Ch 15 Assessing Head And Neck

Front 1

The head and neck assessment focuses on

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The cranium, face, thyroid gland, and lymph nodes contained within the head and neck the sensory organs eyes, ears, nose, and mouth

Front 2

The head is

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The framework of the head is the skull which can be divided into two subsections the cranium and the face

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Cranium

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Houses and protects the brain and major sensory organs consists of eight bones frontal 1 parietal 2 temporal 2 occipital 1 ethmoid 1 sphenoid 1

Front 4

In the adult client, the cranial bones are joined together by a movable sutures called

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The sagittal, coronal squamosal and, lambdoid suture

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Facial bones give shape to the face-to-face consists of 14 bones and they

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Maxilla 2 zygomatic cheek 2 inferior conchae 2 nasal 2 lacrimal 2 palatine 2 vomer 1 mandible jaw 1

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All of the facial bones are immovable except for the

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Mendable which has free movement up, down, and sideways at thetemporomendibular joint

Front 7

Structure of the neck is composed of

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Muscles, ligaments, and cervical vertebrae. Contained within the neck of the bone, several major blood vessels, the larynx, trachea, and the thyroid gland which is in the interior triangle of the neck

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The sternomastoid and trapezius muscles are the two of the pair muscles that

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Allow movement and provide support to the head and neck the sternomastoid muscle rotates and flexes the head where at the trapezius muscle extends the head and moves the shoulders the 11th cranial nerve is responsible for muscle movement that permit shrugging the shoulders by the trapezius muscle and turning their head against resistance by the sternomastoid muscle

Front 9

The cervical vertebrae

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C1 through C7 are located in the posterior neck and support the cranium the vertebra prominens is C7 which can easily be palpated when the neck is flexed using C7 as a landmark will help you locate other vertebrae

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The internal jugular veins and carotid arteries are located

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Bilaterally, parallel and interior to the sternomastoid muscle. The external jugular vein lies diagonally over the surface of these muscles

Front 11

The thyroid gland

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The largest endocrine gland in the body it produces thyroid hormones that increases the metabolic rate of most body cells of the thyroid gland is surrounded by several structures that are important to palpate for accurate location of the thyroid gland. The Sounds Oakland consists of two lateral lobes that curves pussy really on both sides of the trachea and esophagus and all mostly covered by the sternomastoid muscle

Front 12

Lymph nodes

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Filters clear substance composed move your big fat tissue fluids after the lymphatic vessels collected but before it returns to the vascular system. Filtering removes bacteria and tumor cells from them. In addition, the lymph nodes produce lymphocytes and antibodies as a defense against Invasion by Foreign substances the size and shape. Normally lymph nodes or I do not tell people or they may feel like very small beads. You don't know to become overwhelmed by microorganisms, as happens with an infection such as mononucleosis, they swell and become painful. If cancer metastasized to lymph nodes enlarged but not be painful

Front 13

The most common head and neck lymph nodes are referred to as

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Preocular. Postocular tonsillar occipital submandibular submental superficial cervical posterior cervical deep cervical supraclavicular

Front 14

Trigeminal neuralgia

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Sharp, Shooting, piercing Fishel paint that last from seconds to minutes pain occurs over the divisions of the fifth trigeminal cranial nerves. aptholmic maxillary, and mandibular areas

Front 15

Lump and lesions that do not heal or disappear May indicate

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Cancer

Front 16

A goiter is

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An enlarged thyroid gland may appear as large swelling at the base of the neck that the client May notice when shaving or putting on cosmetics make a company by a hoarse voice cough hoarseness difficulty swallowing difficulty breathing

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Sudden weakness and numbness in the face arms or legs especially on one side of the body May indicate

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Impeding stroke

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Thyroid cancer may be due to

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radiation to the neck area radiation is also be a risk for hypothyroidism

Front 19

Signs and symptoms of hypothyroidism

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Sleepiness cold intolerance weight gain muscle ache fatigue menstrual irregularities tell dry skin thin brittle hair or nails bradycardia constipation unintentional weight gain edema especially periorbital difficulty with concentration and memory slowing of relaxation phase of tension reflexes they have higher diastolic blood pressure most serious form of hypothyroidism is myxoedema

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Hyperthyroidism signs and symptoms include

