head and neck
Head and neck assessment focuses on ......
the cranium, face, thyroid gland, and lymph nodes
The sensory organs
(eyes, ears, nose, and mouth)
framework of head
skull
2 subsection of skull
-cranium
-face
The skull
(view/position)
(A) Anterior view
(B) Left lateral view
what is cranium?
The cranium houses and protects the brain and major sensory organs.
8 bones of cranium
Frontal (1)
Parietal (2)
Temporal (2)
Occipital (1)
Ethmoid (1)
Sphenoid (1)
In the adult client, the cranial bones are joined together by immovable sutures:
the sagittal, coronal, squamosal, and lambdoid sutures.
face?
Facial bones give shape to the face.
14 facial bones
Maxilla (2)
Zygomatic (cheek) (2)
Inferior conchae (2)
Nasal (2)
Lacrimal (2)
Palatine (2)
Vomer (1)
Mandible (jaw) (1)
free movement of mandible
up
down
sideways
where the mandible move?
at the temporomandibular joint (TMJ)
a major artery, is located between the eye and the top of the ear.
temporal artery
gland located on each side of the face, anterior and inferior to the ears, and behind the mandible.
parotid glands
gland located inferior to the mandible, underneath the base of the tongue.
submandibular glands
The structure of the neck is composed of
-muscles
-ligaments
-the cervical vertebrae.
Contained within the neck are the
-hyoid bone
-several major blood vessels
-the larynx
-trachea
-thyroid gland, which is in the anterior triangle of the neck
two of the paired muscles that allow movement and provide support to the head and neck
-sternomastoid (sternocleidomastoid)
-trapezius muscles
muscle that rotates and flexes the head
sternomastoid muscle
muscle extends the head and moves the shoulders.
tapezius muscle
a cranial nerve is responsible for muscle movement that permits shrugging of the shoulders by the trapezius muscles and turning the head against resistance by the sternomastoid muscles.
eleventh cranial nerve ACCESSORY NERVE
located under the mandible, anterior to the sternomastoid muscle.
anterior triangle
located between the trapezius and sternomastoid muscles
posterior triangle
(C1 through C7) are located in the posterior neck and support the cranium
cevical vertebrae
which can easily be palpated when the neck is flexed.
as a landmark will help you locate other vertebrae.
vertebra prominence C7
blood vessels are located bilaterally, parallel and anterior to the sternomastoid muscles.
internal jugular veins
carotid arteries
blood vessels lies diagonally over the surface of these muscles.
external jugular vein
largest endocrine gland in the body
thyroid gland
thyroid hormones
thyroxine (T4)
triiodothyronine (T3)
through which air enters the lungs, is composed of C-shaped hyaline cartilage rings.
trachea
first upper tracheal ring, has a small notch in it.
“cricoid cartilage"
(“Adam’s apple”) is larger and located just above the cricoid cartilage.
thyroid cartilage
which is attached to the tongue, lies above the thyroid cartilage and under the mandible
hyoid bone
are connected by an isthmus that overlies the second and third tracheal rings below the cricoid cartilage. In about one-third of the population, there is a third lobe that extends upward from the isthmus or from one of the two lobes. (pyramidal lobe optional)
two thyroid lobes
filter lymph, a clear substance composed mostly of excess tissue fluid, after the lymphatic vessels collect it but before it returns to the vascular system.
lymph nodes
lymph nodes produce
-lymphocytes
-antibodies
The size and shape of lymph nodes vary
most are less than 1 cm long
are buried deep in the connective tissue.
Lymph nodes in the neck (__)
left
Direction of lymph flow (__)
right
Lymph nodes (__________) that are covered by hair may be palpated in the scalp under the hair.
green dots
nodes overwhelmed by microorganism ; infection
mononucleosis
common head and neck lymph nodes:
Preauricular
Postauricular
Tonsillar
Occipital
Submandibular
Submental
Superficial cervical
Posterior cervical
Deep cervical
Supraclavicular
Deep, constant, throbbing pain; pressure-like pain in one specific area of face or head (e.g., behind eyes); face tender to the touch end
sinus headache
Stabbing pain; may be accompanied by tearing, eyelid droop-ing, reddened eye, or runny nose
cluster headache
Dull, tight, diffuse
tension headache
Accompanied by nausea, vomiting, and sensitivity to noise or light
migraine headache
Aching, steady; neu-rologic and mental symptoms as well as nausea and vomiting may develop
tumor-related headache
Sinus Headache
May occur in ___________________________
one area of face or along eyebrow ridge and below the cheek bone
Cluster Headache
Localized in _________________________________
the eye and orbit and radiating to the facial and temporal regions.
Tension Headache
Usually located in ___________________________
the frontal, tem-poral, or occipital region.
Migraine Headache
Located around ____________________________
eyes, temples, cheeks, or fore-head; may affect only one side of the face.
Tumor-related Headache
Varies with location of ____
tumor
Sinus headache
Lasts until ________________________
associated condition is improved.
Cluster headache
Typically occurs in __________________
the late evening or night
Tension headache
Lasts _____,______,________
days, months, years
Migraine headache
Lasts _____________
up to 3 days
tumor-related headache
Commonly occurs in ________________________
the morning and lasts for several hours.
ACT F.A.S.T
Face drooping
Arm weakness
Speech difficulties
Time to call: Time loss is brain loss
is characterized by enlargement of the facial features (nose, ears) and the hands and feet.
acromegaly
may present with a moon-shaped face with reddened cheeks and increased facial hair.
Cushing syndrome
Exophthalmos is seen in ___________
hyperthyroidism
A tightened, hard face with thinning facial skin is seen in ___________
scleroderma
usually begins suddenly and reaches a peak within 48 hours. Symptoms may include twitching, weakness, paralysis, drooping eyelid or corner of the mouth, drooling, dry eye, dry mouth, decreased ability to taste, eye tearing, and facial distortion. One-sided facial paralysis is characteristic
bell palsy
is characterized by a dull, puffy face; edema around the eyes; and dry, course, and sparse hair.
Myxedema (severe hypothyroidism)
Clients with_______________ have a mask-like facial appearance, along with a shuffling gait, rigid muscles, and diminished reflexes.
Parkinson disease
A ____________________ is any enlargement of the thyroid gland not caused by inflammation or neoplasm
simple (nontoxic) goiter
results in neurologic damage. The symptoms depend on what part of the brain was affected.
(CVA) cerebrovascular accident