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NURS 302
chp. 12 head, neck and related lymphatics
173
Nursing
Undergraduate 2
09/21/2011

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Term
the solidification process of the sutures is completed by the ___ yr of life
Definition
2nd yr
Term
what are the major bones of the cranium
Definition
frontial
parietal
temporal
occipital
Term
what are the bones of the face?
Definition
frontal
maxillae
zygomatic
nasal
ethmoid
lacrimal
sphenoid
mandible
Term
the lateral canthus of the eye forms a straight line with the ____ and the nasolabial folds are equal
Definition
pinna
Term
the neck are formed by the ____ cervical vertebrae, ligaments and muscles which support the cranium
Definition
7
Term
the 1st cervical vertebra(C1) is commonly called the _____, which carries the skull
Definition
atlas
Term
the 2nd cervical vertebra (C2) is commonly called ____ which allows for the movement of the head
Definition
axis
Term
which vertebra has the largest movement
Definition
C4
C5
C6
Term
the 7th cervical vertebra (vertebra prominens) has the largest ____
Definition
spinous process
Term
this cervical vertebrae is visible and easily palpated, making it a definite landmark during client assessment
Definition
7th cervical vertebrae(vertebra prominens)
Term
what are the primary muscles of the neck
Definition
sternocleidomastoid and trapezuis
Term
the sternoocleidomastoid muscle is innervated by which cranial nerve? and originates where? and the insertion of this muscle is where?
Definition
cranial nerve XI(accessory)
originate at the manubrium of the sternum and the medial portion of the clavicles.
insertion is at the mastoid process of the temporal bones
Term
trapizuis muscle is innervated by which cranial nerve? where does it originate? and where is this muscle insertion?
Definition
cranial nerve XI (accessory)
originates on the occipital bone of the skull and spine of several vertebrae
insertion is on the scapulae and lateral third of the clavicles
Term
the mandible, the midline of the neck and the anterior aspect of the sternocleidomastoid muscles border the _____
Definition
anterior triangle
Term
the trapezius muscle, the sternocleidomastoid muscle and the clavicle form the _____
Definition
posterior triangle
Term
the only bone in the body that does not articulate directly with another bone
Definition
hyoid
Term
the curved shape of the bone produces a horn at each end that is palpable just inferior to the angle of the jaw. this serves as a landmark for assessing structures of the neck, especially the trachea and the thyroid gland
Definition
hyoid
Term
this is the largest cartilage of the larynx
Definition
thyroid cartilage
Term
the C-shaped rings (1st cartilage ring anchored to the trachea) are palpable where
Definition
superior to the sternum at the midline of the neck
Term
what is the largest gland of the endocrine system
Definition
thyroid gland
Term
what shape is the thyroid gland
Definition
butterfly shaped
Term
what are the 3 sutures
Definition
coronal
sagittal
lamboid
Term
what are the functions of the face and scalp
Definition
facial expressions
movement of head and neck
Term
the ____ of the thyroid connects the right and left lobes of the thyroid gland
Definition
isthmus
Term
what are the arteries and veins of the neck
Definition
temporal artery
carotid arteries
external jugular vein
internal jugular veins
Term
which salivary gland is behind the ear
Definition
parotid
Term
which salivary gland is under the mandible
Definition
submandibular
Term
thyroid gland has how many lobes
Definition
2
Term
thyroid gland secretes _______ which stimulates rate of cellular metabolism in T4 and T3
Definition
thyroxine
Term
system that detects and eliminates foreign substances from body
Definition
lymphatic system
Term
_____ filter lymph and engulf foreign substances preventing them from entering circulation
Definition
lymph nodes
Term
what is the shape and texture of the lymph nodes
Definition
round and smooth
Term
where is the preauricular lymph node
Definition
in front of the ear
Term
where is the occipital lymph node
Definition
at the base of the skull
Term
where is the postauricular lymph node
Definition
behind the ear, over the outer surface of the mastoid bone
Term
where is the submental lymph node
Definition
behind the tip of the mandible at the midline
Term
where is the submaxillary(submandibular) lymph node
Definition
medial border of the mandible
Term
where is the retropharyngeal(tonsillar) lymph node
