Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
106 Cards in this Set
- Front
- Back
|
Headaches |
Numerous types: migraine, tension, cluster, sinus, brain tumor, etc Note frequency, severity, onset, localization |
|
|
Migraine |
Believed to be vasoconstriction of vessels in the head |
|
|
Head Injury |
Note history of trauma, LOC, seizures Epilepsy: use of helmets, education
|
|
|
Concussion |
LOC Brain bruise Repeated concussions cause brain damage r/t neurons inability to heal and regenerate |
|
|
Dizziness vs. Vertigo |
Dizziness: lightheadedness, decreased perfusion to brain, vascular Vertigo: true rotational spinning, cerebellum or inner ear |
|
|
Neck pain |
History of trauma, injury, cervical arthritis Could be r/t a poor pillow Neurological symptoms in upper extremities: cervical spinal nerves can be compresed by vertebral spaces |
|
|
Sensory symptoms |
Paresthesia: decreased sensation, numbness, tingling |
|
|
Motor symptoms |
Paresis, weakness, decreased ROM |
|
|
Lumps or swelling in neck |
Recent injury, infection: ie, tonsillitis, dental infection, eye infection Cancer: mouth vs throat Environmental exposure: ie, radiation, toxic chemicals Thyroid problems: goiter, cancer |
|
|
Dysphagia |
Difficulty swallowing Could be r/t throat cancer, oral cancer |
|
|
Throat cancer |
Increased CA risk with ETOH and smoking |
|
|
Mouth Cancer |
Increased CA risk with smokeless tobacco and pipes |
|
|
Neck: meds |
Analgesics Thyroid replacement |
|
|
Thyroid disorder |
If suspected thyroid disorder, ask related ROS questions for Hyper vs Hypothyroidism |
|
|
Hyperthyroidism ROS |
Tachycardia Diarrhead Fine, silky, soft hair Nervousness Hot Weight loss |
|
|
Hypothyroidism ROS |
Bradycardia Constipation Dry, skin, brittle hair Fatigue Cold Weight |
|
|
Habits of the mother |
Drugs, ETOH, delivery problems Effects development of facies (appearance of face) ie, Fetal ETOH syndrome |
|
|
Head Structure |
Four sets of skull bones: frontal, parietal, temporal, occipital Sagital sutures: separate left to right |
|
|
Head palpation and inspection |
Remove wigs, hair pieces Feel normal bony protrusions of skull Palpate for lumps, depressions, or swelling, especially important s/t head trauma Normocephalic (round and symmetric) |
|
|
NCAT |
Normocephalic, atraumatic Cannot use NCAT s/p trauma |
|
|
Face structure |
Fused bones (non moveable): frontal, nasal, zygomatic, lacrimal, sphenoid, maxilla Mandible (moveable joint): connects temporal bone at TMJ |
|
|
Inspect face |
Assess symmetry Eyebrows Palpebral fissures Nasolabial folds Ears, nose, mouth Expression Skin (pigmentation, lesion, edema) Hair (normal vs hirsutism/endocrine disorder) Involuntary movements/tics Swelling |
|
|
CN V |
Trigeminal: motor and sensory Motor: innervates muscles of chewing (temporal and masseter muscles), assess strength while clenching teeth, assess lateral jaw strength Sensory: 3 zones of sensation, ophthalmic, maxillary, mandibular |
|
|
CN VII |
Facial Nerve: motor and sensory Motor: assess facial movement, experssion (smile, frown, puff cheeks, raise brows, close eyes agains resistance), symmetry Sensory - test sweet and salty to anterior 2/3 of tongue |
|
|
Parkinson's disease |
Effects facial expression Mask-like |
|
|
Palpebral fissures |
Opening between upper and lower lid |
|
|
Nasolabial folds |
Crease from edge of nose to corner of mouth May be absent s/p CVA |
|
|
TMJ Joint |
Anterior to tragus of ear Inspect and palpate while opening and closing mouth Abnormal: opens in zigzag pattern, pain, crepitus, decreased ROM, locking |
|
|
Parotid glands |
Embedded in cheeks over mandibles Nomally not palpable Enlarged with mumps or blocked parotid duct Lose jaw angle |
|
|
Submandibular glands |
Beneath the mandible at angle of jaw May enlarge and become tender with infection |
|
|
Temporal artery |
Feeds the retina Palpate pulse and artery for tenderness and tortuosity May also cause scalp pain when combing hair Auscultate for bruits: indicates stenosed vessel |
|
|
Temporal Arteritis |
Pain over temporal artery is a risk for vision loss Immediate referral for possible temporal artery biopsy If inflammed, may need steroids x6 months or longer |
|
|
Verebra |
Provides support for the head |
|
|
C7 |
Vertebral prominens Long spinous process palpated when head is flexed Prominent occipital bone, first palpated vertebra |
|
|
Neck Vessels |
Carotid and IJ veins lay beneath SCM muscles External jugular vein visible over SCM: seen when neck is strained |
|
|
Carotid |
Most assessable at the angle of jaw where it surfaces |
|
|
Accessory muscles of respiration |
Innervated by the spinal accessory nerve CN XI |
|
|
Sternocleidomastoid Muscle |
