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73 Cards in this Set
- Front
- Back
Where are the two pairs of salivary glands that are accessible on examination of the face? (3rd is sublingual)
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1. The parotic gland: in the cheeks over the mandible anteriro to and below the ear...normally not palpable
2. Submandibular glands: beneatht eh mandible at teh angle of the jaw. |
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Name the major neck vessels
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Name the major neck muscles
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Which cranial nerve innervates the neck muscles?
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Cranial nerve XI
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describe the boundaries of the anterior triangle of the neck (helpful in describing findings in neck)
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lies in front between the sternomastoid and the midline of the body with its base up along the lower border of the mandible and apex at the suprasternal notch
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describe the boundaries of the posterior triangle of the neck (helpful in describing findings in neck)
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behind the sternomastoid muscle, with the trapezius muscle on the other side and with its base along the clavicle below
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Head
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cranium-frontal, parietal, occipital, temporal
facial skeleton 22 bones |
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Sutures
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join bones together
coronal-crosses the top of skull ear to ear sagittal-crosses skull from anterior to posterior lambdiodial-seperatesparietal/occipital bones |
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Where is the "Adam's Apple" exactly?
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It is the palpable notch on the upper edge of the thyroid cartilage
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Name and locate structures/cartilage landmarks of the larynx
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cricoid cartilage, adams apple (top of thyroid cartilage), hyoid bone, trachea, thyroid gland, sternomastoid muscle, manubrium, clavicle
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Blood supply to the head/face
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carotid artery, temporal artery branches off located superior/lateral eye, has normal amplitudes 2+
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Cranial nerves in the head
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Trigeminal nerve V-both motor/sensory
Facial Nerve VII-frown/smile motor/sensory(taste) |
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TMJ-Temporal Joint Dysfunction
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problems/symptoms of chewing muscles, joints that connect your lower jaw to your skull
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Meningitis
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nuccal rigidity-stiff neck, headache, fever
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Neck is supported by
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cervical vertebrae, C1-7
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when vertigo is objective the person feels like _____ and when vertigo is subjective the person feels like _______
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the room spins,
they themselves spin |
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major symptoms of meningeal inflammation
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acute onset of neck stiffness with headache and fever
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normocephalic
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denotes a round symmetric skull that is appropriately r/t body size
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microcephaly
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abnormally small head
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macrocephaly
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abnormally large head
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edema in the face occurs where first?
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around the eyes and cheeks where subq tissue is relatively loose
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mumps swells which gland?
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the parotid gland (salivary gland in front of ear)
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edema in the face occurs where first?
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around the eyes and cheeks where subq tissue is relatively loose
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fontanels
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the spaces where sutures have not fully intersected in neonatal skull.
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Purpose of fontanels?
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Allow for growth of the brain during the first year of life.
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When do fontanels close?
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triangle shaped posterior fontanel closes by 3 months and the diamondshape anterior fontanel closes between 9 months to 2 years Book-18mths
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Infants fontanels
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should be flat
bulging-may be normal when infant cries abnormal-may be cause by intracranial pressure or dehydration |
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Trachea
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should be straight (mid line)
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Cluster headaches may be brought on by:
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alcohol and daytime napping
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Providing resistance whil the patient shrugs the shoulders is a test of the status of cranial nerve:
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11
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The trachea is pulled towards the unaffected side in what conditions?
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aortic aneurysm
a tumor unilateral thyroid lobe enlargement pneumothorax |
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The trachea is pulled towards the affected side in what conditions?
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large atelectasis
pleural adhesions fibrosis |
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What is "tracheal tug"?
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A rhythmic synchronous downward pull that occurs with systole often in presence of an aortic arch aneurysm
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Auscultating a bruit in thyroid means.....
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A bruit occurs with accelerated/turbulent blood flow, so it indicates hyperplasia (proliferation of cells) of the thyroid
e.g. hyperthyroidism |
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caput succedaneum
(kay-put sux sidane ium) |
edamatous swelling ad ecchymosis of the presenting part of teh head caused by birth trauma
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cephalhematoma
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subperiosteal hemorrhage, result of birth trauma (head cones back towards back-top of scalp) No treatment. Is reabsorbed during first few weeks of life.