Definition
at the junction of the posterior and lateral alls of the pharynx at the angle of the jaw
Term
where is the superficial cervical lymph node
Definition
anterior to and over the sternocleidomastoid muscle
Term
where is the deep cervical lymph node
Definition
posterior to and under the sternocleidomastoid muscle
Term
where is the supraclavicular lymph node
Definition
above the clavicle
Term
lymphatics are located throughout the body but only palpable where
Definition
head
neck
arms
axillae
inguinal regions
Term
when lymph nodes are active they stay active for up to how many weeks
Definition
6 weeks
Term
an infants head should be measured at each visit until he or she is how old
Definition
2 yrs old
Term
the newborns head is about how many cm? and is generally equal to the chest circumference
Definition
34
Term
which fontanel is diamond shaped
Definition
anterior
Term
which fontanel is triangular in shape
Definition
posterior
Term
the posterior fontanel closes at how many months
Definition
2 months
Term
the anterior fontanel closes at how many months
Definition
b/w 12-18 months
Term
by how many months is the infant beginning to demonstrate control of head
Definition
4 months
Term
the thyroid is difficult to palpate on an infant, but it can be accomplished on a child using how many fingers
Definition
2 or 3
Term
the pregnant female may develop blotchy pigmented spots (melasma) on her face, facial edema and enlarged thyroid. all of these symptoms are considered normal and subside after childbirth. the pregnant female may also complain of headaches during the 1st trimester which may be related to increase _____. serious headaches especially in late pregnancy are associated with ____
Definition
hormones
preeclampsia
Term
is a serious pregnancy-induced syndrome of high blood pressure, fluid retention and protein excretion in the urine
Definition
preeclampsia
Term
preeclampsia can result in what
Definition
in restricted blood flow to the placenta and harm to the developing fetus
Term
the loss of subcutaneous tissue in the face causes
Definition
sagging skin
wrinkles
more prominent cheekbones
Term
rigidity of cervical vertebrae causes _____ of head and neck
Definition
decreased ROM
Term
the loss of hormones causes what to the eyebrows
Definition
them to be coarse and sparse
Term
which cultures cover their head and face
Definition
muslim and sikh
Term
this causes facial deformity
Definition
fetal alcohol syndrome
Term
some infants have a flat occipital prominence(plagiocephaly) which may result from
Definition
putting them to sleep on their backs
Term
thyroid disease is common in areas where ____ is limited
Definition
iodine
Term
iodine deficiency disorders include what
Definition
goiter and hypothyroidism
Term
goiter is due to what
Definition
dietary practices
Term
they are overseeing global programs to increase the use of iodized salt to prevent hypothyroidism and goiter
Definition
World health organizations (WHO)
Term
iodine deficiencies occur in areas with soil poor in iodine. these areas include
Definition
eastern europe
parts of south america
australia
western US
Term
goiter and hypothyroidism is a big problem where
Definition
india and china
Term
hypothyroidism is more common in ___
Definition
caucasian
Term
what are you some good subjective examination/health history questions to ask for the head and neck
Definition
"are you having any problems with your head or neck today?"(lumps, swelling)
"have you had any recent illnesses?"
Term
what is the term for difficulty swallowing
Definition
dysphasia
Term
what is the term for difficulty eating
Definition
gysphasia
Term
what are you looking for when you do the inspection and palpation of the face
Definition
structures
symmetry
ROM of TMJ
Term
what are you looking for when you do the inspection and palpation of the neck
Definition
symmetry
ROM
carotid/jugular veins
lymph nodes
Term
**when assessing the lymph nodes what are you looking for
Definition
size
shape
delimitation
mobility
consistency
tenderness
Term
over or undersecretion by the thyroid gland may cause
Definition
rapid weight gain or loss
erratic temperature regulation
fatigue
dyspnea (painful breathing)
mood swings
Term
head injury can result in
Definition
acute or chronic neurologic problems
Term
dizziness, loss of consciousness, seizures or blurred vision may indicate problems with
Definition
carotid arteries, cerebral clots or bleeding, recent head injury or neurologic disease
Term
swelling, masses and lesions that do not heal may indicate?