SCM Extends from the anterior neck to the mastoid process behind the ear Rotates head side to side |
|
|
Trapezius |
Large, flat, triangular muscle Attaches to the occipital bone and extends to the scapula Helps with shoulder shrug, rotates head to the side and extends head backward |
|
|
Two triangles |
Defined by muscles, used as markers Anterior Triangle: anterior to SCM Poserior Triangle: between SCM and trapezius |
|
|
Midline neck structure |
Hyoid bone (floor of mouth) Thyroid cartilage (Adam's apple): moves with swallowing Cricoid cartilage (upper tracheal ring) Tracheal rings Thyroid gland |
|
|
Thyroid gland |
Endocrine gland 2 lobes and isthmus Secretes thyroxine (T4) and triiodothyronine (T3) Shaped like a butterfly, 5cm x 3 cm x 2 cm Controls metabolism |
|
|
Inspect Midline Neck |
Assess accessory muscles for symmetry Head position Normally no massess, muscular asymmetry, scars, discoloration, or lesions |
|
|
Assess Trachea |
Inspect for midline position Palpate the trachea above the manubrium of the sternum for midline position Note symmetrical space between trachea and SCM on each side |
|
|
Tension pneumothorax |
A collapsed lung that results in a shifting of the thoracic structures and a pulling of the trachea to the unaffected side: "Tracheal pull" Seen in Trauma pts |
|
|
Assess Thyroid |
Inspect and palpate for nodules (Thyroid CA) or thyromegaly (goiter) Check for fullness at the base of the neck (should be flat or concave Not normally palpable Inspect from side, sip of water, push thyroid to the side. Thyroid can't move posteriorly. |
|
|
Assess neck ROM |
Stop of there is pain Movements should be smooth and controlled Flexion: head to chin 45 degrees Lateral flexion: ear to shoulder 40 degrees Rotation: turn right to left 70 degrees Extension: backwards 55 degrees |
|
|
Traumatic neck injury |
Do not manipulate or examine the cervical spine Stabilize the spine until further eval can be performed |
|
|
Assess CN XI |
Spinal accessory Test should shrug against active resistance |
|
|
Lymphatic tissue |
Lymph nodes Spleen (produces antibodies) Thymus (chest) Tonsils and adenoids Peyer's patches (lymph tissue in the intestines) Bone marrow (produces WBCs) |
|
|
Lymphatic functions |
All tissues supplied by vessels have lymph vessels except the cornea, CNS, and placenta Lymph nodes and vessels are dispersed throughout the body Collect interstitial fluid and drain into specific nodes |
|
|
Lymphocytes |
In lymph nodes Filter and engulf bacteria, RBCs, toxins, microorganisms and abnormal cells (CA cells) May lead to metestatic disease Problematic if lymph nodes are not functioning or there are too many toxins |
|
|
Drainage of lymph nodes |
Circulate to the right lymphatic duct or thoracic duct which empties into the subclavian vein |
|
|
Right lymphatic duct |
Drains the right side ofthe body Right head, neck, arm, thorax, lung, pleura, heart, and upper liver. Systemic disease or malignancy is spread if not caught by duct |
|
|
Thoracic duct |
Drains the rest of the body |
|
|
Lymph nodes |
Assessable to examination in 4 areas Head and neck, arms, axillae, inguinal Greatest supply in head and neck Approximately 75 nodes on each side of neck |
|
|
Lymph node location |
Superficial nodes: lie in subcutaneous tissue, may be palpable Deep nodes: lie in muscle, fascia, or body cavities, non-palpable |
|
|
Lymph node characteristics |
Location Size: length, width, depth Shape Consistency: Soft, firm, hard (cancerous) Mobility: moveable vs fixed (cancerous) to adjacent structures Tenderness (infection) Temperature (warm) Numbers of enlarged nodes (singluar vs multiple) |
|
|
Lymphadenopathy |
Enlarged nodes > 1 cm r/t infection, allergy or neoplasm |
|
|
Malignancy |
Hard, fixed, unilateral, nontender node |
|
|
Infection and lymph nodes |
Bilateral, mobile, warm, tender nodes Nodes receive and drain adjacent tissue Look for a source of problem by assessing surrounding nodes |
|
|
Supraclavicular node |
Metastatic site May indicate a neoplasm in the thorax, breast or abd |
|
|
Palpation of lymph nodes |
Use systemic approach Touch lightly with fingertips - may compress nodes if pressing too hard Palpate bilaterally to compare sides Palpate the deep cervical nodes by bending ipsilaterally (same side), muscles relaxed Assess supraclavicular nodes: hunch shoulders to relax muscles first |
|
|
Preauricular nodes |
Anterior to tragus of the ear Drains scalp, forehead, lateral eyelids, eyes, upper face, EAC LAD with eye infection |
|
|
Postauricular nodes |
Behind ear on mastoid process Drains parietal area of scalp and EAC Adenopathy with otitis externa |
|
|
Occipital nodes |
