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Cranial bones
- a. Frontal
- b. Parietal
- c. Occipital
- d. Temporal
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Sutures
- a. Coronal Suture - crowns the head from ear to ear (frontal/parietal)
- b. Sagittal Suture - separates the head lengthwise between 2 parietal bones
- c. Lamboid Suture - separates the parietal from the occipital
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Salivary Glands
- a. Parotid Glands - cheeks over the mandible (non-palpable)
- b. Submandibular Glands - below the mandible at the angle of the jaw
- c. Sublingual Glands - floor of the mouth
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Cricoid
just above the trachea (below the Adam’s Apple - thyroid cartilage)
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Lymphatics
- 1. Preauricular - in front of the ear
- 2. Posterior Auricular - behind the ear (mastoid process)
- 3. Occipital - base of the skull (posterior)
- 4. Submental - under the chin (midline) behind the tip of the mandible
- 5. Submandibular - along the mandible (jaw)
- 6. Tonsillar (Jugulodigastric) - under the angle of the mandible
- 7. Superficial Cervical - overlying the sternomastoid muscle
- 8. Deep Cervical - deep under the sternomastoid muscle
- 9. Posterior Cervical - along the trapezius muscle
- 10. Supraclavicular - above the clavicle
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History (Subjective)
- A. Headaches - unusually frequent, unusually severe
- B. Head Injury
- C. Dizziness - light headed
- D. Neck Pain - limited ROM
- E. Lumps or Swelling - in the head or neck
- F. History of head or neck surgery
- G. Medications
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Physical Exam/Assessment (Objective)
- Inspect and palpate skull
- 1. Note Size and Shape - normocephallic - term used to describe round, symmetrical skull that is appropriate to body size
- 2. Temporal Area - palpate temporal artery - palpate temporomandibular joint as the pt opens mouth
- B. Inspect Facial Structures
- 1. Note symmetry, emotion, abnormal swelling, involuntary movements
- C. Inspect and Palpate Neck
- 1. Symmetry - neck muscles symmetrical, head midline, (head erect/upright)
- 2. Range of Motion (ROM) and Resistant ROM -
- 3. Swelling - parotid gland, thyroid gland
- D. Inspect and Palpate Lymph Nodes
- E. Lymphadenopathy - enlargement of the lymph nodes (>1 cm) secondary to infection, allergy, neoplasm
- F. Inspect and Palpate Trachea (Midline)
- G. Thyroid Gland Inspection and Palpation
- 1. Inspection - observe swallowing with a sip of water
- 2. Palpation - move behind patient, L hand/fingers sl push trachea to R, apply R fingers between the trachea and sternomastoid muscle, ask pt to swallow
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Hydrocephalus
obstruction of CSF –> accumulation–> increased ICP
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Paget’s Disease
localized bone disease, softens, thickens and deforms bone
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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
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Parotid Gland Enlargement
swelling of the parotid
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Hyperthyroidism
increase in size of thyroid gland (Grave’s disease - bulging eyes)
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Atopic Facies/Allergic Crease
puffy, mouth open, crease across nose
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Fetal Alcohol Syndrome
epicanthal folds, flat midface, low nasal bridge
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Down Syndrome
slanted eyes, inner epicanthal folds, flat nasal body, low nasal bridge, short broad neck
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Bell’s Palsy
unilateral paralysis of the face
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CVA
paralysis lower facial muscles
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Cushing Syndrome
moonlike face, prominent jowles
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Parkinson’s Syndrome
flat, expressionless, mask like
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