head.Expert.pdf

Structure and Function: I- Head (1 of 2)  Skull is rigid box that protects brain.  Includes bones of cranium and face  Supported by cervical vertebra  Cranial bones  Frontal  Parietal  Occipital  Temporal  Sutures—adjacent cr...

Structure and Function: I- Head (1 of 2)  Skull is rigid box that protects brain.  Includes bones of cranium and face  Supported by cervical vertebra  Cranial bones  Frontal  Parietal  Occipital  Temporal  Sutures—adjacent cranial bones  Coronal  Sagittal  Lambdoid Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function  The adjacent cranial bones unite at meshed immovable joints called the sutures  The bones are not firmly joined at birth; this allows for the mobility and change in shape needed for the birth process.  The sutures gradually ossify during early childhood 1. The coronal suture crowns the head from ear to ear at the union of the frontal and parietal bones. 2. The sagittal suture separates the head lengthwise between the two parietal bones. 3. The lambdoid suture separates the parietal bones crosswise from the occipital bone. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function: Head (2 of 2)  14 facial bones also articulate at sutures.  The cranium is supported by the cervical vertebrae: C1; C2, the “axis”; and down to C7. The C7 vertebra.  The C7 vertebra has a long spinous process that is palpable when the head is flexed. Feel this useful landmark, the vertebra prominens, on your own neck. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function: Head (2 of 2)  Facial expressions formed by facial muscles, which are mediated by the facial nerve.  Temporal artery lies superior to temporalis muscle, and pulsation is palpable anterior to ear. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function (Head)  Facial structures are symmetric; the eyebrows, eyes, ears, nose, and mouth appear about the same on both sides.  The palpebral fissures—the openings between the eyelids—are equal bilaterally. Also the nasolabial folds—the creases extending from the nose to each corner of the mouth—should look symmetric. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function (Head)  Two pairs of salivary glands are accessible to examination on the face. The parotid glands are in the cheeks over the mandible, anterior to and below the ear. They are the largest of the salivary glands but are not normally palpable.  The submandibular glands are beneath the mandible at the angle of the jaw.  A third pair, the sublingual glands, lie in the floor of the mouth. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function (Head)  The temporal artery lies superior to the temporalis  muscle; its pulsation is palpable anterior to the ear. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  ‫ڡٮ&ﺔ ﻣﺤﺪدة ٮ&واﺳﻄﺔ‬. ‫اﻟﺮ‬ ‫ﺔ‬2‫ ﻠٮ‬4‫ﻤﺤﻤﺔ واﻟﺤﺪود اﻟﺴڡ‬ & ‫ڡﺎﻋﺪة‬. & ‫اﻟﺤ‬ ‫وٮ&ريﻮم‬4‫ وٮ&واﺳﻄﺔ ﻣﺎٮ‬،‫اﻟﺴكى أﻋﻼه‬ D ‫ ﻚ‬4‫اﻟڡ‬ Structure and Function: ‫ وأول‬،‫ اﻟﻀﻠﻊ اﻷول‬،‫ڡﻮة‬. ‫ٮﺮ‬. ‫ اﻟ‬،‫ى‬4 D ‫ﺮٮ‬2‫ٮٮ‬. ‫ﺳ‬ II- Neck ‫ﺎه‬4‫ﺮة اﻟﺼﺪريﺔ أدٮ‬.‫ ڡ‬4‫اﻟڡ‬  Neck delimited by  Base of skull and inferior border of mandible above, and by manubrium sterni, clavicle, first rib, and first thoracic vertebra below  The neck contains many structures:  Vessels, muscles, nerves, lymphatics, and viscera of respiratory and digestive systems  Internal carotid artery branches off common carotid and runs inward and upward to supply brain.  External carotid artery supplies face, salivary glands, and superficial temporal area. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.   Structure and Function: Neck Muscles  Major neck muscles: Sternomastoid and trapezius are innervated by cranial nerve. Sternomastoid Trapezius muscles muscles function function Head move rotation shoulders Head extend and flexion turn head. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function: III- Thyroid  Thyroid gland location:  is an important endocrine gland with a rich blood supply.  Straddles trachea in middle of the neck  It synthesizes and secretes thyroxine (T4) and triiodothyronine (T3), hormones that stimulate the rate of cellular metabolism  The gland has two lobes connected by a thin isthmus  The neck cartilages are important landmarks for locating the thyroid gland.  