307 (Exam 2) Ch 14: Head, Face, and Neck, and Regional Lymphatics

_____ is rigid box that protects the brain

Skull

Crainal bones consists of:

-

-

-

-

Frontal

Parietal

Occipital

Temporal

Facial expression formed by Facal muscles are mediated by what Cranial Nerve?

Cranial nerve VII

Which gland are in the cheeks over the mandible, the largest of the salivary glands, and are not normally palpable?

Parotid glands

this gland is beneath the mandible at angle of jaw

Submandibular

Which gland lies at the floor of the mouth?

Sublingual gland

Which artery lies superior to temporals muscle and pulsation is palpable to anterior to ear?

Temporal Artery

sternomastoid and trapezius muscles are innervated by which CN?

cn XI

Sternomastoid enables head ___ and ___ and divides each side of neck into two triangles: anterior and posterior triangles

Rotation and flexion

Two trapezius muscles move shoulders and ______ and _____ head

extend, and turn

Which hormones stimulate rate of cellular metabolism?

T4 thyroxine and T3 Triiodothyronine

Which gland straddles trachea in the middle of the neck?

Thyroid gland (Endocrine Gland)

Thyroid gland has how many lobes?

2

The thyroid is Connected in the middle by a thin _______ and above that by the _______ ______ or ________ _______ ring

Isthmus, cricoid cartilage, upper tracheal ring

Lymphatic system is part of what system?

Immune system

The immune system ______ and ______ foreign substances from the body

detects

eliminates

the greatest supply of lymph nodes are in the ______ and _____.

head and neck

What does the lymphatic drainage help prevent?

prevents potentially harmful substances from entering the circulation

preauricular lymph node located

in front of ear

Posterior auricular (mastoid) lymph node is located...

superficial to mastoid process

occipital lymph node located

base of skull

submental lymph node located

midline, behind tip of mandible

submandibular gland

halfway between angle and tip of mandible

Jugulodiagastric node

under angle of mandible

superficial cervical lymph nodes

overlying sternomastoid muscle

deep cervical lymph nodes

deep under sternomastoid muscle

posterior cervical nodes

in posterior triangle along edge of trapezius muscle

Supraclavicular lymph node

just above and behind clavicle, at sternomastoid muscle

Nodes greater than 1 cm from:

-

-

-

- infection

- allergy

- neoplasm (infectious mononucleosis)

Hx of head questions ask for....

-changes in levels of consciousness and/or

falls

Hx of head injuries ask:

-

-

-

-

dizziness

neck pain

lumps or swelling

hx of head or neck sx

Inspect and palpate the skin for

- general ____ and _____

-

- palpate _____ ____ and _____

- size and contour

- deformities

- temporal artery, TMJ

If enlarged auscultate thyroid for

bruit

Inspect and palpate the skull for ____ and ______

size and shape

Normocephalic???

round and symmetric skull

assess shape of the skull by: placing fingers in person's _____ and palpate the ______

hair, scalp

in the temporal area, palpate this artery above zygomatic (cheek) bone between eye and top of ear

temporal artery

these facial structures should always be symmetric

-

-

-

-

eyebrow,

palpebral fissures, nasolabial folds,

sides of mouth

note ______ expression and appropriateness to behavior or reported mood

facial

Note any ______ facial structures

abnormal

note any _____ movements (tics) in facial muscles, normally none occur

involuntary

when inspecting the head and neck, the head position should be ______ in midline and ______ ______ muscles should be symmetric

centered

accessory neck

Head should be held ______ and _____

erect

still

Palpate lymph nodes noting:

-

-

-

-

-

-

-

location

size

shape

delimitation

mobility

consistency

tenderness

when inspecting the trechea it should be_____, palpate for any _______ shift, note any _______ from midline

midline

tracheal

deviation

what are the best approaches to palpate the thyroid gland?

posterior approach

anterior approach

Auscultate thyroid for ______., if enlarged.

bruit

when doing a physical exam on an aging adult, position the _________ _____

to minimize potential for dizziness

changes slowly

There types of headaches:

-

-

-

tension

migraine

cluster

Endemic Goiter is due to _______ deficiency that results in chronic enlargement of the thyroid gland

iodine

multiple nodules usually indicate______ or multi-nodular goiter rather than a neoplasm

inflammation

Grave's Disease/ hyperthyroidism:

physical presentation neck and face:

-

-

-

goiter

eyelid retraction

exophthalmos

Hypothyroidism physical presentations of neck and face:

-

-

-

-

- puffy edematous face

- preorbital edema

- coarse facial features

- coarse hair and eyebrows

UMN lesion leading to paralysis of lower facial mucles is what chronic illness

stroke or brain attack

This chronic illness has a classic "maskline" appearance, elevated eyebrows, staring gaze, oily skin, and drooling due to dopamine deficiency

Parkinson Syndrome

in aging adults, facial bones and orbits appear more______

prominent

in aging adults, skin sags resulting from

-

-

-

- decrease elasticity

- decrease subcutaneous fat

- decrease moisture in skin

Primary Headaches are dx by _____ with no abnormal findings on exam or lab results

Patient Hx

Factors to review with primary headaches

Definition

Location

Character

Duration

Quantity

Severity

Timing

Pt is in for a first visit. You note the following: narrow palpebral fissures, Epicanal folds, mid facial hypoplasia. What condition do you suspect?

Fetal Alcohol Spectrum disorder

fetal alcohol spectrum disorder discriminate features:

Short/narrow palpebral fissure

Flat mid face

Short nose

Thin upper lip

fetal alcohol spectrum disorder associated features:

Epicanthial folds

Low nasal bridge

Ear abnormalities

Microgbathia

Nodes greater than 1cm from infection, allergy, or neoplasm?

Lymphadenopathy

Think of neck as a _______ of many structures

conduit

(as part of the conduit): vessels, muscles, nerves, lymphatics, viscera of _____ system and ____system

respiratory and digestive

(part of the conduit ): Internal carotid branches off _____ _____ and runs ________ and _______ to supply the brain

-common carotid

-inward

-upward

(part of the conduit): external carotid supplies:

-

-

-

- face

- salivary glands

- superficial temporal area

subjective data health history:

-

-

-

-

-

-

- h/a

-head injury

-dizziness

-neck pain/limited rom

-hx of neck or head sx

-lumps & swelling

(dizziness) should provide a description of "feeling" in patient's...

own words

(dizziness) is associated with

-

-

-

-change of position

-nausea

-vomiting

(dizziness and/or neck pain for aging adults) what should you ask?

how does it affect your daily activities/ ADLs?

(aging adults) temporal arteries may look ______ and ______

twisted

prominent

(aging adults) a mild rhythmic tremor of the head may be _____

normal

(aging adults) senile tremors are ____ and include ____ ___ and ____ _____

-benign

-head nodding

-tongue protrusion

(aging adults) if some teeth have been lost, lower face looks unusually ____, with ______ sunken in

small

mouth

(aging adults) neck may show an increased concave curve to compensate for ______

kyphosis

parotid gland enlargement: rapid painful enlargement seen in response to _______, _____ of duct, ____, or _______

-mumps

-blockage

-abscess

-tumor

Thyroid gland enlarges slightly during pregnancy as a result of _____ of tissue and _______ vascularity

hyperplasia

increased

Why can the lower face look smaller for aging adults?

missing teeth