Cranium
houses and protects brain and major sensory organs
Eight Bones of Cranium
frontal (1)
parietal (2)
temporal (2)
occipital (1)
ethmoid (1)
sphenoid (1)
Temporal Artery
major artery located between eye and top of the ear
Parotid Glands
located on each side of face, anterior and inferior to ears and behind mandible
Submandibular Glands
located inferior to mandible, underneath base of tongue
Sternomastoid Muscle
rotates and flexes the head
Trapezius Muscle
extends the head and moves shoulders
Eleventh Cranial Nerve
responsible for muscle movement that permits shrugging of shoulders by trapezius muscles and turning head against resistance by sternomastoid muscle
Internal Jugular Veins and Carotid Arteries
located bilaterally, parallel and anterior to sternomastoid muscles
Trachea
composed of C-shaped hyaline cartilage rings: cricoid cartilage, thyroid cartilage, and hyoid bone
Thyroid Cartilage
Adam's apple; larger than and located just above cricoid cartilage
Hyoid Bone
attached to tongue; lies about thyroid cartilage and under mandible
Cricoid Cartilage
first upper tracheal ring; has small notch in it
Lymph Nodes
filters lymph after lymphatic vessels collect it but before it returns to the vascular system
Lymph
clear substance composed mostly of excess tissue fluid
Filtering Action of Lymph Nodes
removes bacteria and tumor cells from lymph
Size and Shape of Lymph Nodes
vary, but most are less than 1 cm long and buried deep in the connective tissue, making them nonpalpable in normal situations; usually appear in clusters that vary in size from 2 to 100 individual nodes
Happens When Nodes Become Overwhelmed by Organisms
swell and become painful
Happens When Cancer Metastasizes to Lymph Nodes
may enlarge but not be painful
Normal Lymph Nodes
either not palpable or may feel like very small beads
Most Common Head and Neck Lymph Nodes that should be palpated.
Preauricular, Postauricular, Occipital, Tonsillar, Submandibular
Tonsils decrease in size after what age?
5
Palpable cervical lymph nodes decrease between what ages?
50-60
What gland become easier to feel as one ages?
submandibular
What happens to facial bones as one ages?
become more prominent
What happens to skinas one ages?
sags with decreased subcutaneous fat and elasticity
1. Size, shape, configuration, and mobility of head, face, and neck
2. Size, shape and function of neck, trachea, and thyroid gland
3. Palpation of lymph nodes of head and neck
key assessment points
1. Inspect head (size, shape, configuration) & involuntary movement
2. Palpate head
physical assessment
1. Inspect & Palpate: temporal area & Skull for size and shape
2. Inspect the Face & facial structures
3. Palpate temporal artery & temporomandibular joint (TMJ)
4. Inspect neck and palpate
5. Look for symmetry
6. Check range of motion (ROM)
7. Inspect &
objective data of physical exam for head
What Encompasses Inspection of Face?
symmetry, feature, movement, expression, skin condition
What is Palpated to be Certain it's Mid-line on Neck?
trachea
Preauricular
Posterior auricular (mastoid)
Occipital
Submental
Submandibular
Jugulodigastric
(Tonsillar)
Superficial cervical
Deep cervical
Posterior cervical
Supraclavicular
lymph nodes of head & neck
Tobacco use Increases the Risk of which Cancers?
head and neck
Radiation Therapy linked to the Development of which Cancer?
thyroid
A weakened pulsation of the temporal artery is considered
an age related change. It may be common in older clients.
A thick and tender temporal artery may indicate
temporal arteritis accompanied by pain around the temple (no nausea or vomiting)
Temporal arteritis may lead to
blindness
Can be heard via auscultation over the thyroid lobe when there is hyperthyroidism
bruit
Proper technique for examining the thyroid
stand behind client, have him lower chin and turn head toward side being examined.
Less than 1mm, soft, round, mobile from side to side
normal lymph node
Metastatic disease
Lymph nodes become: enlarged, non-tender, fixed (non- moveable)
Meningeal inflammation symptoms
sudden headache, neck pain w/stiffness, fever
Trigeminal neuralgia symptoms
sharp, shooting, facial pain form seconds to minutes in duration.
Cluster headache symptoms
sudden onset of pain, may be precipitated by alcohol, typically occurs in evening, localized to one eye with radiation into facial and temporal areas. Tearing of the eye and runny nose is common.
Migraine headache symptoms
nausea, vomiting, sensitivity to light and sound, pain around the eyes, temples, cheeks, and forehead.
Tension headache symptoms
common in females, usually result from stress, anxiety or depression
Symptom of parotid enlargement
earlobe asymmetry may be due to abscesses or tumors.
Symptoms of mumps
Parotid enlargement w/fever
Symptoms of Bell's palsy
drooping of one side of the face
Inflammation of the facial nerve is associated with
Bell's palsy
Symptoms of adenitis
tenderness, swelling of lymph node in front of ears
Symptoms of TMJ
crepitation with jaw movement
Symptoms of Atelectasis
trachea is pushed to one side
Ideal location to assess facial symmetry
nasolabial folds
Enlargement of supraclavicular lymph nodes may indicate
abdomen or thorax malignancy (supraclavicular lymph nodes are not normally palpable). Check if they are hard, non-tender as these are signs of malignancy as well).
To assess TMJ
ask client to open mouth
Trachea may be pulled to one side in cases of
tumor, thyroid enlargement, aortic aneurysm, pneumothorax, atelectasis, or fibrosis
Thyroid gland is usually
non-palpable (unless client is very thin)
Auscultation of thyroid revealing a soft, blowing, swishing sound may indicate
hyperthyroidism because of increase blood flow through thyroid arteries
Palpate lymph nodes
with fingerpads in a slow waling, gentle circular maotion
Lymph node enlargement exceeding 1 cm
lymphadenopathy (caused by acute or chronic infection, autoimmune disorder or metastatic disease)
lymphadenopathy > 3months
sign of HIV
Normal lymph node mobility
side-to-side & up-down
Normal lymph node in older clients
more fibrotic & fatty
Abnormal lymph node
hard and firm
Enlarged, hard, non-tender node, particularly on left side may indicate
metastasis from a malignancy in the abdomen or thorax
Acorn-shaped, enlarged skull bones
Paget's disease of the bone