Head, Neck, & Lymph

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Author:
ronm
ID:
10297
Filename:
Head, Neck, & Lymph
Updated:
2010-03-13 17:59:52
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Assessment
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Nursing 307
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  1. Cranial bones
    • a. Frontal
    • b. Parietal
    • c. Occipital
    • d. Temporal
  2. 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
  3. 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
  4. Cricoid
    just above the trachea (below the Adam’s Apple - thyroid cartilage)
  5. 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
  6. 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
  7. 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
  8. Hydrocephalus
    obstruction of CSF –> accumulation–> increased ICP
  9. Paget’s Disease
    localized bone disease, softens, thickens and deforms bone
  10. Craniosynostosis
    premature closure of one or more sutures while brain growth continues
  11. Torticollis
    neck tilt to one side
  12. Parotid Gland Enlargement
    swelling of the parotid
  13. Hyperthyroidism
    increase in size of thyroid gland (Grave’s disease - bulging eyes)
  14. Atopic Facies/Allergic Crease
    puffy, mouth open, crease across nose
  15. Fetal Alcohol Syndrome
    epicanthal folds, flat midface, low nasal bridge
  16. Down Syndrome
    slanted eyes, inner epicanthal folds, flat nasal body, low nasal bridge, short broad neck
  17. Bell’s Palsy
    unilateral paralysis of the face
  18. CVA
    paralysis lower facial muscles
  19. Cushing Syndrome
    moonlike face, prominent jowles
  20. Parkinson’s Syndrome
    flat, expressionless, mask like

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