Physical Assessment: Head, Face And Neck

Front 1

Where are the two pairs of salivary glands that are accessible on examination of the face? (3rd is sublingual)

Back 1

1. The parotic gland: in the cheeks over the mandible anteriro to and below the ear...normally not palpable
2. Submandibular glands: beneatht eh mandible at teh angle of the jaw.

Front 2

Name the major neck vessels

Back 2

Front 3

Name the major neck muscles

Back 3

Front 4

Which cranial nerve innervates the neck muscles?

Back 4

Cranial nerve XI

Front 5

describe the boundaries of the anterior triangle of the neck (helpful in describing findings in neck)

Back 5

lies in front between the sternomastoid and the midline of the body with its base up along the lower border of the mandible and apex at the suprasternal notch

Front 6

describe the boundaries of the posterior triangle of the neck (helpful in describing findings in neck)

Back 6

behind the sternomastoid muscle, with the trapezius muscle on the other side and with its base along the clavicle below

Front 7

Head

Back 7

cranium-frontal, parietal, occipital, temporal
facial skeleton
22 bones

Front 8

Sutures

Back 8

join bones together

coronal-crosses the top of skull ear to ear
sagittal-crosses skull from anterior to posterior
lambdiodial-seperatesparietal/occipital bones

Front 9

Where is the "Adam's Apple" exactly?

Back 9

It is the palpable notch on the upper edge of the thyroid cartilage

Front 10

Name and locate structures/cartilage landmarks of the larynx

Back 10

cricoid cartilage, adams apple (top of thyroid cartilage), hyoid bone, trachea, thyroid gland, sternomastoid muscle, manubrium, clavicle

Front 11

Blood supply to the head/face

Back 11

carotid artery, temporal artery branches off located superior/lateral eye, has normal amplitudes 2+

Front 12

Cranial nerves in the head

Back 12

Trigeminal nerve V-both motor/sensory
Facial Nerve VII-frown/smile motor/sensory(taste)

Front 13

TMJ-Temporal Joint Dysfunction

Back 13

problems/symptoms of chewing muscles, joints that connect your lower jaw to your skull

Front 14

Meningitis

Back 14

nuccal rigidity-stiff neck, headache, fever

Front 15

Neck is supported by

Back 15

cervical vertebrae, C1-7

Front 16

when vertigo is objective the person feels like _____ and when vertigo is subjective the person feels like _______

Back 16

the room spins,
they themselves spin

Front 17

major symptoms of meningeal inflammation

Back 17

acute onset of neck stiffness with headache and fever

Front 18

normocephalic

Back 18

denotes a round symmetric skull that is appropriately r/t body size

Front 19

microcephaly

Back 19

abnormally small head

Front 20

macrocephaly

Back 20

abnormally large head

Front 21

edema in the face occurs where first?

Back 21

around the eyes and cheeks where subq tissue is relatively loose

Front 22

mumps swells which gland?

Back 22

the parotid gland (salivary gland in front of ear)

Front 23

edema in the face occurs where first?

Back 23

around the eyes and cheeks where subq tissue is relatively loose

Front 24

fontanels

Back 24

the spaces where sutures have not fully intersected in neonatal skull.

Front 25

Purpose of fontanels?

Back 25

Allow for growth of the brain during the first year of life.

Front 26

When do fontanels close?

Back 26

triangle shaped posterior fontanel closes by 3 months and the diamondshape anterior fontanel closes between 9 months to 2 years Book-18mths

Front 27

Infants fontanels

Back 27

should be flat
bulging-may be normal when infant cries
abnormal-may be cause by intracranial pressure or dehydration

Front 28

Trachea

Back 28

should be straight (mid line)

Front 29

Cluster headaches may be brought on by:

Back 29

alcohol and daytime napping

Front 30

Providing resistance whil the patient shrugs the shoulders is a test of the status of cranial nerve:

Back 30

11

Front 31

The trachea is pulled towards the unaffected side in what conditions?

Back 31

aortic aneurysm
a tumor
unilateral thyroid lobe enlargement
pneumothorax

Front 32

The trachea is pulled towards the affected side in what conditions?

Back 32

large atelectasis
pleural adhesions
fibrosis

Front 33

What is "tracheal tug"?

Back 33

A rhythmic synchronous downward pull that occurs with systole often in presence of an aortic arch aneurysm

Front 34

Auscultating a bruit in thyroid means.....

Back 34

A bruit occurs with accelerated/turbulent blood flow, so it indicates hyperplasia (proliferation of cells) of the thyroid
e.g. hyperthyroidism

Front 35

caput succedaneum
(kay-put sux sidane ium)

Back 35

edamatous swelling ad ecchymosis of the presenting part of teh head caused by birth trauma

Front 36

cephalhematoma

Back 36

subperiosteal hemorrhage, result of birth trauma (head cones back towards back-top of scalp) No treatment. Is reabsorbed during first few weeks of life.

