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62 Cards in this Set
- Front
- Back
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Head and Neck: Anatomy and Physiology
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The head and neck provide protection for the brain and house four of the senses.
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Anatomy and Physiology: Skull: Skull bones
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Seven fused skull bones used as landmarks
Frontal Parietal Temporal Occipital |
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Anatomy and Physiology: Skull:Facial Cavities
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Facial cavities
Eyes Nose Mouth |
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Anatomy and Physiology: Skull: Face bones
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Frontal
Zygomatic Nasal Ethmoid Lacrimal Sphenoid Maxillary Mandible |
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Anatomy and Physiology: Skull: Major Landmarks
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Major landmarks
Palpebral fissures Nasolabial folds |
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Palpebral fissures
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upper and lower eye lid lines.
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Which cranial nerves innervate the face?
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Cranial nerves V and VII innervate face
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What is the major artery of the face?
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Temporal - major artery of face
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Anatomy and Physiology: Salivary glands: Function
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Produce saliva
Moistens mouth Prevents caries Initiates digestion of carbohydrates |
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Anatomy and Physiology: Salivary glands: Name Them
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Three paired glands
Parotid gland - anterior to ear, above mandible Submandibular gland - medial to mandible at angle of jaw Sublingual gland - anterior in floor of mouth |
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Anatomy and Physiology: Neck: Function
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Provides support and movement
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Anatomy and Physiology: Neck:Structure formed by
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Cervical vertebrae
Ligaments Sternocleidomastoid muscles Trapezius muscles |
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Anatomy and Physiology: Neck:Landmark triangles:Posterior Triangle
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Posterior triangle - trapezius, SCM, and clavicle
Content: Posterior cervical lymph nodes |
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Anatomy and Physiology: Neck:Landmark triangles:Anterior Triangle
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Anterior triangle - medial border of SCM and mandible
Content: Hyoid bone, cricoid cartilage, trachea, and anterior cervical lymph nodes |
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Anatomy and Physiology: Neck: Thyroid
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Thyroid - largest endocrine gland in body
Located on each side of the trachea and joined by the isthmus below the cricoid cartilage Produces two hormones (T3 , T4 ) |
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Anatomy and Physiology: Infants
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Cranial bones soft and separated by sutures
Sutures and fontanels permit skull expansion to accommodate brain growth Sutures ossify (age 6-18) Fontanels close (age 2 months-2 years) Anterior closed by 18-24 months Skull molding - from vaginal birth Skull bones shift/overlap Resumes normal shape/size within days |
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Anatomy and Physiology: Adolescents
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Male facial changes
Nose/thyroid cartilage enlarge Facial hair appears |
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Anatomy and Physiology: Pregnant Women
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Changes in thyroid gland/hormones
Enlarged thyroid Mask of pregnancy (chloasma) |
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Anatomy and Physiology: Older Adults
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Decreased Production and degradation of T4
Fibrotic thyroid gland |
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Related History: Present Problem: Head Injury
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Independent observer’s description of event
State of consciousness after injury Predisposing factors Associated symptoms Medications Return to Sports Recommendations |
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Related History: Present Problem:Headache
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Onset
Duration Location Character Pattern Associated symptoms Precipitating factors Treatment efforts Medications |
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Related History: Present Problem:Stiff neck
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Neck injury/strain, head injury, swelling
Fever, bacterial/viral illness Character Predisposing factors Efforts to treat Medications |
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Related History: Present Problem: Thyroid Problem
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Changed temperature preference
Swelling of neck Trouble swallowing Redness Pain Changes in hair, skin, or nails Change in emotions Increased Eye prominence Blurred/double vision Tachycardia Menstrual flow change Changed bowel habits Medications |
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Related History: Past Medical History
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Head trauma
Recent lumbar puncture Radon/radium treatment of head or neck Headaches Seizure disorder Thyroid dysfunction/surgery |
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Related History: Personal/Social History
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Employment risks
Stress Injury risks Recent weight gain/loss Food intolerances Use of alcohol/drugs |
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Related History: Family History
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Headaches
Thyroid dysfunction |
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Related History: Infants
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Prenatal history
Birth history Unusual head shape Head control Acute illness Congenital anomalies Neonatal screening for hypothyroidism |
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Related History: Pregnant Women
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Gestation/postpartum
Presence of preexisting disease History of pregnancy-induced hypertension Medications |
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Related History: Older Adults
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Dizziness with head/neck movement
Weakness/impaired balance |
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Exam & Findings: Head and Face: Inspection
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Head position/shape
Skull size/shape Scalp Hair pattern Facial features Facial asymmetry Tics Spasms |
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Exam & Findings: Head and Face: Palpation
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Skull symmetry/smoothness
Scalp movement Hair texture Temporal arteries TMJ joint space Salivary glands |
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Exam & Findings: Head and Face: Percussion
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Percussion and auscultation not routine
Sinuses can be percussed |
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Exam & Findings: Head and Face: Auscultation
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Percussion and auscultation not routine
Can listen for bruits over skull and eyes |
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Exam & Findings: Neck Inspection
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Muscles symmetry
Alignment of trachea Triangles landmarks Kernigs Supine flex hips then extend the knees Brudzinskis Flexion of the hips and knees with flexion of the neck Masses Webbing Excess skin folds Unusual shortness Asymmetry Carotid artery prominence Jugular vein distension ROM |
