Chapter 15 Assessing Head and Neck - PowerPoint Presentation

1. Chapter 15 Assessing Head and Neck

2. Structure and FunctionThe HeadCranium—8 bonesFrontal (1)Parietal (2)Temporal (2)Occipital (1)Ethmoid (1)Sphenoid (1)

3. QuestionIs the following statement true or false?The skull, which is the framework of a head, has two subsections: the cranium and cervical vertebrae.

4. AnswerFalse. The skull has two subsections: the cranium and the face.

5. The HeadFace—14 bonesMaxilla (2)Zygomatic (2)Inferior conchae (2)Nasal (2)Lacrimal (2)Palatine (2)Vomer (1)Mandible (1)Structure and Function (cont.)

6. The Skull

7. QuestionWhich bone belongs to the face?A. ParietalB. TemporalC. PalatineD. Mandible

8. AnswerC. Palatine.Palatine is a facial bone that gives shape to the face. Parietal, temporal, and sphenoid are bones of the cranium.

9. The NeckHyoid boneSeveral major blood vesselsLarynxTracheaThyroid glandStructure and Function (cont.)

10. Structures of the Neck

11. Cervical Vertebrae

12. QuestionTell whether the following statement is true or false.The axis is the first of the seven cervical vertebrae.

13. AnswerFalse.The axis is the second of the seven cervical vertebrae.

14. Lymph Nodes

15. Traumatic Brain InjuryPresence of transportation accidents involving automobiles, motorcycles, bicycles, and pedestriansPresence of violence, such as firearm assaults and child abuse or self-inflicted woundsFallingExcessive alcohol ingestionInfants and elderly being cared for by caregivers

16. Infant and Toddlers Risk FactorsEnvironmental risks (for falls)Lack of parental knowledge of shaken baby syndrome Caregivers risk of shaken baby syndrome

17. Children and Teens Risk FactorsKnowledge and use of protective equipment in sports and bicycle useKnowledge and use of safety practices when driving

18. Adults and Older Adults Risk FactorsKnowledge and use of safety practices when drivingImpairment of physical or mental stabilityPotential for maltreatment or domestic violence

19. Risk ReductionBuckling your child in the car using a child safety seat, booster seat, or seat belt (according to the child’s height, weight, and age). Know the stages:Birth through age 2Between ages 2 and 4/until 40 lbBetween ages 4 and 8 or until 4’ 9” tallAfter age 8 and/or 4’ 9” tallWearing a seat belt every time you drive or ride in a motor vehicle

20. Risk Reduction (cont.)Never driving while under the influence of alcohol or drugsWearing a helmet and making sure your children wear helmets when:Riding a bike, motorcycle, snowmobile, scooter, or all-terrain vehiclePlaying a contact sport, such as football, ice hockey, or boxingUsing in-line skates or riding a skateboardBatting and running bases in baseball or softballRiding a horseSkiing or snowboarding

21. Risk Reduction (cont.)Making living areas safer for seniors, by:Removing tripping hazards such as throw rugs and clutter in walkwaysUsing nonslip mats in the bathtub and on shower floorsInstalling grab bars next to the toilet and in the tub or showerInstalling handrails on both sides of stairwaysImproving lighting throughout the home

22. Risk Reduction (cont.)Maintaining a regular physical activity program, if your doctor agrees, to improve lower body strength and balanceMaking living areas safer for children, by:Installing window guards to keep young children from falling out of open windowsUsing safety gates at the top and bottom of stairs when young children are aroundMaking sure that the surface on your child’s playground is made of shock-absorbing material, such as hardwood mulch or sand.

23. Interview Approach (COLDSPA)History of current health problem, past health, familyLifestyle and health practicesHealth Assessment: Subjective Data

24. Headache Impact TestWhen you have headaches, how often is the pain severe?How often do headaches limit your ability to do usual daily activities including household work, work, school, or social activities?When you have a headache, how often do you wish you could lie down?In the past 4 weeks, how often have you felt too tired to do work or daily activities because of your headaches?

25. Headache Impact Test (cont.)In the past 4 weeks, how often have you felt fed up or irritated because of your headaches?In the past 4 weeks, how often did headaches limit your ability to concentrate on work or daily activities?

26. GlovesPenlight or flashlightSmall glass of waterStethoscopeEquipment for Head and Neck Examination

27. Inspect the size, shape, configurationConsistencyInvoluntary movementPalpate the headPhysical Assessment: Head

28. Inspect the faceSymmetryFeaturesMovementExpressionSkin conditionPhysical Assessment: Face

29. PalpateTemporal artery: tenderness and elasticityTemporomandibular joint (TMJ): range of motion (ROM), swelling, tenderness, crepitationPhysical Assessment: Face (cont.)

30. Inspect movement of neck structuresCervical vertebraeNeck ROMPhysical Assessment: Neck

31. PalpateTracheaThyroid glandThyroid cartilageCricoid cartilageAuscultate an enlarged thyroid glandPhysical Assessment: Neck (cont.)

32. Palpate lymph nodes of head and neckPreauricularPostauricularOccipitalTonsillarSubmandibular Physical Assessment: Neck (cont.)

33. Palpate lymph nodes of head and neck (cont.)SubmentalSuperficial cervicalPosterior cervicalDeep cervicalSupraclavicularPhysical Assessment: Neck (cont.)

34. Normal and Abnormal FindingsReview and discuss findings of assessment of client’s head and neck with peers.

35. Altered Thyroid FunctionIncreased sensitivity to cold ConstipationDepression FatigueHeavier menstrual periods Pale, dry skinThin, brittle hair or nailsWeaknessUnintentional weight gain

36. HyperthyroidismSudden weight loss, without changes in appetite and dietIncreased appetiteRapid heartbeat (tachycardia) greater than 100 beats a minute, irregular heartbeat (arrhythmia), or palpitationsNervousness, anxiety, and irritabilityTremor in the hands and fingersSweating

37. Hyperthyroidism (cont.)Changes in menstrual patterns Increased sensitivity to heatChanges in bowel patterns, more frequent bowel movements Enlarged thyroid gland (goiter)Fatigue, insomniaMuscle weakness

38. Types of HeadachesSinusClusterTensionMigraineTumor related

39. Abnormal Findings of the Head and NeckAcromegalyCushing syndromeSclerodermaHypothyroidismBell palsy

40. Findings in Older AdultsOlder clients who have arthritis or osteoporosis may experience neck pain and a decreased ROM.In older clients, facial wrinkles are prominent because subcutaneous fat decreases with age. In addition, the lower face may shrink and the mouth may be drawn inward as a result of resorption of mandibular bone, also an age-related process.The strength of the pulsation of the temporal artery may be decreased in the older client.

41. Findings in Older Adults (cont.)In older clients, cervical curvature may increase because of kyphosis of the spine. Moreover, fat may accumulate around the cervical vertebrae (especially in women). This is sometimes called a “dowager’s hump.”Older clients usually have somewhat decreased flexion, extension, lateral bending, and rotation of the neck. This is usually due to arthritis.If palpable, the older client’s thyroid may feel more nodular or irregular because of fibrotic changes that occur with aging; the thyroid may also be felt lower in the neck because of age-related structural changes.

42. Validating and Documenting FindingsHealth promotion diagnosesRisk diagnosesActual diagnosesCollaborative problemsMedical problems