What is the eleventh CN responsible for?
Movement that permits shrugging of the shoulders by the trapezius muscle AND turning the head against resistance by the sternocleidomastoid.
What is the movement allowed by the sternocleidomastoid muscle?
The stermocleidomastoid muscle rotates and flexes the head.
What movement is allowed by the trapezius muscle?
The trapezius muscle extends the head and moves the shoulders.
The sternocleido mastoid and the trapezius muscles form what two angles?
The anterior and posterior angles.
Where is the anterior angle located?
Under the mandible and anterior to the sternocleidomastoid muscle.
Where is the posterior angle located?
Between the trapezius and the sternocleidomastoid muscle.
Where are the internal jugular veins and the carotid arteries located?
They are located parallel and anterior to the sternocleidomastoid muscles.
Why do you need to know the location of the carotid arteries when accessing the neck?
To avoid bilateral compression of the vessels, which reduce blood supply to the brain.
What is one function of the thyroid gland?
Is increases the metobolic rate of most of the bodies cells.
What is the first upper tracheal ring called?
Where is the thyroid cartilage (Adam's apple) located?
Where is the hyoid bone located?
The thyroid cartilage is located above the cricoid cartilage.
Hyoid bone, which is attached to the tongue, is located above the thyroid cartilage and under the mandible.
What does the thyroid gland consist of?
Two lateral lobes connected by an isthmas. The isthmas overlies the second and third tracheal rings below the cricoid cartilage.
What is the function of the lymph vessels?
They filter lymph, which is a clear substance composed mostly of excess fluid, AFTER the lymphatic vessels collect it but BEFORE it returns tot he vascular system.
What does the filtering action of the lymphatic vessels do?
Filtering action removes the bacteria and the tumor cells from the lymph.
What is produced in the lymph nodes?
Lymphocytes and antibodies are produced in the nodes as a defense against invasion by foreign substances.
What is the size and shape of most lymph nodes?
Why is this important?
The size and shape of the nodes varies but most are less than 1 cm long and burried deep in the connective tissue.
It is important because they are nonpalpable in normal situations.
They usually appear in clusters.
What happens to the lymph nodes in the event of an infection by microorrganisms?
They swell and become painful.
What happens to the lymph nodes in cancer matasasizes?
They swell, but do not become painful.
When a nurse detects an enlarged lymph node during an assessment, what does she need to know?
She needs to know what part of the head or neck the nodes recieve drainage from to access if the abnormality is in the area.
For what reasons is a detailed subjective history of the needed?
- 1) Abnormalities can sometimes not be detected in the physical examination, but may be detected in the clients history.
- 2) Becuase there are an overlapping of body systems in this area and there may be a detection of systemic problems.
- 3) History may provide an opportunity to evaluate the ADL's that may affect the condition of the clients head or neck.
What are the four types of headaches?
Migrane, cluster, tension, tumore related
How is a migrane characterized?
Throbbing, severe, recurring pain that is accompanied by nausea, vomitting, and sensitivity to light and noise. They usually last up to three days.
What are the precipitating factors in a migrane headache?
Visual disturbances, vertigo, tinnitus, numbness or tingling of the fingers and toes.
Emotional disturburbances, anxiety, alcohol, cheese or chocolate. Also substances to which the client is sensitive.
What is entailed in the inspection of the head?
Inspection for size, shape, and configuration.
What is entailed in the palpation of the head?
Palpate for consistency. The head is normally hard and smooth without lesions.
What is entailed in the inspection of the face?
Inspect for symmetry, features, movement, expression and skin condition.
What is entailed in the inspection of the neck?
- Observe the client's slightly extended neck for position, symmetry and lumps or masses.
- Shine the light on the side of the neck to highlight any swelling.
** The neck is symmetric with head centered and without bulging masses.
What is entailed in the inspection of the movement of the neck structures?
Ask the client to swallow a sip of water and inspect the movement of the thyroid cartilage (Adam's apple).
** they should move upward symmetrically
What is entailed in the inspection of the cervical vertebrae?
Ask the client to flex the neck.
**C7 is visible and palpable without any swelling or prominances.
What is entailed in inspecting the ROM?
Ask the client to turn the head to the right and the left, touch each ear to the shoulder, touch chin to the chest and lift the chin to the ceiling.
** Normal neck movement should be smooth and controlled with 45 degree angle flexion, 55 degree extension, 40 degree lateral abduction and 70 degree rotation
What is entailed in the palpation of the trachea?
Place your fingers on the sternal notch, feel each side of the notch and palpate the tracheal rings.
** trachea should be midline
What is entailed in palpating the thyroid gland?