Exam 3 - Head, Neck, & Regional Lymphatics Flashcards

(92 cards)

1
Q

What are the cranial bones?

A

Frontal
Parietal
Occipital
Temporal

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2
Q

What are the cervical vertebrae and what is their function?

A

C1-C7
Support the cranium
C7 (vertebra prominens) is a useful landmark

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3
Q

Nerve that mediates facial muscles

A

CN VII

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4
Q

Name the salivary glands

A

Parotid
Submandibular
Sublingual

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5
Q

Where is the parotid salivary gland?

A

Cheeks over mandible

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6
Q

Where is the submandibular salivary gland?

A

Beneath mandible at angle of jaw

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7
Q

Where is the sublingual salivary gland?

A

Floor of the mouth

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8
Q

Where is the temporal artery and why is it important

A

Superior to temporalis muscle

Pulsation is palpable anterior to ear

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9
Q

Function of internal carotid artery

A

Supplies brain

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10
Q

Function of external carotid artery

A

Supplies face, salivary glands, superficial temporal area

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11
Q

Major neck muscles

A

Sternomastoid

Trapezius

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12
Q

Where is the sternomastoid located?

A

Runs from sternum and clavicle, diagonal across neck, to pastors process (behind ear)

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13
Q

Function of sternomastoid muscle

A

Head rotation and flexion
Divides each side of neck into two triangles; anterior and posterior, which are helpful guidelines when describing findings in the neck

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14
Q

Where is the trapezius muscle located?

A

Two, on upper back

From occipital bone and vertebrae, extend fanning out to scapula and clavicle

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15
Q

Function of the trapezius muscle

A

Move shoulders and extend and turn head

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16
Q

Cranial nerve that innervates the major neck muscles

A

CN XI (spinal accessory)

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17
Q

Where is the thyroid gland located?

A

Straddles trachea

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18
Q

Function of the thyroid gland

A

Synthesizes and secretes hormones that stimulate the rate of cellular metabolism: Thyroxine (T4) and Triiodothyronine (T3)

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19
Q

What does the thyroid cartilage look like?

A

Has a small, palpable V in upper edge = Adam’s apple

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20
Q

Where is the carotid cartilage located?

A

Beneath thyroid cartilage

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21
Q

Where is the Isthmus of the thyroid gland?

A

Hugs 2nd and 3rd tracheae rings

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22
Q

What are lymph nodes?

A

Small, oval clusters of lymphatic tissue that are set at intervals along lymph vessels

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23
Q

Function of lymph nodes

A

Slowly filter lymph and engulf pathogens

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24
Q

Where are lymph nodes located?

A

Present throughout the body, but are only palpable in head and neck, arms, axillae, and inguinal regions

