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PE Skills Exam 4 Neck
Neck
62
Anatomy
Graduate
11/18/2010

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Term
The skull is composed of ___ fused bones. Name them.
Definition
- seven
- 2 frontal
- 2 parietal
- 2 temporal
- 1 occipital
Term
List the face bones:
Definition
Frontal
Nasal
Zygomatic
Ethmoid
Lacrimal
Sphenoid
Maxilla
Mandible
Term
Palpebral fissures are the ___ __ __ ___,
Definition
slits of your eyes
Term
Major landmarks of face:
Definition
- palpebral fissures
- nasolabial folds
Term
The ____ artery is the major accesible artery of the face.
Definition
temporal
Term
List the 3 salivary glands and their locations:
Definition
Parotid gland: anterior to ear, above mandible
Submandibular gland: medial to mandible at angle of jaw
Sublingual gland: anterior in floor of mouth
Term
Mumps make the ___ glands swollen.
Definition
parotid
Term
Stenson's ducts drain the ___ glands.
Definition
parotid
Term
___ ducts drain the sublingual glands.
Definition
Whartons
Term
Structure of the neck is formed by the :
Definition
- cervical vertebrae
- ligaments
- sternocleidomastoid mm.
- trapezius mm.
Term
Contents of the neck:
Definition
Trachea
Esophagus
Internal and external jugular veins
Internal and external carotid arteries
Thyroid
Lymph nodes
Term
Posterior triangle of the neck is formed by:
Definition
- trapezius muscle
- sternocleidomastoid muscle
- clavicle
Term
The anterior triangle of the neck is formed by:
Definition
- sternocleidomastoid muscle
- mandible
- midline
Term
The ____ is the largest endocrine gland in the body.
Definition
thyroid
Term
The thyroid produces what two hormones?
Definition
- T3: triiodothyronine
- T4: thyroxine
Term
The thyroid is located on each side of the ____ and is joined by the ___ below the ___ cartilage.
Definition
- trachea
- isthmus
- cricoid
Term
Thyroid is very important in kids b/c involved with ___ development.
Definition
brain
Term
What is the difference between T3 and T4?
Definition
number of iodides attached
Term
In infants the cranial bones are soft and separated by ____ and ___.
Definition
sutures and fontanels
Term
A suture is where ___ bones come together, while a fontanel is where ___ bones come together.
Definition
- two
- multiple
Term
Sutures ossify at what age?
Definition
- age 6 to 18 years
Term
Fontanels close at what age?
Definition
- 2 months to 2 years
Term
The anterior fontanel is made of what bones and when does it close?
Definition
- frontal
- temporal
- parietal
- closes between 9 and 18 months
Term
The posterior fontanel is made of what bones and when does it close?
Definition
- parietal bones and occipital bone
- closes at 2 months
Term
When you observe the head position look for:
Definition
- tilt
- tremor
Term
Inspect the skull, scalp, and face for:
Definition
Size and shape
Symmetry, tics
Characteristic facies, unusual features
Lesions, skin coloring
Trauma
Term
Palpate head and scalp for:
Definition
Symmetry
Tenderness (particularly over areas of frontal and maxillary sinuses)
Sutures/ fontanels
Hair texture, color, and distribution
Temporomandibular Joint (TMJ)
Term
Head exam continued:
Definition
Ausculate the temporal arteries and palpate, noting the following:
Bruits
Thickening or hardness
Tenderness
Inspect and palpate the salivary glands.
Transilluminate the skull of infants with rapidly increasing head circumference.
Percussion
When evaluating for hypocalcemia
Percussion on the masseter muscle may produce a hyperactive masseteric reflex, Chovstek’s sign.
When evaluating sinuses
Frontal and Maxillary
Term
You measure head circumference up to age _. You can ____ the skull to check for rapidly increasing head circumference. If it glows, you know there is extra fluid.
Definition
- transilluminate
Term
How do you evaluate for hypocalcemia?
Definition
- percuss the masseter muscle and it may produce a hyperactive masseteric reflex called Chovstek's sign
Term
Chovstek's sign:
Definition
- you percuss over masseter muscle b/c facial nerve is under there
- if hypocalcemic, the face will twitch on the same side= Chovstek's sign
- seen with parathyroid disorders
Term
Neck exam:
Definition
Inspect the neck for the following
Symmetry
Alignment of trachea
Masses, webbing
Auscultate the carotids
Palpate the neck, noting the following:
Tracheal position
Lymph nodes
Carotids
Palpate the thyroid gland for the following:
Size and shape
Consistency
Tenderness and nodules
If gland is enlarged, auscultate for bruits.
Evaluate range of motion of the neck.
Flexion and extension
Lateral flexion
Rotation
Term
A trachea deviated to the left means ___ ___ ____.
