Chapter 12 - Head and Neck Anatomy PDF

Chapter 12—Head and Neck Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins  Learning Objectives v 1. Demonstrate knowledge of anatomy and physiology of the head and neck. v 2. Identify important topics for health promotion and risk reduction related to the head and neck...

Chapter 12—Head and Neck Copyright © 2015 Wolters Kluwer Health | Lippincott Williams & Wilkins  Learning Objectives v 1. Demonstrate knowledge of anatomy and physiology of the head and neck. v 2. Identify important topics for health promotion and risk reduction related to the head and neck. v 3. Collect subjective data related to headache, head trauma, neck pain, neck masses, and thyroid dysfunction. v 4. Collect objective data related to the scalp, cranium, facial structures, neck, hearing, and vision using physical examination techniques. v 5. Identify normal and abnormal findings from inspection and palpation of the head and neck. v 6. Analyze subjective and objective data from the head and neck assessment. v 7. Communicate and document data from the head and neck assessment using appropriate medical terminology. Copyright © 2019 Wolters Kluwer All Rights Reserved Structure and Function v Structures interact with multiple body systems. o Integumentary (skin); neurological; respiratory; vascular; gastrointestinal; lymphatic; endocrine v Head o Skeletal structure; muscles; blood supply; nerve supply; salivary glands v Neck (C1–C7) o Trachea (windpipe) o Thyroid, parathyroid glands o Lymphatics Copyright © 2019 Wolters Kluwer All Rights Reserved Lymphatics vLymph nodes o Approximately 80 lymph nodes in head and neck region vSpecific drainage pattern o Enlargement = inflammation or infection Copyright © 2019 Wolters Kluwer All Rights Reserved Lifespan Considerations: Older Adults v Bony structures more pronounced o D/T decreased subcutaneous fat v Skin lesions more likely o Careful assessment for skin cancers, especially in commonly sun-exposed areas v Hypothyroidism/hyperthyroidism more common o Hypothyroidism > Hyperthyroidism v Thinning hair v Exaggerated concave curve of upper spine (kyphosis) v Reduced neck ROM Copyright © 2019 Wolters Kluwer All Rights Reserved Cultural Variations and Health Disparities v Skin color v Shape of eyes, nose, and lips v Hypo- and hyperthyroidism: more common in females o Hyperthyroidism: goiter, more in females; higher in African Americans than Whites v Thyroid cancer o More in females than males o Highest among Asian/Pacific Islanders and Whites Copyright © 2019 Wolters Kluwer All Rights Reserved Urgent Assessment v Acute head injuries and neurological changes o Stabilization of head, neck; trauma assessments v Severe head/neck pain: usually muscle tension, spasm o Beware: fever + headache; possible cardiac v Lymphatics o > 1 cm; fixed, irregular, hard or rubbery § Require emergency investigation for cancer v Hyperthyroidism: “thyroid storm”, “thyroid crisis” o Hypermetabolism in all systems v Acute bacterial thyroiditis o High risk for airway compromise, thyroid dysfunction Copyright © 2019 Wolters Kluwer All Rights Reserved Subjective Data Collection v Multiple systems may influence structure, function v Assessment of risk factors o Personal history o Medications o Family history v Risk reduction and health promotion o Reducing injury risk o Preventing thyroid disorder complications o Early detection of masses or malignant lymph nodes Copyright © 2019 Wolters Kluwer All Rights Reserved Common Symptoms vCommon head, neck symptoms o Headache; neck pain o Limited neck movement o Vision and Hearing o Facial pain o Lumps/masses o Hypo/hyperthyroidism o Sleepiness Copyright © 2019 Wolters Kluwer All Rights Reserved Assessment of Head and Face: 1. Inspects head for size, shape, and configuration 2. Palpates head for consistency while wearing gloves 3. Inspects face for symmetry, features, movement, expression 4. Palpates temporal artery for tenderness 5. Palpates temporomandibular joint for swelling or tenderness 6. Assesses for malocclusion by asking client to open and shut jaw and while exposing teeth 7. Assesses temporal pulse Copyright © 2019 Wolters Kluwer All Rights Reserved Assessment of Neck v 1. Inspects neck for position, symmetry and presence of lumps and masses v 2. Palpates head and neck lymph nodes, preauricular, post auricular, occipital, superficial, posterior and deep cervical, supraclavicular, tonsillar, submandibular and submental v 3. Palpates trachea for position, nodes, and tenderness v 4.Palpates/auscultate thyroid for nodules and tenderness Copyright © 2019 Wolters Kluwer All Rights Reserved Critical Thinking v Common laboratory and diagnostic testing o CT; MRI; lumbar puncture; thyroid labs: TSH, T3, T4 v Diagnostic reasoning: Nursing diagnosis, outcomes, and interventions, collaboration o Outcomes (partial list) § Patient verbalizes increased energy, well-being. § Pain goals are met. o Interventions (partial list) § Allow for period of rest before planned activity. § Set small, achievable short-term activity goals Copyright © 2019 Wolters Kluwer All Rights Reserved