Thyroid cartilage: has a small, palpable V in its upper edge. This is the prominent “Adam's apple” in men Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function: Lymphatic System  The lymphatic system is a separate vessel system from the cardiovascular system and a major part of the immune system, whose job it is to detect and eliminate foreign substances from the body  The vessels gather the clear, watery fluid (lymph) from the tissue spaces into the circulation. Lymph nodes are D ‫ ﺎويﺔ‬4‫ﻤڡ‬2‫ ﺪد اﻟﻠٮ‬Q‫اﻟﻌ‬ ‫هى‬ small, oval clusters of lymphatic tissue & ‫ﺮة ٮ&يﻀﺎويﺔ ﻣﻦ‬2‫ ٮ‬Q‫ﻣﺤﻤﻮﻋﺎت ﺻﻌ‬ that are set at intervals along the ‫ ﺎويﺔ‬4‫ﺴﺤﺔ اﻟﻠﻤڡ‬4 & ‫اﻷٮ‬ lymph vessels like beads on a string. ‫ٮرات ﻋﲆ ﻃول‬. ‫ڡ‬4 ‫ٮﻢ ﺿٮ&ﻄﻬﺎ ﻋﲆ‬. 2 ‫اﻟﱵ ٮ‬ 4 ‫ ﺎويﺔ ﻣ _ٮﻞ‬4‫ﻤڡ‬2‫ﺔ اﻟﻠٮ‬2‫اﻷوﻋٮ‬ ‫اﻟﺤرز ﻋﲆ‬ Updated Copyright © 2020 by Elsevier Inc. All rights reserved..‫ﻂ‬2‫ﺣٮ‬4  Structure and Function: Lymphatic System  The nodes slowly filter the lymph and engulf pathogens, preventing harmful substances from entering the circulation  Nodes are located throughout the body but are accessible to examination only in four areas: head and neck, arms, axillae, and inguinal region. The greatest supply is in the head and neck. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function: Lymph Nodes (1 of 2) The head and neck have a rich supply of 60 to 70 lymph nodes  Preauricular  In front of the ear  Posterior auricular (mastoid)  Superficial to mastoid process  Occipital  At base of skull  Submental  Midline, behind tip of mandible  Submandibular  Halfway between angle and tip of the mandible Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Structure and Function: Lymph Nodes (2 of 2)  Jugulodigastric  Under angle of mandible  Superficial cervical  Overlying sternomastoid muscle  Deep cervical  Deep under sternomastoid muscle  Posterior cervical  In posterior triangle along edge of trapezius muscle  Supraclavicular  Just above and behind clavicle, at sternomastoid muscle Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  Examining Lymph Nodes  Using a gentle circular motion of finger pads, palpate lymph nodes.  Beginning with preauricular lymph nodes in front of ear, palpate the 10 groups of lymph nodes in routine order  Many nodes are closely packed, so you must be systematic and thorough in your examination.  Do not vary sequence or you may miss some small nodes.  Developmental Competence  Infants and Children  The bones of the neonatal skull are separated by sutures and fontanels, allowing for growth of the brain during the 1st year.  During the fetal period head growth predominates. Head size is greater than chest circumference at birth. The head size grows during childhood, reaching 90% of its final size when the child is 6 years old.  Facial bones grow at varying rates, with the mandible and maxilla being small and the nasal bridge low. Lymphoid tissue is well developed at birth and grows to adult size when the child is 6 years old.  In adolescence facial hair appears, and thyroid cartilage enlarges and the voice deepens.  Pregnant female  Thyroid gland enlarges slightly during pregnancy as a result of hyperplasia of tissue and increased vascularity.  Aging adult  Facial bones and orbits appear more prominent.  Facial skin sags resulting from decreased elasticity, decreased subcutaneous fat, and decreased moisture in skin.  Lower face may look smaller if teeth have been lost. Updated Copyright © 2020 by Elsevier Inc. All rights reserved.  A. Subjective Data: Health History about:  Headache  Head injury  Dizziness  Neck pain, limitation of motion  Lumps or swelling  History of head or neck surgery  Health History Questions: Headaches onset pattern characteristics. most people have had at least one HA. A red flag is a severe HA in an adult or child who has never had one before. location of headache Tension headaches are occipital, frontal, or with bandlike tightness; migraines are supraorbital, retro-orbital, or frontotemporal; sinus headaches produce pain around the eye or cheek pain localized on one side or all Unilateral or bilateral (e.g., with cluster headaches, pain is always unilateral over?. and always on the same side of the head). course and duration. Migraines occur ≥15 days/month if chronic or