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nervousness fatigue weakness palpitations heat intolerance excessive sweating dyspnea diarrhea insomnia full concentration oligomenorrhea weight loss hair loss tachycardia proximal myopathy stair lid lag later attraction and exothalmost with Graves disease emotional lability hyperactive reflexes thyroid enlargement in most cases

Front 21

General head and neck routine screening includes

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Inspect head for size, shape, and configuration. Palpate temporal arteries. Temporomandibular joint for swelling, tenderness, or crepitation. Inspect net for movement, position, symmetry, lumps, or masses. Palpate trachea for position. Palpate thyroid enlargement, lumps, or masses. Palpate for any enlarged or Tender lymph nodes. Auscultate for bruit over thyroid is enlarged

Front 22

Focus specialty assessment of the head and neck

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Assess and determine types of headache client is experiencing. Assess signs of thyroid dysfunction. Assess signs of Bell palsy

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Microcephaly

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Abnormally small head

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Acromegaly

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The skull and facial bones are larger than and thicker facial features such as nose ears and the hands and feet

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Paget's disease

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Acorn shaped, and large skull bones

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Neurologic disorders may cause

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A horizontal jerking movement. And involuntary nodding movement may be seen in patient with aortic insufficiency. Head tilted to one side May indicate unilateral Vision or hearing in deficiency or shortening of the stermastoid muscle

Front 27

Asymmetry interior to the earlobes occurs with

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Parotid gland enlargement from an abscess or tumors. Unusual or asymmetric Arrow facial movements maybe from an organic disease or neurology problem which should be referred for medical follow-up

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Drooping, weakness, or Paralysis on one side of the face may result from

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A stroke or from a neurology condition known as Bell palsy

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A mask like face marks Parkinson disease, is sunken face with depressed eyes and Hollow Cheeks is typical of

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Cachexia emaciation or wasting

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acute urgent condition is seen one the temporal artery is

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Hard, steak, and tender with inflammation as seen with temporal arteries inflammation of the temporal arteries that may lead to blindness

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Older adult consideration the strength of deportation of the temporal artery may be decreased in the older clients

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Limited range of motion, swelling, tenderness or crepitation may indicate

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Temporomandibular joint Syndrome

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Swelling, and large masses or nodules May indicate an

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Enlarged thyroid gland, inflammation of lymph nodes, or a tumor

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Asymmetric movement or generalized enlargement of the thyroid gland is considered

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Abnormal

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Muscle spasms, inflammation, or cervical arthritis may cause

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Stiffness, rigidity, and limited Mobility to the next, which may affect daily functioning a stiff neck is often a late sentencing and meningitis

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Older clients, cervical curvature main Chris because of kyphosis of the spine. Moreover, fat May accumulate around the cervical vertebrae especially in women this is sometimes called A do wagers hump . Older clients usually have somewhat decreased flexion, extension, lateral bending and rotation of the neck this is usually due to arthritis

Front 35

The tricky and maybe pulled to the affected side in cases of

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Large atelectasis, fibrosis, or plural and adhesions. The trachea is pushed to the ill effects and side in cases of a tumor enlarged thyroid lobe pneumothorax or with an aortic aneurysm

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Lendmark deviated from midline or obscure because

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Of masses or abnormal growth

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Cases of diffuse enlargement such as hypothyroidism Graves disease or endemic goiter the thyroid gland maybe palpated and enlarge tender gland May result from

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Thyroiditis. Multiple nodules of the thyroid may be seen in metabolic processes however rapid enlargement of a single nodule suggest a malignancy and must be evaluated further

Hint 37

If palpable, the older clients that I would make sure more nodular or irregular because of fibroid changes that occur within Aging for thyroid may also be felt lower in the neck because of the age-related structural changes

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Horse tissue or irregular consistency of the neck May indicate

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An inflammatory process. Nodules should be described in terms of location size and consistency

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A songs, blowing, swishing sound auscultated over the thyroid lobes is often heard in

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And hyperthyroidism because of an increase in blood flow through the thyroid

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Head and neck cancer includes

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cancers of the mouth, nose, sinuses, salivary glands, throat, and lymph nodes in the neck

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Large pre ocular nose post ocular nodes occipital nodes tonsillar nodes submandibular nodes submental nodes superficial cervical nodes posterior cervical nodes deep cervical nodes

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Enlarged swelling tenderness hardness immobility are abnormal

