N307 Head, Neck, Lymph Assessment [Ch 13]
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| Identify the four cranial bones. | Frontal, parietal, occipital, temporal
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| sutures | immovable joints that unite the cranial bones
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| Identify the 3 cranial sutures. | Coronal, sagittal, lamboid
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| Identify the 3 salivary glands. | Parotid, submandibular, sublingual
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| Is salivary gland swelling common? | No
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| Identify the two major neck muscles. | Sternomastoid, trapezius
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| Identify the function of lymphatics. | Major part of the immune system; detects and eliminates foreign substance from the body
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| Normally, should you be able to feel the thyroid gland? | No. Feeling thyroid is an abnormal result.
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| A patient comes in with a headache and vomiting, what could they possibly have? | Intracranial pressure
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| A patient comes in with a headache and a stiff neck, what could they possibly have? | Meningitis
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| normocephalic | term used to describe round, symmetrical skull that is appropriate to body size
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| lymph nodes | small, oval clusters of lymphatic tissue that are set at intervals along the lymph vessels
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| temporal arteritis; s/s (3) | inflammation of the temporal arteries; characterized by headaches and difficulty chewing and (sometimes) visual impairment
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| Loss of consciousness prior to a fall signifies _______. | cardiac cause
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| objective vertigo vs. subjective vertigo | objective - room spins; subjective - person spins
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| dysphagia | difficulty swallowing
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| Identify the 2 types of vascular headaches. | Migraines and cluster headaches
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| What factor(s) precipitate a cluster headache? (2) | Alcohol ingestion and daytime napping
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| What factor(s) precipitate a migraine? (5) | Alcohol, letdown after stress, menstruation, eating chocolate or cheese
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| rhinorrhea | a condition where the nasal cavity is filled with a significant amount of mucous fluid
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| What are the associated factors for a cluster headache? (5) | Eye reddening and tearing, eyelid drooping, rhinorrhea, nasal congestion
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| What are the associated factors for a migraine? (5) | Nausea/vomiting and visual disturbances
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| Identify the course and duration for migraines. | Twice per month, lasting 1-3 days
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| Identify the course and duration for cluster headaches. | 1-2 daily, 1/2 - 2 hours each, for 1-2 months with remission
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| 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.
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| 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
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| microcephaly | abnormally small head
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| macrocephaly | abnormally large head
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| Where does a edema in the face occur first? | Around the eyes (periorbital) and the cheeks
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| Parotid gland swelling is associated with ______ and ________. | Mumps and AIDS
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| lymphadenopathy | enlargement of lymph nodes (>1 cm) from infection, allergy, or neoplasm
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| _____ nodes are often palpable in healthy persons. | Cervical
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| How should lymph nodes feel? (4) | Movable, discrete, soft, nontender
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| If lymph nodes are enlarged and tender, where do you check for the source of the problem? | Where the nodes drain
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| _____ enlargement is common with HIV infection. | Occipital node enlargement
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| Identify a possible cause for the following symptoms: acute onset, <14 days duration, present bilateral, enlarged, warm, tender, firm, freely movable | Acute infection
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| Identify a possible cause for the following symptoms: hard nodes, >3 cm, unilateral, nontender, matted, fixed | Cancerous nodes
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| Identify a possible cause for the following symptoms: nodes are enlarged, firm, nontender, and mobile | HIV infection
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| Identify a possible cause for the following symptoms: single, enlarged, nontender, hard, left supraclavicular node | Neoplasm in thorax or abdomen
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| Identify a possible cause for the following symptoms: painless, rubbery, discrete nodes that gradually appear | Hodgkin's lymphoma
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| Virchow's node | single, enlarged, nontender, hard, left supraclavicular node
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| The trachea is pushed to _______ side in aortic aneurysm, tumor, unilateral thyroid lobe enlargement, and pneumothorax. [affected/unaffected] | unaffected or healthy side
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| The trachea is pulled toward the affected or diseased side with __________. (3) | Large atelectasis, pleural adhesions, fibrosis
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| tracheal tug | rhythmic downward pull that is synchronous with systole and that occurs with aortic arch aneurysm
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| Identify the two approaches for palpating the thyroid gland. | Posterior (better) and anterior (more awkward)
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| Describe the characteristics of a normal lymph node. | < 1 cm, movable, soft, nontender, discrete
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| What should you document if you find an enlarged lymph node? (7) | Location, size, shape, delimitation (discrete or matted), mobility, consistency, tenderness
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| hydrocephalus | obstruction of cerebrospinal fluid –> causes accumulation –> increased intracranial pressure
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| Paget's Disease | localized bone disease, softens, thickens and deforms bone
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| 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
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| 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
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| What symptoms are caused by enlarging skull bones pressing on cranial nerves? | Headache, vertigo, tinnitus, progressive deafness, optic atrophy and compression of spinal cord
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| craniosynostosis | premature closure of one or more sutures while brain growth
continues
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| torticollis | neck tilt to one side, often associated with muscle spasm
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| 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
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| parotid gland enlargement | swelling of the parotid
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| hyperthyroidism | increase in size of thyroid gland (clue: Grave’s disease - bulging eyes)
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| 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
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| Identify the facial clinical manifestation(s) of fetal alcohol syndrome. (4) | narrow epicanthal folds, flat midface, low nasal bridge, thin upper lip
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| 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
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| Identify the facial clinical manifestation(s) of Bell's Palsy. (2) | unilateral paralysis of the face, rapid onset
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| 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
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| Identify the best way to check for CVA paralysis? | Ask pt to smile
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| Identify the facial clinical manifestation(s) of Cushing's syndrome. | overly round, moon-like face, prominent jowls, hirsutism
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| jowls | lower part of a person's or animal's cheek, esp. when it is fleshy or drooping
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| Identify the facial clinical manifestation(s) of Parkinson syndrome. | Flat, expressionless, masklike, staring gaze
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| Why do we measure head circumference during the first 2 years of life? | Assess for hydrocephalus
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