Definition
- right sided pneumothorax
Term
To palpate the trachea you place your thumbs on either side to make sure it is midline. Also are checking for ___ ___, this is seen with an ____ in the __ ___, which would pull the trachea down when the heart is contracting.
Definition
- tracheal tug
- aneurysm
- aortic arch
Term
If the thyroid gland is enlarged, you should ___ for ___.
Definition
- auscultate
- bruits
Term
To palpate the thyroid, stand ___ the patient and find the thryoid, using ___ pressure. Have the patient swallow and palpate one side at a time. You should feel the trachea and thryoid gland move up.
Definition
- behind
- light
Term
In infants measure the _______ head circumference.
Definition
- fronto-occipital
Term
If a fontanel feels tense in an infant, and the infant is really fussy, you need to worry about ____.
Definition
- meningitis
Term
You may see ___ ___ ___ in an infant whose head is enlarging rapidly.
Definition
- dilated scalp veins
Term
Caput succedaneum is where there is swelling or blood trapped between the ___ and ___ of the skull, so a large area of the head will be enlarged, discolored, and squishy.
Definition
- periosteum
- scalp
Term
Cephalhematoma is swelling or trapped blood between the ___ and ___ of the skull, thus swelling will not cross suture lines, and will only be in one area.
Definition
- bone
- periosteum
Term
Baby can usually lift it's head at __ months.
Definition
2
Term
What is craniotabes?
Definition
softening of edges of skull bones in babies
Term
You can identify a tension headache how?
Definition
palpating the head will cause tenderness
Term
classic migraine definition:
Definition
- migraine with an aurora, smell or see lights or crescent shape before headache begins
Term
Common migraine:
Definition
- migraine without and aurora
Term
Cluster headaches
Definition
fairly young men, very intense headaches just behind the eyes, usually last 20 minutes and go away, come in clusters for 2 weeks or so and then go away and come back later
Term
Salivary gland tumors are most likely to be in the ___ gland.
Definition
parotid
Term
Thyroglossal duct cyst will present as a ___ ___ ___. Normally this duct closes off before you are born, but if it doesn't you can get a cyst.
Definition
palpable cystic mass in the neck
Term
In the embryo, the thyroglossal duct connects the ___ of the ___ to the __ ___.
Definition
- back of the tongue to the thyroid gland
Term
A Branchial cleft cyst is a ___ lesion formed by ___ ___ of the ___ ___. In the fetus, the branchial cleft is responsible for development of neck structures, it should involute on its own, but if it doesn't these cysts can happen.
Definition
- congenital
- incomplete involution
- branchial cleft
Term
Torticollis aka ___ __ can be caused by birth trauma, tumors, cranial nerve palsy, muscle spasms, infection, and drug ingestion. The patient will have their head ___ flexed to the ___ side, and their head rotated to the __ side.
Definition
- wry neck
- laterally flexed to affected side
- rotated to opposite side
Term
Myxedema definition:
Definition
- skin and tissue disorder due to severe prolonged hypothyroidism
Term
Myxedema looks like regular edema. What happens is the low thyroid level feeds back on the ____ gland, causing it to make more ____ ___ ___. But still the thyroid gland can't make enough thyroid hormone, so ___ keeps increasing. TSH stimulates ___ in the body to produce ___ ___, which gets deposited in the lower extremities and hands. This new tissue pulls water into it and results in edema.
Definition
- pituitary
- thyroid stimulating hormone
- TSH
- fibroblasts
- connective tissue
Term
Grave's Disease is an ___ disorder in which there are antibodies to the ___ ___ __ receptor leading to an ___ thyroid. A hallmark sign of this is ____, caused by deposition of connective tissue behind the eyes, causing them to buldge.
Definition
- autoimmune
- thyroid stimulated hormone receptor
- overactive
- exopthalmos
Term
Hashimoto's thyroiditis is an ___ disorder in which ___ attack the thyroid gland, causing ____. Signs of this incluide ___ ___ and ___.
Definition
- autoimmune
- antibodies
- hypothyroidism
- lymphoid deposits
- inflammation
Term
An Encephalocele is a ___ ___ defect with protrusions of ___ and ___ that cover it through openings in the skull.
Definition
- neural tube
- brain and membranes
Term
Microcephaly:
Definition
- circumference of head is smaller than normal
- brain has not developed properly or has stopped growing
Term
Craniosynostosis:
Definition
- premature closure of one or more cranial sutures before brain growth is complete
- leads to mishapen skull
Term
Plagiocephaly:
Definition
- condition of flattening of one side of skull
Term
Brachycephaly is a condition where the __ suture closes preamturely causing a shortened __ to ___ diameter of the skull.
Definition
- coronal
- shortened back to front diameter
Term
Important things to document on neck exam:
Definition
Inspection
Palpate
ROM
Carotids
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