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Supraclavicular nodes are abnormal if

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Enlarged, hard, non-tender nose, particularly on the left side May indicate a metastasis from a malignancy in the abdomen or thorax

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Size and shape of the lymph node should be

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Normally lymph nodes which are round and smaller than one centimeter or not top table an older client is specially the lymph nodes become fibrotic fatty and smaller because of a loss of lymphoid elements related to aging this may decrease the other person's resistance to infection

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Lymphadenopathy

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Lymph node enlargement exceed 1 cm which may be caused by chronic infection and autoimmune disorder or metastatic disorder

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Regional lymphadenopathy

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One or two lymphatic groups in large

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Generalized lymphadenopathy

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Three or more groups enlargement that persist for more than 3 months maybe a sign of human immunodeficiency virus infection

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Delimitation

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Normally lymph node delimitation the lymph nodes position or boundary is discrete period and chronic infection however, the lymph nodes become confluent they merge and infection they remain discreet

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Mobility of lymph nodes

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Typical lymph nodes on mobile both from side to side and up and down. And metastatic disease, the lymph nodes enlarged and become fixed in place

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Consistency of the lymph nodes

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Somewhat more fibrotic and fatty in older clients, the normal lymph nodes is soft whereas the abnormal node is hard and firm. Hard, firm, unilateral nodes are seen with metastatic cancer

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Tenderness and location of the lymph node

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Tenders, and large nodes suggest acute infections, normally lymph nodes are not sore or Tender. Of course you need to document the location of the lymph node being assessed

Front 51

Sinus headache

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Deep, constant, throbbing pain pressure like pain in one specific area of face or head example behind eyes face tender to the touch period occurs with or after it cold or acute sinusitis or acute febrile illness with purulent discharge from nose may occur in one area of space or alone eyebrow Ridge and below the cheekbone last until Associated condition is improved maybe moderately severe not deliberating pain worse with sudden movement of the head bending forward lying down in the morning due to mucus collecting and draining all night or we starting temperature changes going from warm room to cold associated with other symptoms of sinusitis such as nasal drainage fever and foul-smelling breath sinus headaches may be confused wish tension headaches and migraines

Front 52

Cluster headache

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Stabbing pains may be accompanied by sharing eyelid drooping red eye or runny nose has a sudden onset may be precipitated by ingesting alcohol localized in the eye and orbit and radiating to the facial and temporal region typically occurs in the late evening or night intense movement or walking back and forth May relieved the discomfort occur more in young males

Front 53

Tension headache

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Dumb tight diffuse your most age may occur with stress anxiety or depression usually located in the frontal temporal or occipital region last days months or years aching symptomatic relief may be obtained by local heat massage and take antidepressants and muscle relaxant affect women more often than men

Front 54

Migraine headache

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Accompanied by nausea vomiting and sensitivity to noise or lights may have prodromal stage visual disturbances vertigo tinnitus numbness or tingling of fingers or toes maybe precipitated by emotional disturbances anxiety or ingestion of alcohol cheese chocolate or other food and substances to which client is sensitive located around eyes temples cheeks or forehead may affect only one side of the face last for up to 3 days throbbing severe rest may bring relief occur more often in women

Front 55

Tumor related headache

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Aching study neurologic and mental symptoms as well as nausea and vomiting May develop prodromal stage may be aggravated by coughing sneezing or sudden movements of the head varies with location of tumor commonly occurs in the morning and last for several hours variable in intensity usually subside later in the day

Front 56

Cushing syndrome

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May present with a moon shaped face with red cheeks and increased facial hair

Front 57

Scleroderma

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Is tighten hard face with thinning facial skin is seen and scleroderma

Front 58

Bell palsy

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Bell palsy usually begins suddenly in riches a pic with in 48 hours. Symptoms may include twitching witness paralysis drooping eyelid or corner of the mouth drooling dry eye dry mouth decreased ability to taste eye tearing and facial Distortion one side facial paralysis is characteristic

Front 59

Myxedema hypothyroidism

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Severe hypothyroidism is characterized by a dull puffy face eczema around the eyes and dry horse in sparse chair

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Cerebral vascular accident

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Results and neurologic damage the symptoms depends on what part of the brain was affected

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Parkinson disease

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Patients with Parkinson's disease have a mask-like facial appearance along with his shuffling gait rigid muscles and diminished reflexes