Definition
cancer
Term
lateral neck masses are usually due to
Definition
enlargement of the cervical lymph nodes, indicative of infection or malignancy
Term
swelling in the medial aspect of the neck may be indicative of
Definition
thyroid pathology
Term
the rationale for the question "has your neck been weak, sore or stiff?
Definition
neck symptoms may indicate problems with the muscles of the neck or the cervical spinal cord or an infectious problem such as meningitis
Term
use of alcohol, tobacco, street drugs, and large amounts of caffeine can affect neurologic function and ____ headaches
Definition
increase
Term
a depressed fontanel can indicate _____
Definition
dehydration
Term
a bulging fontanel can indicate an _____
Definition
infection
Term
radiation exposure increases the risk for thyroid tumors. yes or no
Definition
yes
Term
the thyroid is palpated for
Definition
movement, texture, identification of size or abnormalities
Term
the lymph nodes of the head and neck are palpated to
Definition
evaluate enlargement, tenderness, and mobility
Term
the temporal artery is auscultated.true or false
Definition
true
Term
in adults, the skull should be ______, that is a rounded and symmetric shape
Definition
normocephalic
Term
carotid artery pulsation is usually visble ____
Definition
bilaterally
Term
the trachea is visible ____
Definition
midline
Term
what moves with swallowing
Definition
trachea, hyoid bone and tracheal cartilage
Term
jerky movements or tics of the head, face and eyes may be a result of
Definition
neurologic or psychologic disoders
Term
which cranial nerves control movement of the eye
Definition
III(oculomotor), IV(Trochlear), VI(abducens)
Term
which cranial nerve stimulates movement for mastication
Definition
V(trigeminal)
Term
which cranial nerve controls movement of the face?
Definition
VII (facial)
Term
while you palpate the head and scalp what should you note
Definition
contour, size and texture
Term
while you palpate the head and scalp what abnormalities should you note?
Definition
tenderness, swelling, edema, or masses which require further evaluation
Term
when you palpate the temporal artery (between the eye and the top of the ear) the artery should feel smooth. but if you feel any thickening or tenderness that could indicate
Definition
inflammation of the artery
Term
when you auscultate the temporal artery, which part of the stethoscope do you use
Definition
bell
Term
you use the bell of the stethoscope to auscultate the temporal artery looking for a ______
Definition
bruit(a soft blowing sound)
Term
do you usually hear bruits?
Definition
no
Term
what is bruits indicative of
Definition
stenosis(narrowing of the vessel)
Term
when you place your fingers in front of each ear and ask the client to open and close the mouth slowly. there should be no limitation of movement or tenderness. you should feel a slight ______ of the joint
Definition
indentation
Term
if you hear soft clicking noises while doing TMJ is that normal
Definition
yes
Term
crepitation, a cracking sound on movement of TMJ indicates
Definition
joint problems
Term
when you palpate the thyroid gland do you do it from the front or back
Definition
from the back
Term
excessive rigidity of the neck may indicate
Definition
arthritis
Term
inability to hold the neck erect may be due to
Definition
muscle spasms
Term
any pain or limitation of movement when you are doing the ROM of the neck that indicates
Definition
arthritis, muscle spasm or inflammation
Term
rapid movement and compression of the cerebral vertebrae may cause
Definition
dizziness
Term
if any distention or prominence while observing the carotid arteries and jugular veins may indicate
Definition
a vascular disorder
Term
is the result of masses in the neck or mediastinum, pneumothorax, or pulmonary fibrosis
Definition
tracheal displacement
Term
when is the thyroid observable
Definition
when the client swallows. so give the client a cup of water
Term
if the client has any enlargement of the thyroid or masses near the thyroid, they appear as _____ when the client swallows
Definition
bulges
Term
the thyroid moves _____ as the client swallows
Definition
superiorly
Term
what can you do so you can see the thyroid better
Definition
adjust the lighting in the room so that shadows are cast on the clients neck.
