Health & Physical Assessment in Nursing

First Edition

Donita DAmico
and

Colleen Barbarito

Chapter 12
Head, Neck, and Related Lymphatics
Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Anatomy and Physiology Review

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE ONE

Head
Skull
Cranium and face

Cranial bones
Frontal Parietal Temporal Occipital
Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 12.1

Bones of the head.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE ONE

Head
Facial muscles
Expression of emotion Neck movement Controlled by cranial nerves V and VII

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.2

Facial landmarks.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.3

Muscles of the head and neck.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Neck
Carotid and temporal arteries Supported by vertebra and muscles Neck muscles
Anterior and posterior triangles

Hyoid bone Thyroid gland

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 12.4

Triangles of the neck.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.5

Structures of the neck.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 12.6

Vessels of the neck.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE ONE

Lymphatics

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 12.7

Lymph nodes of the head and neck.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE ONE

Lymphatics
Nine sets of lymph nodes drain the head and neck
Preauricular Occipital Postauricular Submental Submaxillary Retropharyngeal Superficial cervical Deep cervical Supraclavicular
Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE TWO

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE TWO

Focused Interview
General questions

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE TWO

Specific Questions
Illness, infection, or injury Symptoms Pain Behaviors Infants and children Pregnant females Older adults Environment
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Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

LEARNING OBJECTIVE THREE

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE THREE

Assessment of the Head and Neck
Techniques
Inspection Palpation Auscultation

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE THREE

Areas of the Head
Inspection of the head and scalp Inspection of the face Observation of movements of the head, face, and eyes

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE THREE

Areas of the Head
Palpation of the head and scalp Observation of the skin and tissue integrity Palpation of the temporal artery

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 12.10

Palpating the temporal artery.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE THREE

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

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE THREE

Areas of the Neck
Inspection of skin Testing range of motion Observation of the carotid arteries and jugular veins Palpation of the trachea
Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 12.11

Palpating the trachea.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE THREE

Areas of the Neck
Inspection, palpation, and auscultation of the thyroid gland

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

Figure 12.12

Palpating the thyroid using a posterior approach.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.13

Alternative technique for palpating the thyroid.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE THREE

Areas of the Lymphatics
Palpation of node groups

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.14

Suggested sequence for palpating lymph nodes.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.15

Palpating lymph nodes. A. Cervical. B. Supraclavicular.

A
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Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

Figure 12.15 (continued)

Palpating lymph nodes. A. Cervical. B. Supraclavicular.

B
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Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

LEARNING OBJECTIVE THREE

Areas of the Lymphatics
Palpation of node groups
Preauricular Postauricular and occipital Retropharyngeal and submaxillary Submental Superficial cervical chain Deep cervical chain Supraclavicular
Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito 2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE FOUR

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE FOUR

Abnormal Findings
Headaches Abnormalities of the skull and face Thyroid abnormalities

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Headaches
Migraine Cluster Tension

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Hydrocephalus

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.16

Hydrocephalus.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Craniosynostosis

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.17

Craniosynostosis.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Acromegaly

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.18

Acromegaly.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Bells palsy

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.19

Bells palsy.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Cushings syndrome

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.20

Cushings syndrome.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Down syndrome

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.21

Down syndrome.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Parkinsons disease

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.22

Parkinsons disease.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Paralysis following brain attack

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.23

Brain attack.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Fetal alcohol syndrome

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.24

Fetal alcohol syndrome.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Abnormalities of the Skull and Face
Torticollis

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Figure 12.25

Torticollis.

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FOUR

Thyroid Abnormalities
Hypothyroidism Hyperthyroidism

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FIVE

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

2007 Pearson Education, Inc. Pearson Prentice Hall Upper Saddle River, NJ 07458

LEARNING OBJECTIVE FIVE

Special Considerations - Developmental, Psychosocial, Cultural, and Environmental

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE FIVE

Developmental Considerations - Pediatric
Head

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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Figure 12.8

The newborns skull.

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Figure 12.8 (continued)

The newborns skull.

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LEARNING OBJECTIVE FIVE

Developmental Considerations - Pediatric
Thyroid

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LEARNING OBJECTIVE FIVE

Developmental Considerations - Pregnant Female
Skin Edema Thyroid

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LEARNING OBJECTIVE FIVE

Developmental Considerations - Geriatric
Facial fat Hair changes Teeth losses Range of motion limitations

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LEARNING OBJECTIVE FIVE

Psychosocial Considerations
Stress - induced illness

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LEARNING OBJECTIVE FIVE

Cultural and Environmental Considerations
Religion Birth anomalies Dietary deficiencies

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LEARNING OBJECTIVE SIX

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LEARNING OBJECTIVE SIX

Focus Areas Outlined in the Healthy People 2010
Head Injury

Health and Physical Assessment in Nursing, 1e By Donita DAmico and Colleen Barbarito

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LEARNING OBJECTIVE SIX

Key Objectives for Head Injury
Reduce hospitalization for nonfatal head injuries Reduce deaths caused by motor vehicle crashes Increase the use of safety belts Increase the use of helmets by cyclists Reduce deaths by falls

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LEARNING OBJECTIVE SEVEN

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LEARNING OBJECTIVE SEVEN

Critical Thinking and the Nursing Process

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LEARNING OBJECTIVE SEVEN

Learning Needs and Teaching Plans

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