what muscle divides the neck into two triangles? and what are the two triangles?
Anterior triangle= Lies in front, between the sternomastoid and the midline of the body
Posterior triangle= behind the sternomastoid muscle, with the trapezius muscle on the other side.
what is the location and function of thyroid gland?
straddle trachea in middle of neck and has a rich blood supply and synthesizes and secretes thyroxine (T4) and triiodothyronine (T3)
name the 10 lymph nodes
- Perauricular: in front of ear
- Posterior auricular (mastoid): superficial to mastoid process
- Occipital: at the base of skull
- Submental : midline, behind the tip of the mandible
- Tonsillar: under the angle of the mandible
- Jugulodigastric: Posterior belly of the digastric muscle crosses the internal jugular vein
- Superficial cervical: overlying the sternomastoid muscle
- Deep cervical: deep under the sternomastoid muscle
- Posterior cervical: In the posterior triangle along the edge of the trapezius muscle
- Supraclavicular: just above and behind the clavicle, at the sternomastoid muscle
what are lymph nodes?
Lymph nodes are small, oval clusters of lymphatic tissue set at intervals along lymph vessels (like beads on a string)
what is the function of nodes?
Nodes filter the lymph and engulf pathogens, preventing potentially harmful substances from entering the circulation
where are the four accessible locations to access nodes on body?
Head + neck
what is specific with head and neck for infants and children?
- bones of neonatal skull are separated by sutures and fontanelles which allow for brain growth in the first year
- cartilage ossifies into true bone for infants
- head growth predominates during fetal period
- trunk growth predominates during infancy
what is specific with head and neck for pregnant women?
their thyroid gland enlarges slightly as a result of hyperplasia (enlargement) of tissue and increased vascularity
what is specific with head and neck for older adults?
-facial bones appear more prominent and skin sags due to decreased elasticity, decreased subcutaneous fat, and decreased moisture in skin
list abnormalities of head and neck issues
- head injury
- neck pain, limitation of movement
- lumps or swelling
- history of head or neck surgery
what is the additional history for infants and children?
- prenatal drug exposure (did mother use drugs while pregnant)
- delivery (c section or vaginal)
- growth (was growth normal)
additional history for older adults?
- any dizziness (does it affect ADL’s)
- pain (able to drive, go to work, chores etc)
what is microcephaly?
abnormally small head
what is macrocephaly?
abnormally large head
what do normal nodes feel like?
moveable, discrete, soft, non tender
what is lymphadenopathy?
enlargement of lymph nodes
what could enlarged and tender lymph nodes mean?
inflammation or neoplasm (abnormal growth) in head and neck
what are the two common variations in the newborn that cause skull shape to be asymmetrical?
caput succedaneum: edematous swelling and ecchymosis of head caused by birth trauma (soft)
cephalohemoatoma: subperiosteal hemorrhage from birth trauma. Soft, fluctuant, well defined over one cranial bone
what 3 cranial nerves stimulate the movement of the extraocular muscles?
abducens VI: innervates lateral rectus muscle.. abducts the eye
trochlear IV: innervates superior oblique muscle.. downward and inward
oculomotor III: innervates all the other muscles
what is the outer layer of the eye composed of?
sclera (protective white covering) and cornea (clear covering over the iris)
what is the middle layer of eye composed of?
choroid: dark pigment to prevent light from scattering. Highly vascularized to deliver blood to retina
iris: colour in eye that controls amount of light admitted into retina
pupil: size determined by parasympathetic (constrict) and sympathetic (dilate)
lens: refracts light to retina
anterior chamber: between cornea and iris posterior chamber (behind iris to side of lens)
what is the inner layer of eye composed of?
retina: light waves changed to nerve impulses.
optic disc: fibres from retina converge to form the optic nerve
macula: slightly darker pigment surrounding fovea centralis: area of sharpest, keenest vision
what is direct reflex and consensual reflex for the eye?
direct: constriction of pupils when bright light shines on retina (the eye that the light hits) vs consensual reflex which is the other eye
what is specific to older adults for the eye?
- pupil size decreases
- lens loses elasticity (becomes hard and glass like)
- inability to change shape and focus for near vision
- transparent fibers of lens become thick and yellowed by age 70 (senile cataract)
- visual acquity begins to diminish after age 50, which results in decreased adaptation to dark (poor night driving skills)
what is 20/60 vision?
cannot be improved by medicine or surgery
what is 20/50 vision?
cannot have drivers license or are restricted to daytime driving
what is 20/200 (or worse) vision?
legal blindness that cannot be corrected or peripheral vision that cannot be corrected to better than 20 degrees
what are the types of visual screening?
primary: reduce occurrence or incidence of disease, encourage eye protection
secondary: reduce/control the consequences of existing disease impacting vision
tertiary: reduce harm of chronic diseases (eg. reduce intraocular pressure causing further glaucoma)
how often should patients be screened?
low risk: 19-40yrs (every 10 years). 41-55yrs (every 5 years). 56-65yrs (every 3 years). 65+ every 2 years
high risk: 40-50yrs (every 3 years). 50-60yrs (every 2 years). 60+ (annually)
what are the risk factors for glaucoma (blindness)?
- being older than 60yrs old
- african descent
- being a women
- increased intraocular pressure
- family history of glaucoma
- steroid use
- decreased central cornea thickness
- eye injury
- severe myopia (nearsightedness)
- use of certain other medications
what does the acronym PERRLA stand for?
Pupils Equal, Round, Reactive to Light, and Accommodate
what is rhinorrhea ?
what is Xerostomia?
what can pregnant women experience with their mouth and throat?
- Gum hypertrophy may occur normally at puberty or during pregnancy.
- Gums may bleed as a result of increased hormone production.
- Proper oral hygiene and healthy food choices help prevent pregnancy gingivitis.
when is lymphoid tissue full grown? and describe its growth
its well developed at birth and grows to adult size by age 6. By about puberty lymphoid tissue atrophies (smaller in size)
what is chloasma? and when does this occur?
happens to pregnant women and its blotchy/hyper pigmentation of face that fades after delivery
what are the developmental considerations for infants/children with eyes?
- born far-sighted
- peripheral vision intact
- macula (keenest vision) is poor
- poor eye control
what age group is more prone to ear infections? why?
children because of horizontal/shortness of auditory tube
what are developmental considerations for infants and children for the ears?
- pinna should be in line with eye
- eardrum looks infected after birth
- increase infections: soothers, bottle fed, daycare, exposure to cold
what are developmental considerations for older adults with the ears?
- cilia can become stiff, catches more cerumen which decreases hearing
- decrease in apocrine glands= dryer cerumen