgery?

• acromegaly

• scleroderma

• bell’s palsy

• brain

• tumor

• craniotomy

posterior cervial

the group of nodes posterior to the sternocleidomastoid muscle; common in mononucleosis

facial asymmetry may indicate inflammation of which cranial nerve with bell palsy?

cranial nerve VII

how do you assess a client’s TMJ?

place your finger over the front of each ear as you ask the client to open her mouth

what instruction should the nurse provide to assess a client’s TMJ?

“i’m going to put my fingers in front of your ears and ask you to open your mouth wide”

A 57-year-old client reports, 'I am having the worst headache I have ever experienced.' Which action should the nurse perform next?

Assess the client's blood pressure

• rationale: Markedly elevated blood pressure could be indicative of imminent danger to the client's life. Assessment of the blood pressure should be the nurse's first action.

A client presents to the emergency department with reports of neck pain and a sudden onset of a headache. Upon examination, the nurse finds that the client has an increased temperature and nuchal rigidity. The nurse recognizes these findings as most likely to be caused by what condition?

Meningeal inflammation

Meningeal inflammation

manifests as sudden headache, neck pain with stiffness, and fever

Migraine headaches are accompanied by

nausea, vomiting, and sensitivity to noise or light and not by fever and neck stiffness.

Trigeminal neuralgia is manifested by

sharp, shooting, piercing facial pains that last from seconds to minutes