Health Assessment Chp. 13 Head, Face, Neck

Front 1

Cranial bones

Back 1

Frontal, parietal, occipital, and temporal

Front 2

Facial bones

Back 2

Composed of 14 fused bones, except the mandible

Front 3

Sutures

Back 3

Coronal, lamboid, saggital

Front 4

Facial muscles

Back 4

Innervated by cranial nerves (CN) V—trigeminal and VII (facial)

Front 5

Salivary glands

Back 5

Parotid
Submandibular
Sublingual

Front 6

Neck

Back 6

Contains cervical spine, sternocleidomastoid muscle, hyoid bone (anchors tongue), larynx, trachea, esophagus, thyroid gland, lymph nodes, carotid arteries, and jugular veins

Front 7

Neck muscles

Back 7

Sternocleidomastoid
Trapezius

Front 8

Larynx

Back 8

The “voice box” found below the trachea & above the pharynx

Front 9

Cardiovascular Structures

Back 9

Carotid arteries
Jugular vein

Front 10

Thyroid gland

Back 10

argest endocrine gland that produces 2 hormones
Regulates cellular metabolism
Located in the anterior portion of the neck, just below the larynx

Front 11

Lymph Nodes

Back 11

Preauricular
Posterior auricular (mastoid)
Occipital
Submental
Submandibular
Anterior superficial cervical
Posterior superficial cervical

Front 12

head Size and shape

Back 12

Normocephalic
Palpate the scalp
Fontanals on infants – posterior closes 1-2 months, anterior closes 4 months -2 years

Front 13

Temporal area

Back 13

Palpate temporal artery (smooth and nontender, listen if tortous)

Front 14

Inspect facial structures (lesions, drainage)

Back 14

Palpate temporolmandibular joint (clicking)

Front 15

neck Symmetry

Back 15

Head should be midline
Muscles should be symmetrical – check for atrophy

Front 16

neck Range of motion

Back 16

side to side, front to back
Test CN XI (spinal accessory)

Front 17

Lymph nodes

Back 17

Palate lymph nodes with circular motions with your finger pads
Should be mobile, discrete, soft, and nontender – normal not to find
Note any lymphadenopathy

Front 18

Trachea

Back 18

Should be midline
Push on suprasternal notch to check for shift

Front 19

Tracheal shift to the unaffected side

Back 19

aortic aneurysm, tumor

Front 20

Tracheal shift to the affected side

Back 20

atelectisis

Front 21

Posterior approach
thyroid gland

Back 21

Examiner is behind client
Head held slightly forward and to the right left hand pushed trachea to the right right fingers palpate between trachea and sternomastoid muscle client swallows
Normally, not palpable

Front 22

Anterior approach
thyroid gland

Back 22

Examiner faces client
Head held forward and to the right right thumb pushes trachea to client’s right left thumb and fingers hooks around sternomastoid muscle

Front 23

Auscultate – listen if palpable

Back 23

Normally, no bruit

Front 24

Hydrocephalus:

Back 24

Gradual increase in intracranial pressure and head enlargement, bulging of fontanels, dilation of scalp veins

Front 25

Paget’s disease of bone (osteitis deformans)

Back 25

Softens, thickens, and deforms bone
Etiology unknown
Clinical Manifestations:
Bowing of long bones, acorn-shaped heads, headaches, tinnitus, progressive deafness, vertigo

Front 26

Acromegaly

Back 26

Syndrome that results when the pituitary gland produces excess growth hormone (hGH) after epiphyseal plate closure at puberty
Clinical Manifestations: Enlarged, thickened skull, elongated head, enlargement of hands, feet, lips, deep voice, soft tissue swelling of internal organs
Cause: 90% by pituitary adenoma

Front 27

Torticollis (wryneck)

Back 27

Head tilt to one side with limited ROM
Result of hematoma in one sternomastoid muscle

Front 28

Thyroid nodules

Back 28

Multiple
Usually r/t inflammation or goiter
Single
Higher risk of malignancy

Front 29

Down Syndrome

Back 29

Trisomy 21
Genetic disorder in which a person has 47 chromosomes instead of the usual 46

Front 30

Hyperthyroidism

Back 30

Excessive production of thyroid hormone; tsh low (don’t need to stimulate, have enough)
Most common: Graves’ disease – quick weight loss, hot and sweaty, anxiety, goiter
Clinical Manifestations: Goiter, exophthalmos, weight loss, heat intolerance, nervousness, tachycardia, diaphoresis
Too little medication or underactive thyroid

Front 31

Myxedema (hypothyroidism)

Back 31

Deficiency of thyroid hormone causing non-pitting edema
Clinical Manifestations: Dry skin and hair, periorbital edema, weight gain
Tsh high (trying to stimulate)
Medication dose too high, or overactive thyroid

Front 32

Bell’s palsy – facial droop; more common in younger people (20’s 30’s)

Back 32

Temporary form of facial paralysis that occurs with damage to the nerve (CN VII--facial) that controls movement of the muscles in the face
Etiology unknown but thought be linked to the herpes simplex virus

Front 33

hypothyroidism

Back 33

Thyroid stimulating hormone (TSH) is elevated
Underactive thyroid gland not responding to the stimulating hormone
Too little thyroid medication

Front 34

Hyperthyroidism

Back 34

TSH is low
Overactive thyroid hormone
Too much thyroid replacement medication

Front 35

Cluster headache

Back 35

unilateral, behind eye, temporal, stabbing and excruciating pain, ptosis, wandering of eye, 30 min to 2 hours, repeat daily for weeks, common to teens, middle age, increased incidence of suicide – very painful

Front 36

tension headache

Back 36

bilateral, frontal or occipital, band like pain, gradual onset, last for several days, 20-40 years of each

Front 37

Migraine headache

Back 37

1 to 2 month, last up to 3 days, front of head, orbital