Term
with the clients head turned slightly to the right, you use your left hand to push the trachea to the right. use light pressure during palpation to avoid obliterating findings. with the fingers of the _____ hand, palpate the area between the trachea and the sternocleidomastoid muscle. slowly and gently retract the sternocleidomastoid muscle and then ask the client to drink a sip of water. palpate as the thyroid glands moves up during swalowing.
Definition
right
Term
an enlarged thyroid gland may be due to a metabolic disorder such as _____. palpable masses of ______ are alterations in health. there _____,____, and ___ should be documented
Definition
hyperthyroidism or hypothyroidism
5 mm or larger
location, shape and size
Term
enlarged thyroid gland during pregnancy can be a normal finding. however most pathologic hyperthyroidism in pregnancy is caused by
Definition
graves disease
Term
an autoimmune disorder that causes increased production of thyroid hormone
Definition
graves disease
Term
enlargement of lymph nodes is called what? and can be due to what
Definition
lymphadenopathy
infection, allergies, or a tumor
Term
the presence of a bruit is an abnormal and is indication of
Definition
increased blood flow
Term
this is usually preceded by an aura during which the client may feel depressed, restless, or irritable; see spots or flashes of light; feel nauseated; or experience numbing or tingling in the face or extremites
Definition
classic migraine
Term
classic migraine it is usually a pulsating pain that is localized to the ________ of the head and may be accompanied by nausea, vertigo, tremors and other symptoms
Definition
side, front or back
Term
the acute phase of a classic migraine typically lasts how long
Definition
4-6 hrs
Term
do you classic migraines have aura?
Definition
yes
Term
do cluster headaches have aura?
Definition
no
Term
this headache is named that way because numerous episodes occur over a period of days or even months and then are followed by a period of remission during which no headaches occur
Definition
cluster headaches
Term
is cluster headaches sudden
Definition
yes
Term
cluster headaches may be associated with
Definition
alcohol consumption, stress or emotional distress
Term
this headache suddenly begins at night with an excruciating pain on one side of the face spreading upward behind one eye.
Definition
cluster headache
Term
how long do cluster headaches last
Definition
for only a few minutes or up to a few hours
Term
the nose and affected eye water, and nasal congestion is common with this headache
Definition
cluster headache
Term
a tension headache is also known as
Definition
muscle contraction headache
Term
this headache is due to sustained contractions of the muscles in the head, neck, or upper back.
Definition
tension headache (muscle contraction headache)
Term
what is the onset of tension headache
Definition
gradual
Term
this headache the pain is usually steady, not throbbing. the pain may be unilateral or bilateral and typically ranges from the cervical region to the top of the head
Definition
tension headache (muscle contraction headache)
Term
tension headaches may be associated with
Definition
stress, overwork, position, dental problems, premenstrual syndrome, sinus inflammation and other health problems
Term
is the enlargement of the head caused by inadequate drainage of cerebrospinal fluid, resulting in abnormal growth of the skull
Definition
hydrocephalus
Term
is the early closure of sutures.
