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N307 E2 HNL

N307 Head, Neck, Lymph Assessment [Ch 13]

Identify the four cranial bones. Frontal, parietal, occipital, temporal
sutures immovable joints that unite the cranial bones
Identify the 3 cranial sutures. Coronal, sagittal, lamboid
Identify the 3 salivary glands. Parotid, submandibular, sublingual
Is salivary gland swelling common? No
Identify the two major neck muscles. Sternomastoid, trapezius
Identify the function of lymphatics. Major part of the immune system; detects and eliminates foreign substance from the body
Normally, should you be able to feel the thyroid gland? No. Feeling thyroid is an abnormal result.
A patient comes in with a headache and vomiting, what could they possibly have? Intracranial pressure
A patient comes in with a headache and a stiff neck, what could they possibly have? Meningitis
normocephalic term used to describe round, symmetrical skull that is appropriate to body size
lymph nodes small, oval clusters of lymphatic tissue that are set at intervals along the lymph vessels
temporal arteritis; s/s (3) inflammation of the temporal arteries; characterized by headaches and difficulty chewing and (sometimes) visual impairment
Loss of consciousness prior to a fall signifies _______. cardiac cause
objective vertigo vs. subjective vertigo objective - room spins; subjective - person spins
dysphagia difficulty swallowing
Identify the 2 types of vascular headaches. Migraines and cluster headaches
What factor(s) precipitate a cluster headache? (2) Alcohol ingestion and daytime napping
What factor(s) precipitate a migraine? (5) Alcohol, letdown after stress, menstruation, eating chocolate or cheese
rhinorrhea a condition where the nasal cavity is filled with a significant amount of mucous fluid
What are the associated factors for a cluster headache? (5) Eye reddening and tearing, eyelid drooping, rhinorrhea, nasal congestion
What are the associated factors for a migraine? (5) Nausea/vomiting and visual disturbances
Identify the course and duration for migraines. Twice per month, lasting 1-3 days
Identify the course and duration for cluster headaches. 1-2 daily, 1/2 - 2 hours each, for 1-2 months with remission
With migraines, people must _______ to feel better, whereas with cluster headaches, they need to _______ to feel better. With migraines, people must LIE DOWN to feel better, whereas with cluster headaches, they need to MOVE to feel better.
A 42 y/o pt comes in with a persistent lump (lymph node) on his neck. Do you suspect it to be malignant or benign? Malignant until proven otherwise, esp. since pt is over 40 y/o
microcephaly abnormally small head
macrocephaly abnormally large head
Where does a edema in the face occur first? Around the eyes (periorbital) and the cheeks
Parotid gland swelling is associated with ______ and ________. Mumps and AIDS
lymphadenopathy enlargement of lymph nodes (>1 cm) from infection, allergy, or neoplasm
_____ nodes are often palpable in healthy persons. Cervical
How should lymph nodes feel? (4) Movable, discrete, soft, nontender
If lymph nodes are enlarged and tender, where do you check for the source of the problem? Where the nodes drain
_____ enlargement is common with HIV infection. Occipital node enlargement
Identify a possible cause for the following symptoms: acute onset, <14 days duration, present bilateral, enlarged, warm, tender, firm, freely movable Acute infection
Identify a possible cause for the following symptoms: hard nodes, >3 cm, unilateral, nontender, matted, fixed Cancerous nodes
Identify a possible cause for the following symptoms: nodes are enlarged, firm, nontender, and mobile HIV infection
Identify a possible cause for the following symptoms: single, enlarged, nontender, hard, left supraclavicular node Neoplasm in thorax or abdomen
Identify a possible cause for the following symptoms: painless, rubbery, discrete nodes that gradually appear Hodgkin's lymphoma
Virchow's node single, enlarged, nontender, hard, left supraclavicular node
The trachea is pushed to _______ side in aortic aneurysm, tumor, unilateral thyroid lobe enlargement, and pneumothorax. [affected/unaffected] unaffected or healthy side
The trachea is pulled toward the affected or diseased side with __________. (3) Large atelectasis, pleural adhesions, fibrosis
tracheal tug rhythmic downward pull that is synchronous with systole and that occurs with aortic arch aneurysm
Identify the two approaches for palpating the thyroid gland. Posterior (better) and anterior (more awkward)
Describe the characteristics of a normal lymph node. < 1 cm, movable, soft, nontender, discrete
What should you document if you find an enlarged lymph node? (7) Location, size, shape, delimitation (discrete or matted), mobility, consistency, tenderness
hydrocephalus obstruction of cerebrospinal fluid –> causes accumulation –> increased intracranial pressure
Paget's Disease localized bone disease, softens, thickens and deforms bone
Paget's Disease affects ___ % of those over 80 y/o and occurs more often in this gender: _______. 10% over 80 y/o; common in males
Identify the clinical manifestation(s) of Paget's disease. (4) Bowed long bones, sudden fractures, frontal bossing, enlarging skull bones that form an acorn-shaped cranium
What symptoms are caused by enlarging skull bones pressing on cranial nerves? Headache, vertigo, tinnitus, progressive deafness, optic atrophy and compression of spinal cord
craniosynostosis premature closure of one or more sutures while brain growth 
torticollis neck tilt to one side, often associated with muscle spasm
Identify the etiology of torticollis. How does it present? hematoma in sternomastoid muscle; firm, discrete, nontender mass in middle of sternomastoid muscle on the involved side
parotid gland enlargement swelling of the parotid
hyperthyroidism increase in size of thyroid gland (clue: Grave’s disease - bulging eyes)
Identify the facial clinical manifestation(s) of atopic facies/allergic crease. (5) puffy face, mouth open, blue shadows under eyes, crease on lower eyelids, crease across nose
Identify the facial clinical manifestation(s) of fetal alcohol syndrome. (4) narrow epicanthal folds, flat midface, low nasal bridge, thin upper lip
Identify the facial clinical manifestation(s) of Down syndrome. (6) slanted eyes, inner epicanthal folds, flat nasal body, low nasal 
bridge, thick tongue, short broad neck
Identify the facial clinical manifestation(s) of Bell's Palsy. (2) unilateral paralysis of the face, rapid onset
Identify the facial clinical manifestation(s) of a CVA. (1) paralysis lower facial muscles; pt will still be able to wrinkle forehead and close eyes
Identify the best way to check for CVA paralysis? Ask pt to smile
Identify the facial clinical manifestation(s) of Cushing's syndrome. overly round, moon-like face, prominent jowls, hirsutism
jowls lower part of a person's or animal's cheek, esp. when it is fleshy or drooping
Identify the facial clinical manifestation(s) of Parkinson syndrome. Flat, expressionless, masklike, staring gaze
Why do we measure head circumference during the first 2 years of life? Assess for hydrocephalus
Created by: nikkirosety
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