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25
List the lymph nodes in order of how you should palpate them
``` 1- Preauricular 2- Posterior auricular 3- Occipital 4- Submental 5- Submandibular 6- Jugulodigastric 7- Superficial cervical 8- Deep cervical 9- Posterior cervical 10- Supraclavicular ```
26
Where do all head and neck structures eventually drain?
Into the deep cervical chain
27
Where is the Preauricular lymph node located?
In front of ear
28
Where is the posterior auricular (mastoid) lymph node located?
Superficial to mastoid process
29
Where is the occipital lymph node located?
At base of skull
30
Where is the Submental lymph node located?
Midline, behind tip of mandible
31
Where is the submandibular lymph node located?
Halfway between angle and tip of mandible
32
Where is the Jugulodigastric (tonsillar) lymph node located?
Under angle of mandible
33
Where is the superficial cervical lymph node located?
On top of sternomastoid muscle
34
Where is the posterior cervical lymph node located?
In posterior triangle, along edge of trapezius muscle
35
Where is the supraclavicular lymph node located?
Just above and behind clavicle, at sternomastoid muscle
36
Function of the lymphatic system
Detects and eliminates foreign substances from body | Gather clear, watery fluid (lymph) from tissue spaces into circulation
37
Leading cause of acute pain
Headaches
38
Things headaches can be produced by:
``` Hypertension Fever Hypothyroidism Vasculitis Oral contraceptives Bronchodilators Alcohol Nitrates Carbon monoxide inhalation ```
39
When are headaches a red flag?
If sever headache in pt who has never had one
40
How do you know if a headache is a tension headache?
If it’s occipital, frontal, bandlike tightness | Viselike pain
41
What are tension headaches associated with?
Anxiety/stress
42
How can you tell if a headache is a migraine?
Supraorbital, retro-orbital, frontotemporal | Sever, throbbing pain
43
What makes a migraine chronic?
If 15 or more days per month
44
What makes a migraine episodic?
If <15 days per month | Last 1-3 days
45
What are migraines associated with?
Nausea Vomiting Visual disturbances
46
How can you tell if a headache is a sinus headache?
Pain around eye or cheek
47
What makes a headache a cluster headache?
Unilateral pain, always on same side of head, excruciating
48
What does temporal arteritis feel like?
Throbbing pain
49
What is presyncope?
Light headed/swimming sensation or feeling of fainting or falling
50
What is presyncope caused by?
Decrease of blood flow to the brain
51
What is vertigo?
True rotational spinning
52
Types of vertigo and what they mean
Objective - pt feels like the room is spinning | Subjective - pt feels like they are spinning
53
If a pt has vertigo with unilateral hearing loss, what could that mean?
Meniere disease
54
What is disequilibrium?
Shakiness or instability when walking, related to musculoskeletal disorder or multi sensory deficits
55
Pt has acute onset of neck stiffness with HA and fever
Meningitis
56
If pt has lumps or swelling in neck and feels tenderness when palpating
Acute infection
57
If pt has persistent lump
Be suspicious of malignancy | If pt age 40+, assume malignancy until proven otherwise
58
If pt has history of radiation, what are they at an increased risk of?
Risk for salivary and thyroid tumors
59
Trouble swallowing
Dysphagia
60
Pt has an abnormally small head
Microcephaly
61
Pt has an abnormally large head
Macrocephaly
62
Obstruction of drainage of cerebrospinal fluid that results in accumulation, increasing intracranial pressure and enlargement of head
Hydrocephaly
63
Excessive secretion of GH from pituitary gland after puberty resulting in enlarged skull and thickened cranial bones
Acromegaly
64
If pt has tenderness and hard band to palpating in temporal area
Temporal arteritis
65
If pt has facial asymmetry with central brain lesion
Stroke
66
If pt has facial asymmetry with peripheral CN VII damage
Bell palsy
67
If pt has immobility of facial features with a flat and expressionless face
Parkinson syndrome
68
Cranial nerve affected with Bell palsy
CN VII
69
When checking neck ROM and pt has a head tilt
Occurs with muscle spasm
70
When checking pt’s neck ROM, and they have a rigid head and neck with ratchety or limited movement. Person turns at shoulders
Arthritis
71
What does lymphoid enlargement look like?
Unilateral lump or diffuse and looks like a donut
72
If pt has a swollen parotid gland
Seen with mumps | And AIDS
73
What is lymphadenopathy?
Enlargement of lymph nodes > 1 cm
74
What could lymphadenopathy be caused by?
Infection, allergy, or neoplasm
75
What would make you think a patient has an acute infection in lymph nodes?
``` Acute onset <14 days Nodes enlarged bilaterally Warm Tender Firm but freely movable ```
76
What would make you think a pt has chronic inflammation of their lymph nodes?
>14 days duration
77
Example of chronic inflammation of lymph nodes
Tuberculosis
78
What would make you think a pt has cancerous lymph nodes?
``` Hard rocks >3 cm Unilateral Nontender Matted Fixed ```
79
What would make you think a pt has an HIV infection?
``` Nodes enlarged Firm Nontender Mobile Occipital node enlargement common ```
80
What would make you think a pt has a neoplasm in their thorax or abdomen?
Single enlarged Nontender Hard left supraclavicular node
81
What would make you think a pt has Hodgkin lymphoma?
Nodes are painless Rubbery Discrete nodes that gradually appear (commonly in cervical region)
82
What does it mean if a pt’s trachea is pushed to the affected side?
Aortic aneurysm Tumor Unilateral thyroid lobe enlargement Pneumothorax
83
What does it mean if a pt’s trachea is pulled toward the affected side?
Large atelectasis Pleural adhesions Fibrosis
84
What does it mean if a pt has a tracheal tug?
Rhythmic downward pull, synchronous with systole | Occurs with aortic arch aneurysm
85
What should you look at when palpating the thyroid gland?
Look for diffuse enlargement or nodular lump
86
What would be abnormal when palpating the thyroid gland?
Enlarged lobes that are easily palpated before swallowing or are tender to palpation or presence of a lump
87
What do cancerous nodes on a thyroid gland feel like?
Usually hard and fixed to surrounding structures
88
**How does the thyroid negative feedback system work?
1- hypothalamus secretes TRH, which 2- acts on anterior pituitary to secrete TSH, which 3- directs thyroid gland to produce T3 & T4 hormones. When T3 & T4 are high in blood stream, they 4- direct the pituitary and hypothalamus to shut off their signaling hormones When T3 & T4 levels are low, pituitary sends out increasing TSH to stimulate new production of T3 & T4
89
What is Graves’ disease?
Hyperthyroidism = increased metabolism
90
What does Graves’ disease look like?
Goiter Eyelid retraction Bulging eyes
91
What is myxedema?
Hypothyroidism = decreased metabolism | Usually caused by Hashimoto thyroiditis
92
What does myxedema look like?
Fatigue | Cold intolerance