6/29/2012

Module 4 Week 4
Head, Neck, and Related Lymphatics, Eyes and Ears

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Identify the anatomy and physiology of the structures of the head, neck, ears, eyes, nose, throat and mouth.
◦ Develop questions to be used when completing the focused interview. ◦ Describe the techniques required for assessment. ◦ Differentiate normal from abnormal findings in the physical assessment. ◦ Describe the developmental, psychosocial, cultural, and environmental variations in assessment techniques and findings. ◦ Discuss the objectives related to the overall health as presented in Healthy People 2020.

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Skull
◦ Cranium and face

Cranial bones
◦ ◦ ◦ ◦ Frontal Parietal Temporal Occipital

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Nine sets of lymph nodes drain the head and neck.
◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ ◦ Preauricular Occipital Postauricular Submental Submaxillary Retropharyngeal Superficial cervical Deep cervical Supraclavicular

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Illness, infection, or injury Symptoms Pain Behaviors Infants and children Pregnant females Older adults Environment

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Techniques
◦ Inspection ◦ Palpation ◦ Auscultation

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Inspection of the head and scalp Inspection of the face Observation of movements of the head, face, and eyes Palpation of the head and scalp Observation of the skin and tissue integrity Palpation of the temporal artery

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Auscultation of the temporal artery Testing range of motion of the temporomandibular joint

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Inspection of skin Testing range of motion Observation of the carotid arteries and jugular veins Palpation of the trachea Inspection, palpation, and auscultation of the thyroid gland

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Palpation of node groups
◦ ◦ ◦ ◦ ◦ ◦ ◦ Preauricular Postauricular and occipital Retropharyngeal and submaxillary Submental Superficial cervical chain Deep cervical chain Supraclavicular

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Headaches Abnormalities of the skull and face Thyroid abnormalities

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Migraine
◦ Migraine headache is caused by vasodilatation (enlargement of blood vessels) that causes the release of chemicals from nerve fibers that coil around the large arteries of the brain. Enlargement of these blood vessels stretches the nerves that coil around them and causes the nerves to release chemicals. The chemicals cause inflammation, pain, and further enlargement of the artery. The increasing enlargement of the arteries magnifies the pain.

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Cluster
◦ A distinctive syndrome of headaches, also known as migrainous neuralgia. There are two main clinical patterns of cluster headache -- the episodic and the chronic:
 Episodic: This is the most common pattern of cluster headache. It is characterized by 1-3 short attacks of pain around the eyes per day, with these attacks clustered over a stretch of 1-2 months followed by a pain-free remission, a breathing spell. The average length of remission is a year.  Chronic: Characterized by the absence of sustained periods of remission, chronic cluster headache may start with no past history of cluster headaches, or it may emerge several years after the patient has experienced an episodic pattern of cluster headaches.

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Tension
◦ A headache caused by contracting of the muscles in the back of the neck, on the scalp, and sometimes in the jaw. Tension headaches are usually related to stress.

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Hydrocephalus Craniosynostosis Acromegaly Bell’s palsy Cushing’s syndrome Down syndrome Parkinson’s disease

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Paralysis following brain attack Fetal alcohol syndrome Torticollis

The term hydrocephalus is derived from the Greek words "hydro" meaning water and "cephalus" meaning head. As the name implies, it is a condition in which the primary characteristic is excessive accumulation of fluid in the brain. Hydrocephalus may be congenital or acquired. Congenital hydrocephalus is present at birth and may be caused by either events or