DH 356 - Chapter 1 - Review of Head and Neck Regions.ppt

Chapter 1: Face and Neck Regions 1 2  Case Study 1.0 Age 62 YRS Scenario Sex Male Patient of record has not visited Height 6’ 2” t...

Chapter 1: Face and Neck Regions 1 2  Case Study 1.0 Age 62 YRS Scenario Sex Male Patient of record has not visited Height 6’ 2” the office for 4 Weight 220 LBS years. He is concerned about BP 95/75 the appearance Chief “Why does it of his lower lip. A Complaint look like my limited lower lip is examination was disappearing?” performed. Medical Past history of A clinical History basal photograph was carcinoma on taken. He needs the tip of his routine nose maintenance Fehrenbach, MJ, Weiner J. Saunders Review of Dental Hygiene, ed 2. Saunders, Philadelphia, 2009 Current None appointments and Medications full mouth radiographic Social Alaskan series. History fisherman 3  Regions of the Face  Frontal  Orbital  Nasal  Infraorbital  Zygomatic  Buccal  Oral  Mental 4  Lymph Nodes  Lymph nodes are bean-shaped bodies grouped in clusters along the connecting lymphatic vessels, positioned to filter toxic products from the lymph to prevent their entry into the blood.  What would you do if you notice an enlarged and firm lymph node during an EO/IO exam? 5  Lymph Nodes  The lymph nodes can be superficial in position with the superficial veins, or deep in the tissue with the deep blood vessels.  All the nodes of the head and neck drain either the right or left tissues in the area, depending on their location (except for the midline submental nodes, which drain the tissues in the region bilaterally).  What is lymphadenopathy? 6 Superficial Nodes of the Head 7 Deep Nodes of the Head 8 DEEP LYMPH NODES OF THE HEAD Drainage Patterns Fehrenbach MJ and Herring SW. Illustrated Anatomy of the Head and Neck, ed 4. Saunders, Philadelphia, 2012 9 LYMPH NODES OF THE HEAD REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 10 LYMPH NODES OF THE HEAD REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 11  Frontal Region  Includes the forehead and the area above the eyes. Figure 1-3 12  Nasal Region  The root of the nose is located between the eyes, and the tip is the apex of the nose.  Inferior to the apex on each side of the nose is a nostril, or naris (plural, nares).  The nares are separated by the nasal septum  The nares are also bounded laterally by winglike Figure 1-4 cartilaginous structures, each ala (plural, alae). 13 Nasal Region Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 14 Nasal Region Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 15  Buccal and Zygomatic Region  The parotid salivary gland has a small part that can be palpated in the buccal region as well as in the zygomatic region. 16 Parotid Salivary Gland Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 17 Parotid Salivary Gland Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 18  Oral Region: Lips  Width of lips should be about same distance between irises of the eyes  Vermillion borders are only found in humans 19 Oral Region: Lips Nanci A. Ten Cate’s Oral Histology, ed 7. Mosby, St. Louis, 2008 20 Lip Anatomy Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 21 Lip Anatomy Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 22  Clinical Considerations with Lips: Angular Cheilitis  Angular cheilitis  At commissures  Possible candida inflection  Possible nutritional deficiency B2 Iron deficiency Zinc deficiency Ibsen OAC, Phelan JA. Oral Pathology for Dental Hygienists, ed 5. Saunders, Philadelphia, 2009 23  Clinical Considerations with Lips: Loss of Vermilion Border  Any loss of the vermilion border is very important to note in the patient record.  With this loss, it is hard to determine the border between the lips and the surrounding skin. 24 Mental Region Figure 1-8 25  Mental Region: Mandible  The posterior border of the ramus is thickened and extends from the angle of the mandible to a projection, the mandibular condyle with its neck.  The articulating Figure 1-9 surface of the condyle is an oval head involved in the TMJ. 26 Regions of Face Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 27 Regions of Face Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 28 Vertical Dimension of the Face Facial dimensions: May affect esthetics May affect speech VDO (Vertical Dimension of Occlusion) Small VDO – common with edentulous patients means loss of vertical dimension from missing teeth Large VDO – patient may not be able to close lips 29 Loss of height in the lower third, which contains the teeth and jaws, can occur in certain circumstances. 30 Regions of the Neck Figure 1-11 31 SCM Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 32  SCM Review Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 33 Superficial Cervical Nodes Figure 1-12A 34 CERVICAL LYMPH NODES REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 35 CERVICAL LYMPH NODES REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 36  SUPERFICIAL CERVICAL LYMPH NODES Drainage Patterns Fehrenbach MJ and Herring SW. Illustrated Anatomy of the Head and Neck, ed 4. Saunders, Philadelphia, 2012 37  Regions of the Neck  At the anterior midline is the hyoid bone, which is suspended in the neck.  Many muscles attach to the hyoid bone, which controls the position of the base of the tongue. Figure 1-11 38  Regions of the Neck  Also found in the anterior midline, inferior to the hyoid bone, is the thyroid cartilage, which is the prominence of the “voice box,” or larynx.  The vocal cords, or ligaments of the larynx, are attached to the Figure 1-11 posterior surface of the thyroid cartilage. 39  Regions of the Neck  The thyroid gland  Endocrine gland  Temp, weight, digestion  It is located inferior to the thyroid cartilage, at the junction of the larynx and the trachea. Figure 1-13 40  Regions of the Neck Examined  The hyoid bone can be effectively palpated by feeling inferior to and medial to the angles of the mandible.  Do not confuse the hyoid bone with the inferiorly placed thyroid cartilage when palpating the neck. Fehrenbach MJ and Herring SW. Illustrated Anatomy of the Head and Neck, ed 4. Saunders, Philadelphia, 2012 41 THYROID GLAND REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 42 THYROID GLAND REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 43  Regions of the Neck  The submandibular salivary gland and the sublingual salivary gland can also be palpated in the neck region. Figure 1-5 44  SUBMANDIBULAR SALIVARY GLAND REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 45  SUBMANDIBULAR SALIVARY GLAND REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 46  SUBLINGUAL SALIVARY GLAND REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 47  SUBLINGUAL SALIVARY GLAND REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 48 SALIVARY GLANDS REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 49 SALIVARY GLANDS REVIEW Fehrenbach MJ, editor. Dental Anatomy Coloring Book. Saunders, Philadelphia, 2007 50