Ch 13 - Head, Face, and Neck, Including Regional Lymphatics
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39 terms
Terms | Definitions |
|---|---|
 fontanels | posterior fontanel (triangle) closed by 1-2 months anterior fontanel (diamond) closed by 9mo-2 years |
| growth in infants/children | head growth predominates in fetal period trunk growth predominates in infancy head reaches final size @ age 6 lymphatic tissues grows rapidly until age 10-11, exceedes adut size before puberty |
| subjective data for head and neck | - headache - injury - dizziness - neck pain, limitation of ROM - lumps or swelling - history of head/neck surgery |
| tension headaches | tend to be occipital, frontal, or w/bandlike tightness - vicelike pain |
| migraines (vascular) | supraorbital, retro orbital, or frontotemporal - throbbing pain - occur 2 x month lasting 1-3 days - nausea, vomiting, visual disturbances - relieved w/supination |
| cluster headaches (vascular) | pain around eye, temple, cheek, forehead - eye reddening, tearing, runny nose - pain is alwats unilateral and always on the same side of head - once or twice per day lasting .5-2 hours for 1 to 2 months then stop for a long time - relieved by activity |
| meningitis or encephalitis | nuchal rigidity, fever - acute onset of neck stiffness and fever |
| dizziness | light-headed, swimming sensation, feeling of falling |
| vertigo | true rotational spinning from neurologic disease objective: feels like the room is spinning subjective: the person feel like she is spinning |
| inspect and palpate head | normal: normocephalic = round, symmetrical skull that is appropriately related to body size, no tenderness, normal protrusions abnormal: microcephaly, macrocephaly (hydrocephaly, acromegaly, Paget's disease), no lumps or depressions |
| TMJ | normal: smooth w/out limitation or tenderness abnormal: crepitation, tortuous artery, limited ROM or tenderness |
| lymph nodes | normal: cervical nodes can be palpable in healthy person esp if younger. should be moveable, discrete, soft, nontender abnormal: parotid enlargement - mumps, aids lymphadenopathy (>1 cm) from infection, allergy, neoplasm |
| trachea | should be midline if not, due to: pushed to the other size = aneurysm, tumor, unilateral thyroid, lung collapse pulled down - large atelectasis, pleural adhesions, fibrosis - tugged down w/systole = aortic arch aneurysm |
| thyroid | not usually felt, best if palpated from behind abnormal: lumps, enlargement, tenderness bruit = hyperplasia/hyperthyroidism |
| infant's head size | newborn: ~34cm, 2cm larger than chest circumferance by age 2: head = chest childhood: chest>head by 5-7cm abnormal: frontal bulges/bossing = premature rickets |
| caput succedaneum | edematous swelling and ecchymosis of presenting part of the head due to birth trauma - feels soft, may extend across suture lines - resolves, no treatment needed |
| cephalhematoma | subperiosteal hemorrhage right below the skin due to birth trauma - soft, well defined, held over one bone by periosteum - will be reabsorbed without treatment, just looks weird - at risk for jaundice as blood is broken down by body |
| infant skull | normal: sutures smooth and not palpable after 6 mo can be asymmetric after birth due to molding from birth canal or if infant sleeps on one side abnromal: craniosynostosis, marked asymmetry, from premature closing of sutures = long, narrow head flattening from rickets or mental retardation depressed/sunken = dehydration bulging or pulsations = increased cranial pressure delayed closure/large fontanel size = hydrocephaly, Downs, rickets, hypothyroidism |
| infant head and neck posture | normal: turn head side to side by 2 weeks - tonic neck reflex when supine (disappears btwn 3-4 mo) - fencing position - head control at 4 months percussion = resonant/cracked pot sound - bruits common <5 years w/anemia (after 5 years = brain pressure, aneurysm) abnormal: tonic head reflex beyond 5 mo = brain damage head tilt w/tumor, porr vision, spasm head lag after 4 mo = mental or motor retardation |
| cholasma | normal hyperpigmentation in pregant woman's face thyroid may be palpable (normal) |
| senile tremors | benign, include head nodding (like yes/no), and tongue protrustion |
| hydrocephalus | obstruction of CSF drainage so head sweels - percussion = cracked pot (macewen's sign) - downcast eyes - bossing |
| paget's disease of bine | askeletal disease w/increased bone resorption and formation which softens, thickens, deforms bone - 10 of those 80+, men - bossing - enlarged skull presses cranial nerves = headache, vertigo, tinnitus, |
| acromegaly | excessive secretion of growth hormone from pituitary gland after puberty = enlarged skull and thick cranial bones |
| torticollis (wryneck) | hematoma on sternomastoid muscle results in head tilt and limited neck ROM to opposite side - firm, nontender mass in midmuscle - must be treated or muscle becomes fibrotic and perma shortened |
| goiter | chronic enlargement of thyroid gland due to low iodine |
| thyroid - multiple nodules | multiple - inflammation single - usually benign but can be malignany. painless, rapid growth. cancerous tends to be hard and fixed |
| pilar cyst (wen) | smooth firm swelling on scalp filled w/sebum and keratin - skin is shiny and taut |
| parotid gland enlargement | rapid inflammation of parotid (from mumps or tumor, abcess) - swelling anterior to earlobe - stensen duct obstruction can occur in aging adult from dehydration |
| fetal alcohol syndrome | narrow palebral fissures, flat midface, thin upperlip, short nose, indistinct philtrum |
| congenital hypothyroidism | low hairline, hirsuite forehead, swollen eyelids, puffy face, widely spaced eyes, head size normal but anterior and posterior fontanels open |
| down syndrome | upslanting eyes, flat nasal bridge, thick tongue, short and webbed neck, small hands w/one palmar crease |
| atopic (allergic) facies | in children w chronic allergies - blue shadows below the eyes - creases on lower lids = morgans lines - open outh breathing - transverse line on nose = allergic salute |
| parkinson syndrowm | flat expressionless face |
| cushing syndrome | excessive ACTH = moonlike jowls, red cheeks, hair on upper lip, cheeks, chin - rash on chest |
| cachectic appearance | from chonic wasting disease - sunken eyes, hollow cheeks, defeated expression |
| stroke or CV accident | upper motor neuron lesion = paralysis of lower facial muscles but can still close eyes and wrinkle forehead (vs bells palsey = lower motor neuron) |
| facial bone that articulates at a join instead of a suture | mandible |
| bells palsy | unilateral paralysis of half of the face |
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