Definition
craniosynostosis
Term
with early closure of the sagittal suture, the head _____
Definition
elongates
Term
with early closure of the coronal sutures, the head, face and orbits are ____
Definition
altered
Term
is the enlargement of the bones, facial features, hands and feet due to INCREASED GROWTH HORMONE
Definition
acromegaly
Term
is a temporary disorder affecting cranial neves VII(facial) and producing a UNILATERAL FACIAL PARALYSIS
Definition
bells palsy
Term
what is bells palsy usually caused by
Definition
virus
Term
what is the onset of bells palsy
Definition
sudden and it usually resolves spontaneously in a few weeks without residual effects
Term
is an INCREASED ADRENAL HORMONE PRODUCTION leading to a rounded "moon" face, ruddy cheeks, prominent jowls, and excess facial hair
Definition
cushing syndrome
Term
WHAT CAUSES CUSHING SYNDROME
Definition
long term use of corticosteriods
Term
is a chromosomal defect causing varying degrees of mental retardation and characteristic facial features such as slanted eyes; a flat nasal bridge, a flat nose; a protuding tongue; and a short, broad neck
Definition
down syndrome
Term
MASK LIKE APPEARANCE OF THE FACE
Definition
parkinsons disease
Term
parkisons disease is the result of
Definition
decrease in dopamine, a neurotransmitter
Term
FACIAL PARALYSIS
Definition
cerebrovascular accident/brain attack(stroke)
Term
is a disorder characterized by epicanthal folds, narrow palpebral fissures, a deformed upper lip below the septum of the nose, and some degree of mental retardation.
Definition
Fetal alcohol syndrome (FAS)
Term
is a spasm of the muscles supplied by the spinal accessory nerve, causing lateral flexion contracture of the cervical spine musculature. it may be a result of birth trauma(congenital), scars, disease of teh cervical vertebrae, abscesses, TMJ, tumores or other problems in the cervical area.
Definition
torticollis
Term
if torticollis is left untreated the muscle becomes _____
Definition
fibrotic and permanently shortened
Term

**what are the signs of hyperthyroidism?

 

Definition
Results in enlargement of the gland, exophthalmos(bulging eyes), thinnning hair, weight loss, diarrhea
Term
excessive production of thyroid hormones
Definition
hyperthyroidism
Term
GOITER is an enlarged thyroid gland which may be caused by _____
Definition
hyperthyrodism or hypothyroidism
Term
**general term for enlarged thyroid gland
Definition
goiter
Term
what is exophthalmos
Definition
bulging eyes
Term
what is the most common type of hyperthyroidism
Definition
graves disease
Term
**what are the signs of hypothyroidism?
Definition
fatigue, weakness, weight gain, constipation, memory impairment
Term
can occur following radiation of the thyroid, chronic goiter, or as a result of hereditary factors. they are malignant tumors in hormone-producing cells or supporting cells.
Definition
thyroid carcinoma
Term
what is produced in the thyroid carcinoma
Definition
excess thyroid hormone
Term
in congenital hypothyrodism, the thyroid is nonfunctioning at ___
Definition
birth
Term
this severe hypothyroidism causes nonpitting edema throughout the body and thickening of facial features. complications of this disease affect major organ systems. results in cardiovascular collapse, electrolyte disturbances, respiratory depression and cerebral hypoxia
Definition
myxedema
Term
is an inflammation of the thyroid gland. this inflammation may cause release of stored hormones, resulting in temporary hyperthyroidism of weeks or months
Definition
thyroiditis
Term
postpartum thyroidism is a temporary condition occuring in _____ % of the females population
Definition
5-9%
Term
is an autoimmune disease that results in primary hypothyroidism. this form of thyroidtis occurs most frequenty in females and tends to be familial
Definition
hashimotos thyroiditis
Term
**the nurse is preparing to teach an expectant parent class and includes information about signs and symptoms of hypothyroidism because
Definition
congenital hypothyroidism is a cause of mental retardation
Term
**what should the nurse ask the client to do to make the palpation of the supraclavicular nodes easier?
Definition
"shrug your shoulders"
Term
**when preparing to do an assessment of a client presenting to the clinic with head and neck problems, in what order will the nurse perform the assessment?
Definition
1. interview
2. inspect
3. palpate
4. auscultate
Term
to physically examine the trachea and thyroid gland, the nurse begins with the
Definition
hyoid
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