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Dillon Ch 11

Assessing the Head, Face, and Neck

Interaction with Respiratory System nasal and oral are entry points; injury/disease impairs ability to breath can result in infections in upper and lower respiratory systems
Interaction with Cardiovascular System disorders may be seen: some infarction/ischemic pain may radiate to jaw or throat; facial edema can have fluid retention
Interaction with Musculoskeletal System: facial expressions - communication and nourishment
Interactions with Neurological System altered - speech, feeding, expression
Interaction with Endocrine System thyroid disfunction - hypertrophy or enlargements (goiters) and facial spasms could show signs of disease
Disorders of head, face and neck have the potential to influence the morbidity and mortality of patients profoundly
Physical changes of the head, face and neck are associated with disorders that can have devastating effects
Head, face and neck structures are greatly influenced by other systems
Head inspection should be of size, shape and symmetry of facial features (variation between genders, race and ethnic groups vary widely)
Asymmetry of facial features indicates previous trauma, surgery, congenital deformity, paralysis, edema, stroke or Bell's Palsy
Palpation of TMJ smooth, symmetrical movement w/ no pain, crepitus or clicking
Where are Stensen's ducts located upper buccal mucosal at point of second upper molar. they drain the parotid
Where are Wharton's ducts located on either side of frenulum, drain the submandibular glands
When do the anterior and posterior fonanesl close on children? anterior fontanels close at 10-18 months, posterior close by 2 months.
Which sinuses do you percuss during the assessment of the head? frontal and maxillary sinuses
What isn unique about how infants breath and what may indicate respiratory distress? infants are obligate nose breathers. nasal flaring is associated with respiratory distress.
When assesing a child, what may a foul odor or unilateral discharge from the nose indicate? A foreign body
How are enlarged tonsils graded? Grade 1- within normal limits Grade 2- enlarged but separate from uvula Grade 3- tonsils touching uvula Grade 4- tonsils touching each other
What is geographic tongue? A benign variation of smooth tongue and raised papillae. map like appearance.
What is hair tongue? Black hairy tongue. Elongated darkened papillae. Benign, often due to staining, infection, or antibiotic treatment
What is lichen planus? Benign, painless, white, lace-like eruptions. bilateral on buccal mucosa.
What is leukoplakia? Precancerous, white plaques, on buccal mucaosa, gingivae or tongue. Hairy leukoplakia of tongue associated with HIV.
What are the 10 lymph node groups? Pre-auricular Post-auricular Occipital Tonsilar Submaxillary Submental Superficial clavical Posterior clavical Supraclavicular Infraclavicular
Where do you palpate the Maxillary sinuses? Under the eyes
Where would you look to inspect Wharton's duct opening? On either side of the frenulum, under the tongue
When auscultating the carotid arteries, which part of your stethoscope would you use? The bell
Created by: MEPN 2013