Front 37

periosteum

Back 37

mebrane that lines the outer surface of all bones

Front 38

skull sutures are palpable in infants until they reach ______ of age

Back 38

6 months

Front 39

tonic neck reflex

Back 39

lay an infant supine, turn head to side, same side arm extends and leg flexes

Front 40

when should the tonic neck reflex disappear

Back 40

by 5 months (if not, may indicate brain damage)

Front 41

3 major types of headaches

Back 41

tension
migraine
cluster

Front 42

tension headache

Back 42

usually both sides
tight non throbbing
mild-moderate pain
gradual onset lasts 30" to days
associated with stress
occurs situationally (stress)

Front 43

migraine headache

Back 43

commonly one sided,sometimes both
throbbing/pulsating
rapid onset, lasts 6-24 hrs
mod to severe pain
photophobia
nausea, vomiting
often preceded by aura (tingling, visual changes, vertigo abd pain

Front 44

cluster headache

Back 44

always one sided
continuous burning piercing pain
abrupt onset lasts 45-90 minutes
can occur multiple x in day (clusters)
exacerbated by ETOH, stress, wind or heat exposure
relieved by moving/pacing

Front 45

hydrocephalus

Back 45

obstruction of drainage of CSF results in excessive accumulation, increasing ICP and enlargement of head

Front 46

Macewen's sign

Back 46

"crack pot" sound on percussing head, common in hydrocephalus, normal in infants pre fontanel closure

Front 47

hydrocephalus

Back 47

obstruction of drainage of CSF results in excessive accumulation, increasing ICP and enlargement of head

Front 48

Macewen's sign

Back 48

"crack pot" sound on percussing head, common in hydrocephalus, normal in infants pre fontanel closure

Front 49

Paget's disease ("padge-it")

Back 49

skeletal disease of increased bone resorption and formation which softens, thickens and deforms bone. Affects 10% of those older than 80, more in males.
Characterisitcs: bowed legs, fractures, enlarged skull presses on cranial nerves-headaches, deafness etc.

Front 50

Acromegaly

Back 50

excessive sxrn of growth hormone from pituitary gland after puberty creates enlarged skull and thickened cranial bones (often pituitary tumor)

Front 51

Torticollis (Wryneck)

Back 51

hematoma in one sternomastoid muscle (often d/t intrauterine malposition) results in head tilt. Permanent ROM problems if not treated

Front 52

goiter

Back 52

chronic enlargement of the thyroid gland that occurs in some regions of the world where the soil is low in iodine. NOT d/t neoplasm

Front 53

Pilar Cyst (Wen)

Back 53

smooth firm swelling on scalp that contains sebum and keratin. Benign growth.

Front 54

Parotid gland enlargement

Back 54

rapid painful enlargement of the parotid, occurs with mumps or blockage of duct, abscess or tumor. Can occur with dehydration.

Front 55

Fetal alcohol syndrome

Back 55

growth and developmental abnormalities from drinking during pregnancy.
Characteristic facies: mid facial hypoplasia, short pallpebral fissures (eyes), thin upper lip

Front 56

Down syndrome

Back 56

chromosomal aberration (trisomy 21).

Front 57

Cushing syndrome

Back 57

excessive sxrn of corticotropin hormone (ACTH) and chronic steroid use, person develops "moon face", prominent jowls, red cheeks, hirsuitism upper lip

Front 58

myxedema

Back 58

deficiency of thyroid hormone, when severe, causes a non pitting edema or myxedema

Front 59

Bell's palsy

Back 59

lower motor neuron lesion (peripheral) producing cranial nerve VII paralysis which is almost always unilateral. rapid onset.
Cant' whistle, raise eyebrows etc.

Front 60

scleroderma

Back 60

literally "hard skin", rare connective tissue disease characterized by chronic hardening and shrinking, degenerative changes in skin, vessels, skeletal muscles, synovium.
Characteristic facies: hard shiny skin, thin pursed lips

Front 61

atopid (allergic) facies

Back 61

children with chronic allergies have these facial characteristics: exhausted face, blue shadows below eyes d/t sluggish venous return, open mouth breathing, central facial pallor

Front 62

Parkinson syndrome

Back 62

deficiency of neurotransmitter dopamine and degeneration fo basal ganglia in the brain. Immobility of features produces flat expression.

Front 63

cachetic appearance

Back 63

accompanies chronic wasting disease such as cancer, dehydration, starvation. sunken eyes, hollow cheeks, exhausted, defeated expression

Front 64

stroke facies

Back 64

an upper motor neuron (central ) lesion. Upper half of face not affected because of the intact nerve from the unaffected hemisphere. can still close eyes/wrinkle forehead.

Front 65

Cepahlhematoma is associated with:

Back 65

subperiosteal hemorrhage

Front 66

Head/neurological

acute assessment

Back 66

-head injuries and neurologic changes
-neck pain
-trauma to head or neck
-lymphatics larger than 1 cm, fixed, irregular, hard or rubbery
-hyperthyroidism- if hypermetabolism in all systems

Front 67

neckpain

Back 67

related to muscle tension or spasm. assocaited with fever and headache may signify serious illness such as meningitis and should be carefully evaluated

Front 68

any patient with sudden onset of neck or jaw pain should be evaluated for

Back 68

any patient with sudden onset of neck or jaw pain should be evaluated for

Front 69

patients treated with radiation to neck chest or back

Back 69

have increased risk for thyrpod and salivary gland malignancies

Front 70

Healthy People Goals

Head and Neck

Back 70

Front 71

Risk factors for cancers in the Neck

Back 71

male gender, age older than 50, tobacco use, alcohol consumption

Front 72

primary headaches

Back 72

benign, often recurring, and not associated with underlying pathology

Front 73

secondary headaches

Back 73

associated with underlying pathology that ranges from mild, to severe