Head and Neck Disorders PDF

Structure and Function of the Head Cranium encases and protects brain and brainstem Consists of 22 cranial and facial bones...

Structure and Function of the Head Cranium encases and protects brain and brainstem Consists of 22 cranial and facial bones Movements of these bones allows for facial expressions, eating, speech, and head movement Information processing center Head and Neck Disorders Aids in sensory functions Shermel Edwards-Maddox, PhD, RN, CNE, CHSE, RN-BC Disorders of the Head Headaches Most commonly treated disorder Interferes with functions needed for daily living: Concentration ability Vision and hearing Appetite Exercise ability Can be benign or a warning sign of a serious condition: Ex: brain tumor or subarachnoid hemorrhage 3 Types of Headaches Headaches Traumatic Brain Injury (TBI) Tension Cluster Migraine Assessment of Headaches Tension Headaches Medical and social history Occurring episodically because of stress Neurological exam The pain is dull, aching with gradual in onset and presents as a pressure or “bandlike” sensation in the Headache Impact Test (HIT-6) head. Headache diary Pain is often bifrontal or occipitofrontal. CT scan Often associated with muscular tightness in the neck, shoulders, and occipital area MRI Vital signs and neurological examination are normal. EEG Nonopioid medications provide relief Cluster Headaches Migraine Headaches A neurovascular disorder characterized by severe, unilateral, periorbital Etiology: genetic, environmental and neurological factors pain. 75% of the sufferers being women Involves the activation of the hypothalamus and the trigeminal nerve Neurogenic process with secondary changes in cerebral perfusion, causing recurrent Commonly occurs in early morning hours or during sleep. headaches Pain is described as sharp, stabbing, and unilateral with radiation to the Low serotonin levels lead to constriction/dilation of blood vessels cheek, jaw, occipital region, or neck. The hallmark signs include: Without treatment, a migraine headache can last 4 to 72 hours. tearing of the eyes Unilateral, vascular, throbbing headache conjunctival injection Associated symptoms of nausea, vomiting, and sensitivity to light and sound. rhinorrhea eyelid edema Often preceded by an aura, a visual or sensory experience that occurs before the ptosis headache. Triggers: Alcohol, tobacco, stress, allergy, and weather changes Commonly precipitated by stress, hormones, smoking, weather changes, food additives, Vital signs and neurological examination are normal. caffeine, alcohol, or excessive fatigue. Nonopioid medications provide relief Treatment of migraine is focused on alleviating pain: Acute headache Preventative treatment Traumatic Brain Injury (TBI) Structure and Function of the Neck Injury to the brain that causes temporary, short-term or long-term problems with brain function Made of vertebrate and muscles Extent and location of injury determine level of disability Etiology: Supports the head and that it houses arteries Accidents involving automobiles, motorcycles, bicycles that supply blood to the brain from the heart. Falling Excessive alcohol ingestion Carotid arteries Abuse of infants and elderly being cared for by caregivers Jugular veins Symptoms: Headache and fatigue Assists in movement Blurred vision Vomiting Contains: Confusion Memory problems Larynx Loss of consciousness Thyroid gland Seizures Changes in speech Lymphatic tissue Treatment: Varies based on extent of injury Lymphatic Tissue of the Neck Multiple Myeloma Function to transport lymph, a fluid containing WBCs, Cancer of the lymphatic system throughout the body. Arises from B-lymphocytes that are neoplastic and Lymph nodes: serve as centers for proliferation and invade bone marrow response of immune cells Pathophysiology: proliferation of malignant plasma 100’s of them throughout the body (neck, groin, cells in bone marrow and osteolytic bone lesions throughout the skeletal system chest, axilla) Overproduction of monoclonal antibody Examples: tonsils, adenoids, spleen and thymus Disrupts normal antibody production Lymph nodes filter the debris that has been collected Weakens immune system through the use of macrophages. Incurable Become enlarged when pathogens have invaded the More common in men; African-Americans body Risk factors: exposure to chemicals, Agent Orange, Known as lymphadenopathy radiation, genetic factors  Multiple Myeloma Thyroid Disorders Clinical Manifestations: Diagnostics: Butterfly shaped gland on front of the neck Severe bone pain Bone marrow biopsy Pathologic fractures X-rays Functions: metabolism, growth and development of the human Hypercalcemia (high blood CBC body calcium levels) Urine – Bence Jones proteins In response to TSH, produces two hormones Anemia Management: T3- trioodothronine Recurrent infection Steroids Weight loss Chemotherapy T4- thyroxine Fatigue Stem cell transplant Hyperthyroidism: gland is overly reactive Renal insufficiency Complications Hypothyroidism: gland is under active Fractures Leads to bone destruction, bone marrow failure, renal failure, and neurological Assessment and Diagnostics: complications Palpate thyroid gland Example of Osteolytic Lesions T3/T3/TSH levels Altered Thyroid Function Practice Question Hyperthyroidism: Hypothyroidism: When a patient is experiencing a cluster headache, the nurse will plan to Sudden weight loss, without changes in Increased sensitivity to cold assess for appetite Unintentional weight gain Tachycardia, irregular heartbeat or A. nuchal rigidity Pale, dry skin palpitations Thin, brittle hair or nails B. projectile vomiting Nervousness, anxiety, and irritability Tremor in the hands and fingers Constipation C. unilateral eyelid swelling Depression D. throbbing, bilateral facial pain Sweating Fatigue Changes in bowel patterns, more frequent bowel movements Weakness Fatigue, insomnia, muscle weakness Practice Question A 39-year-old female presents to the clinic with complaints of difficulty swallowing, hoarseness, and a noticeable swelling in her neck. On physical examination, the nurse palpates a firm, non-tender mass in the region of the thyroid. The patient also reports feeling more fatigued than usual and has QUESTIONS? gained weight over the past few months. Based on these findings, which of the following actions should the nurse take next? A) Perform a thorough neck assessment and document the size, shape, and consistency of mass B) Instruct the patient to rest and drink warm fluids to soothe the throat C) Recommend an over-the-counter thyroid supplement to improve symptoms D) Refer the patient for immediate surgery to remove the thyroid mass