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Increased CA risk factors for;
Throat?
Oral?
- Throat-ETOH and smoking
- Oral-smokeless tobacco and pipes
- Also:
- environmental factors (radiation, toxins)
- thyroid problems (goiter, CA)
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Neurologic Systems:
Sensory?
Motor?
Parasthesia (decreased sensation)
Paresis (weakness)
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Postauricular nodes drain what areas? (2)
- Parietal area of scalp
- External auditory canal
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Prauricular nodes drain what areas? (6)
- Scalp
- Forehead
- Lateral eyelids
- Eyes
- Upper face
- External auditory canal
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How would you assess the supraclavicular nodes?
Hunch the shoulders to relax the muscle
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What technique helps in palpating the deep cervical nodes?
Bending ipsilaterally (to the same side, which relaves the muscle)
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Infection lymphadenopathy
- Bilateral, warm, mobile, and tender nodes
- Drain adjacent tissue so look for source
-
Malignant lymphadenopathy
- Hard, fixed, unilateral, nontender node
- Supraclavicular node (metastatic site); may indicate neoplasm in the thorax, breast or abdomen
-
Lymphadenopathy
- Enlarged lymph nodes (>1cm)
- d/t infection, allergy, or neoplasm
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Lymph nodes are accessible to examination in what areas (4)?
Head and neck, arms, axillae, and inguinal regions
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What areas drain into the Right Lymphatic Duct?
The Thoracic Duct?
- R lymphatic: right head, neck, arm, thorax, lung, pleura, heart, and upper liver
- Thoracic: everything else
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Drainage from lymph nodes circulates where?
- Right lymphatic duct or Thoracic duct
- Then into the Subclavian vein
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Fxns of lymphocytes in lymph nodes
Engulf bacteria, RBCs, toxins, microorganisms, and abnormal cells
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Tissues without lymph vessels (3)
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Lymph structures (6)
- Lymph nodes
- Spleen (produces antibodies)
- Thymus (chest)
- Tonsils and adenoids
- Peyer's Patches (intestinal lymph tissue)
- Bone marrow (produces WBCs)
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How do you assess CN 11?
Shoulder shrug against resistance
-
Neck ROM (degrees)
Flexure (head to chin)?
Lateral flexure (ear to shoulder)?
Rotation?
Extension (backwards)?
- Flexure - 45*
- Lateral flexion - 40*
- Rotation - 70*
- Extension - 55*
-
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Tension Pneumothorax
Collapsed lung causes the trachea to shift from midline to the UNaffected side
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Thyroid gland structure?
Shape?
Size?
- 2 lobes and an isthmus
- Butterfly shaped
- Each lobe is 5cm x 3cm x 2m
-
Thyroid gland hormones
- T4 - Thyroxine
- T3 - Triiodothyronine
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Midline neck structures (5)
- Hyoid bone (at floor of mouth)
- Thyroid cartilage (adam's apple)
- Cricoid cartilage (upper tracheal ring; cricoidotomy)
- Tracheal Rings
- Thyroid gland (endocrine)
-
Two triangles of the neck
- Anterior (anterior to SCM)
- Posterior (b/n SCM and Trapezius)
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Two major neck muscles
- SCM-Sternocleidomastoid (rotates head side to side)
- Trapezius (shoulder shrug, rotates head side to side, extends head backwards
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The accessory muscles of respiration are innervated by which cranial nerve?
CN 11 - Spinal Accessory Nerve
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Which vertebra is the vertebral prominens?
C7 - location where the head is flexed
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When are Parotid Glands palpable?
With enlarged mumps or blocked parotid duct (loose jaw angle)
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How will an abnormal TMJ joint open?
- Zig-zag
- There can also be:
- Pain, Crepitus, Decreased ROM, or Locking
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CN 7
Motor fxns?
Sensory fxns?
- Facial nerve
- Facial movements and expression
- Sweet and salty taste on anterior 2/3 of tongue
-
CN 5
Motor fxns?
Sensory fxns?
- Trigeminal
- Temporal and masseter muscles
- Light touch in ophthalmic, maxillary and mandibular areas
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Parkinson's disease has what type of facial expression?
Mask Like
-
Nasolabial folds may be absent when?
With Stroke
-
Fused bones of the face
- Frontal
- Nasal
- Zygomatic
- Lacrimal
- Sphenoid
- Maxilla
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NCAT
- NormoCephalic (round, symmetric)
- ATraumatic
-
Four sets of skull bones
- Frontal
- Parietal
- Temporal
- Occcipital
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Effects of HYPOthyroidsm on:
Cardiovascular?
GI?
Integument?
Neuro?
Temperature?
Weight?
- Bradycardia
- Constipation
- Dry skin, brittle hair
- Fatigue
- Cold
- Weight gain
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Effects of HYPERthyroidism on
Cardiovascular?
GI?
Integument?
Neurologic?
Temperature?
Weight?
- Tachycardia
- Diarrhea
- Fine, silky, soft hair
- Nervousness
- Hot
- Weight loss
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Acute lymphadenitis?
Inflammation of lymph vessels d/t systemic neoplastic disease, bacterial infection, or other inflammatory conditions/s: enlarged, tender, firm nodes with surrounding edema and erythema (cat scratch disease)
-
Acute lymphangitis?
- Inflammation of lymph vessels d/t strep infection of extremities
- s/s: red streaks, fever, chills
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Acquired lymphedema?
Congenital Lymphedema?
d/t lymph duct trauma (surgery or metastasis)
Milroy disease; mal-development of lymph system
-
Lymphedema
Excessive collection of fluid in the interstitial spaces d/t blocked or infected lymphatic channels
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2 head and neck changes in Aging Adults
- change in curve of neck compensates for kyphosis
- prominent facial bones d/t decreased elasticity of tissues
-
Chloasma
Facial discoloration
-
Craniostenosis
Premature closure of 1 or more sutures while brain growth is still continuing
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Sunken fontanels?
Buldging fontanels?
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Anterior fontanel
- Diamond shape
- Closes at 24 months
-
Posterior fontanel
- Triangle shape
- Closes at 2 months
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Fetal skull seperated by?
Why?
- Fontanels and sutures
- Allows for growth
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How long do you record the head circumference of an infant?
Up to 2 yo
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Supraclavicular nodes drain what areas?(4)
- Upper abdomen
- Lungs
- Breasts
- Arms
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Posterior Cervical Chain nodes draiin what areas? (3)
- Posterior scalp
- Posterior skin of neck
- Thyroid
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Deep Cervical Chain nodes drain what areas? (5)
- Ear
- Larynx
- Thyroid
- Trachea
- Upper esophagus
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Superficial/Anterior Cervicalnodes drain what area?
Skin of ear and neck
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Tonsillar/Jugulodigastric nodes drain what areas? (8)
- Eyelids
- Frontotemporal skin
- External auditory meatus
- Tympanic cavity
- Tonsils
- Posterior palate
- Floor of mouth
- Thyroid
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Submandibular/Submaxillary glands drain what areas? (4)
- Lips
- Mouth
- Tongue
- Submaxillary
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Submental nodes drain what areas? (3)
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Occipital nodes drain what area?
Parietal region of scalp
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