Base of skull Drains parietal region of scalp Adenopathy with scalp lesion |
|
|
Submental nodes |
Midline behind the tip of mandible Drains mouth, lips, and tongue Adenopathy with oral cancer |
|
|
Submaxillary nodes |
Submandibular Located halfway between jaw angle and tip of mandible Drains lips, mouth, tongue, submaxillary glands Adenopathy with oral cancer |
|
|
Tonsillar nodes |
Retropharyngeal or jugulodigastric Located at the angle of the jaw/mandible Drains eyelids, frontotemporal skin, external auditory meatus, tympanic cavity, tonsils, posterior palate, floor of mouth and thyroid Adenopathy with tonsillitis |
|
|
Superficial nodes |
Anterior cervical Overlying the SCM muscle Drains skin of ear and neck |
|
|
Deep cervical chain |
Located under the SCM Drains ear, larynx, thyroid, trachea, upper portion of the esophagus Adenopathy with laryngeal cancer |
|
|
Posterior cervical chain |
Located above and behind the SCM Drains posterior scalp, posterior skin of neck and thyroid adenopathy with thyroid cancer, mononucleosis |
|
|
Supraclavicular Nodes |
Located above and behind the SCM Drains upper abd, lungs, breast and arm adenopathy here is usually bad, r/o neoplasm |
|
|
Newborn and infants: assessment |
Record head circumference to age 2 |
|
|
Fetal skull |
Separated by sutures and fontanel: allows for growth of brain Posterior fontanel Anterior fontanel |
|
|
Posterior fontanel |
Triangle shape Closes at 2 months |
|
|
Anterior fontanel |
Diamond shape Closes at 24 months |
|
|
Sunken fontanel |
Dehydration |
|
|
Buldging fontanel |
Increased ICP |
|
|
Craniosynostosis |
Premature closure of one or more cranial sutures while brain growth continues |
|
|
Children and lymphatics |
Overactive lymphatic system LAD seen frequently Enlarged nodes common with minor infection |
|
|
Pregnancy and lymphatics |
Chloasma Prominent facial bones r/t decreased tissue elasticity |
|
|
Chloasma |
Facial discoloration Happens in pregnancy |
|
|
Aging adults and lymphatics |
Change in curve of the neck to compensate for kyphosis Prominent facial bones r/t decreased tissue elasticity |
|
|
Microcephalus |
Abnormally small head |
|
|
Hydrocephalus |
Obstruction to CSF drainage results in an enlarged head and increased ICP |
|
|
Sebaceous cysts |
Wen Smooth, firm, mass on the scalp r/t occlusion of the sebaceous duct |
|
|
Trisomy 21/Downs syndrome |
3 chomosomes instead of 2 Eyes have inner epicanthal fold, flat nasal bridge, small broad flat nose, protruding thick tongue, ear dysplasia (incorrect slant) and short broad neck with webbing |
|
|
Epicanthal fold |
Extra fold on skin covering inner corner of eye |
|
|
Acromegaly |
Excessive secretion of growth hormone produces an enlarged skull Thickened cranial bones and coarse facial features Increased bone and soft tissue development |
|
|
Parkinson's disease |
Mask-like face with staring gaze Doesn't show expressions |
|
|
Cushing's syndrome |
Increased adrenal glucocorticoids Moonlike/round face, prominent jowls, hirsutism |
|
|
Nephrotic Syndrome |
Face edematous and pale Periorbital edema |
|
|
Graves Disease |
Hyperthyroidism Exophthalmos - protruding eyeballs |
|
|
Myxedema |
Sever hypothyroidism Puffy face Periorbital edema Dry skin and hair Eyebrows coarse and thin at lateral margins |
|
|
Facial asymmetry |
CVA - able to wrinkle forehead Bell's Palsy - can't wrinkle forehead Tics/fasiculations |
|
|
Tics/Fasiculations |
Involuntary contraction of a muscle group |
|
|
Bell's Palsy |
Maybe r/t HSV I Paralysis of CN VII - facial Self-limiting May have inability to close or open eye, which leads to dryness and corneal abrasions |
|
|
Painful facial disorders |
Temporal arteritis Trigeminal neuralgia Herpes Zoster |
|
|
Herpes Zoster |
Inflammation along any nerve root |
|
|
Temporal arteritis |
Pain with palpation of temporal artery |
|
|
Trigeminal neuralgia |
Tic Delaroux Affects CN V - trigeminal Extremely painful |
|
|
Lymphadema |
Excessive collection of fluid in interstitial spaces r/t blocked or infected lymphatic channel Acquired r/t lymph duct trauma: surgery (mastectomy), metastasis, NO BP on affected side because it damages remaining lymphatics and can lead to infection r/t decreased immunities Congenital LAD: milroy disease |
|
|
Milroy disease |
Mal-development of the lymph system Congenital LAD |
|
|
Acute lymphangitis |
Inflammation of lymph vessels r/t strep infection of any extremity Red streaks extending to axilla or groin, f/c Signifies infection is spreading |
|
|
Acute lymphadentitis |
Inflammation of lymph nodes r/t systemic neoplastic disease, bacterial infection, or other inflammatory condition Enlarged, tender, firm nodes with surrounding edema and erythema ie, cat scratch disease |