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periosteum
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mebrane that lines the outer surface of all bones
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skull sutures are palpable in infants until they reach ______ of age
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6 months
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tonic neck reflex
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lay an infant supine, turn head to side, same side arm extends and leg flexes
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when should the tonic neck reflex disappear
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by 5 months (if not, may indicate brain damage)
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3 major types of headaches
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tension
migraine cluster |
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tension headache
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usually both sides
tight non throbbing mild-moderate pain gradual onset lasts 30" to days associated with stress occurs situationally (stress) |
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migraine headache
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commonly one sided,sometimes both
throbbing/pulsating rapid onset, lasts 6-24 hrs mod to severe pain photophobia nausea, vomiting often preceded by aura (tingling, visual changes, vertigo abd pain |
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cluster headache
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always one sided
continuous burning piercing pain abrupt onset lasts 45-90 minutes can occur multiple x in day (clusters) exacerbated by ETOH, stress, wind or heat exposure relieved by moving/pacing |
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hydrocephalus
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obstruction of drainage of CSF results in excessive accumulation, increasing ICP and enlargement of head
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Macewen's sign
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"crack pot" sound on percussing head, common in hydrocephalus, normal in infants pre fontanel closure
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hydrocephalus
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obstruction of drainage of CSF results in excessive accumulation, increasing ICP and enlargement of head
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Macewen's sign
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"crack pot" sound on percussing head, common in hydrocephalus, normal in infants pre fontanel closure
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Paget's disease ("padge-it")
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skeletal disease of increased bone resorption and formation which softens, thickens and deforms bone. Affects 10% of those older than 80, more in males.
Characterisitcs: bowed legs, fractures, enlarged skull presses on cranial nerves-headaches, deafness etc. |
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Acromegaly
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excessive sxrn of growth hormone from pituitary gland after puberty creates enlarged skull and thickened cranial bones (often pituitary tumor)
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Torticollis (Wryneck)
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hematoma in one sternomastoid muscle (often d/t intrauterine malposition) results in head tilt. Permanent ROM problems if not treated
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goiter
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chronic enlargement of the thyroid gland that occurs in some regions of the world where the soil is low in iodine. NOT d/t neoplasm
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Pilar Cyst (Wen)
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smooth firm swelling on scalp that contains sebum and keratin. Benign growth.
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Parotid gland enlargement
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rapid painful enlargement of the parotid, occurs with mumps or blockage of duct, abscess or tumor. Can occur with dehydration.
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Fetal alcohol syndrome
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growth and developmental abnormalities from drinking during pregnancy.
Characteristic facies: mid facial hypoplasia, short pallpebral fissures (eyes), thin upper lip |
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Down syndrome
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chromosomal aberration (trisomy 21).
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Cushing syndrome
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excessive sxrn of corticotropin hormone (ACTH) and chronic steroid use, person develops "moon face", prominent jowls, red cheeks, hirsuitism upper lip
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myxedema
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deficiency of thyroid hormone, when severe, causes a non pitting edema or myxedema
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Bell's palsy
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lower motor neuron lesion (peripheral) producing cranial nerve VII paralysis which is almost always unilateral. rapid onset.
Cant' whistle, raise eyebrows etc. |
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scleroderma
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literally "hard skin", rare connective tissue disease characterized by chronic hardening and shrinking, degenerative changes in skin, vessels, skeletal muscles, synovium.
Characteristic facies: hard shiny skin, thin pursed lips |
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atopid (allergic) facies
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children with chronic allergies have these facial characteristics: exhausted face, blue shadows below eyes d/t sluggish venous return, open mouth breathing, central facial pallor
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Parkinson syndrome
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deficiency of neurotransmitter dopamine and degeneration fo basal ganglia in the brain. Immobility of features produces flat expression.
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cachetic appearance
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accompanies chronic wasting disease such as cancer, dehydration, starvation. sunken eyes, hollow cheeks, exhausted, defeated expression
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stroke facies
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an upper motor neuron (central ) lesion. Upper half of face not affected because of the intact nerve from the unaffected hemisphere. can still close eyes/wrinkle forehead.
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Cepahlhematoma is associated with:
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subperiosteal hemorrhage
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Head/neurological
acute assessment |
-head injuries and neurologic changes
-neck pain -trauma to head or neck -lymphatics larger than 1 cm, fixed, irregular, hard or rubbery -hyperthyroidism- if hypermetabolism in all systems |
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neckpain
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related to muscle tension or spasm. assocaited with fever and headache may signify serious illness such as meningitis and should be carefully evaluated
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any patient with sudden onset of neck or jaw pain should be evaluated for
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any patient with sudden onset of neck or jaw pain should be evaluated for
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patients treated with radiation to neck chest or back
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have increased risk for thyrpod and salivary gland malignancies
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Healthy People Goals
Head and Neck |
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Risk factors for cancers in the Neck
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male gender, age older than 50, tobacco use, alcohol consumption
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primary headaches
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benign, often recurring, and not associated with underlying pathology
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secondary headaches
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associated with underlying pathology that ranges from mild, to severe
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