Head Face and Neck Including Regional Lymphatics Chapter

Head, Face, and Neck, Including Regional Lymphatics Chapter 13 Elsevier items and derived items © 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc.

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Structure and Function Subjective Data—Health History Questions Objective Data—Physical Exam Abnormal Findings Slide 13 -2

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Structure and Function Head Cranial bones Sutures Facial bones Facial muscles Salivary glands Slide 13 -3

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Structure and Function (cont. ) Neck muscles Anterior and posterior triangles Thyroid gland Slide 13 -4

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Structure and Function (cont. ) Lymphatics Preauricular Posterior auricular (mastoid) Occipital Submental Submandibular Slide 13 -5

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Structure and Function (cont. ) Lymphatics (cont. ) Jugulodigastric (tonsilar) Superficial cervical Deep cervical Posterior cervical Supraclavicular (may be assessed with breast exam) Slide 13 -6

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Structure and Function (cont. ) Developmental care Infants and children ◦ Fontanels ◦ Head growth ◦ Lymphatic system Pregnant female- thyroid enlargement Aging adult-more prominent nose, orbits Slide 13 -7

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Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Subjective Data— Health History Questions Headache Head injury Dizziness Neck pain or limitation of motion Lumps or swelling History of head or neck surgery Slide 13 -9

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Subjective Data— Health History Questions (cont. ) Additional history for infants and children Maternal alcohol Type of delivery Growth pattern or drug use Additional history for aging adult Dizziness Neck pain Slide 1310

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Objective Data— Physical Exam Head–Inspect and palpate the Skull Size and shape (normocephalic) Temporal area-TMJ Head–Inspect the face Facial structures- symmetry Slide 1311

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Objective Data—Physical Exam (cont. ) Neck–Inspect and palpate Symmetry Trachea position Range of motion Lymph nodes Muscle strength ◦ SCM, Trapezius Slide 13 -12

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Objective Data—Physical Exam (cont. ) Neck–Inspect and palpate (cont. ) Thyroid gland ◦ Posterior approach ◦ Anterior approach ◦ Auscultate Slide 13 -13

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Objective Data—Physical Exam (cont. ) Developmental care Infants and children ◦ Skull- head circumference ◦ Special procedures Pregnant female Aging adult Slide 1314

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Abnormal Findings Abnormalities in Head Size and Contour Hydrocephalus Paget’s disease of bone (osteitis deformans) Acromegaly Slide 1315

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Abnormal Findings (cont. ) Swellings of the Head and Neck Torticollis (wryneck) Thyroid—multiple nodules Thyroid—single nodule Pilar cyst (wen) Parotid gland enlargement Slide 1316

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Abnormal Findings (cont. ) Pediatric Facial Abnormalities Fetal alcohol syndrome Congenital hypothyroidism Down syndrome Atopic (allergic) facies Allergic salute and crease © Pat Thomas, 2006. Slide 13 -17

Chapter 13: Head, Face, and Neck, Including Regional Lymphatics Abnormal Facial Appearances With Chronic Illnesses Parkinson’s syndrome Cushing’s syndrome Graves’ disease Hyperthyroidism Myxedema (hypothyroidism) Bell’s palsy Brain attack or cerebrovascular accident Cachectic appearance Scleroderma Slide 1318