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Kernigs
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Supine flex hips then extend the knees
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Brudzinskis
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Flexion of the hips and knees with flexion of the neck
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Exam & Findings: Neck Palpation
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Tracheal alignment
Smoothness/tenderness Hyoid bone Thyroid cartilage Cricoid cartilage Tracheal tugging |
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CERVICAL NODES
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XXXXXX
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Exam & Findings: Thyroid Gland Inspection
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Symmetry
Swallowing symmetry |
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Exam & Findings: Thyroid Gland Palpation
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Size
Shape Configuration Consistency Tenderness Nodules |
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Exam & Findings: Thyroid Gland Auscultation
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Enlarged gland
Vascular sounds |
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Exam & Findings: Infants Inspection
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Head circumference
Head symmetry of shape Fontanels Scalp scaling/crusting, dilated scalp veins Hair/hairline Caput succedaneum Birth Trauma Crosses suture Cephalhematoma Hematoma Does not cross suture |
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Caput succedaneum
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Birth Trauma
Crosses suture |
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Cephalhematoma
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Hematoma
Does not cross suture |
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Exam & Findings: Infants Inspection
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Head control/position/ movement
Facial features Facial symmetry Neck symmetry/size/shape |
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Exam & Findings: Infants Palpation
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Suture lines/fontanels
Craniotabes- a softening of the outer tables of the skull above and behind the ears. A snapping sensation similar to the bounce of a pingpong ball indicates craniotabes. Neck muscle tone/masses Trachea Thyroid goiter |
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Craniotabes
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- a softening of the outer tables of the skull above and behind the ears. A snapping sensation similar to the bounce of a pingpong ball indicates craniotabes
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Exam & Findings: Infants: Transillumination
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Transillumination
All newborns Older infants with suspected intracranial lesion or rapidly increasing head circumference Should have a ring of light about 2cm in all but the occipital region (1cm) |
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Exam & Findings: Children
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Percussion of skull to detect Macewen sign
Bruits common in children up to 5 years of age Thyroid may or may not be palpable Percuss skull has a thud quality like striking a cracked pot, normal if fontenals are open, related to increased intercranial pressure if the fontonells are closed. |
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Exam & Findings: Pregnant Women
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Inspect for chloasma
Palpate for hypertrophy of thyroid Auscultate for thyroid bruit |
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Chloasma
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Mask of pregnancy. 16weeks blotchy, brownish hyperpigmentation of the face.
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Exam & Findings: Older Adults
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Facies vary with nutritional status
Sunken eyes Eyelids loose and wrinkled Evaluate ROM of neck Pain/crepitus Jerkiness/limited movement Palpate thyroid for nodules/irregularities Thyroid more fibrotic as individual ages Feels more nodular or irregular on palpation |
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Common Abnormalities: Head
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Headache
Migraine Cluster Hypertensive Muscular tension Temporal arteritis |
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Common Abnormalities: Facies
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Facies - expression or appearance of face and features of head/neck that are characteristic of a clinical condition
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Common Abnormalities: Thyroid Gland: Myedema
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Hypothyroid
Cold Weight gain Coarse/breakable Scaly dry skin Thick nails Puffy eyes No goiter Constipation Menorrhagia Lethargy |
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Common Abnormalities: Thyroid Gland: Adult Onset hypothyroidism
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Adult onset hypothyroid
Facial edema, dull expression. Weight gain, hair is coarse, thick fingernails, menorrhagia, constipation |
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Common Abnormalities: Thyroid Gland:Graves disease
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Hyperthyroidism
Hyperthyroid, usually 30-40s women. Thyroid enlargement, weight loss, fine warm skin, hair loss, thin Hot Weight loss Fine hair/hair loss Warm skin Thin nails Proptosis Goiter Tachycardia Diarrhea Amenorrhea Muscle weakness |
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Common Abnormalities: Thyroid Gland: Hashimoto disease
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Hyper to Hypothyroid
in children or 50s year old female. Hypothyroid if chronic. |
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Grade I Concussion
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Transient confusion, no loss of consciousness, and a duration of mental status abnormalities of < 15 minutes.
Athlete should be removed from the sport immediatly and examined and serial exams every 5 minutes, if all mental status abnormalities resolve within 15 minutes, may return to sport activity that day. If athlete sustains a second grade I concussion, the athlete should be removed from sports activity until asymptomatic for 1 week. If the athlete sustains a grade II concussion the same day, they should be removed from sports for 2 weeks. |
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Grade II Concussion
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Transient confusion, no loss of consciousness, and duration of mental status abnormalities of > 15 minutes.
Athlete should be removed from sports immediately and examined and frequent exams there after. If symptoms worsen or continue for longer then 1 week an extensive diagnostic evaluation is recommended. The athlete can return to sports after asymptomatic for 1 full week. |
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Grade III Concussion:
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Loss of Consciousness (LOC), either brief (seconds) or prolonged (minutes or longer).
Athlete should be removed from sports immediately and examined. If LOC is prolonged the athlete should be transported by ambulance to the nearest emergency department. If the LOC was brief the athlete can return to sports after being asymptomatic for 1 week. For prolonged LOC, the athlete can return after being asymptomatic for 2 weeks. If the athlete sustains a second grade III concussion, the athlete should be removed from sports for 1 month. If any abnormality on CT scan or MRI consistent with brain swelling, contusion or other intracranial pathology the athlete should be removed from sports for the season and discouraged from participation in contact sports in the future |
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Headaches-High Risk S&S
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Thunderclap headache
Migraine history Same as prior Aura Associated symptoms Worst ever SAH Menningitis Prodrome Upper Respiratory Infections Injury |
