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HEAD AND NECK REGIONAL LYMPHATICS

HEAD AND NECK REGIONAL LYMPHATICS. LEARNING OBJECTIVE ONE. Anatomy and Physiology Review. LEARNING OBJECTIVE ONE. Head Skull Cranium and face Cranial bones Frontal Parietal Temporal Occipital. ** The Head:. Skull : a bony box protects the brain & special sense organs.

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HEAD AND NECK REGIONAL LYMPHATICS

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  1. HEAD AND NECKREGIONAL LYMPHATICS

  2. LEARNING OBJECTIVE ONE Anatomy and Physiology Review

  3. LEARNING OBJECTIVE ONE Head Skull Cranium and face Cranial bones Frontal Parietal Temporal Occipital

  4. ** The Head: • Skull: a bony box protects the brain & special sense organs. • Cranial bones: frontal, parietal, occipital, temporal

  5. Sutures: • immovable joints; coronal: crowns head from ear to ear at the union of the frontal & parietal bones, sagittal: separate headlengthwise between two parietal bones. lambdoid suture separates parietal bones from occipital bone.

  6. FONTANELS(fontenelle= little fountain) • At birth, membrane-covered soft spots between cranial bones • These soft spots will eventually ossify-replaced by bone • Allow for growth of the brain during the first year • Posterior or occipital will ossify by 2 months • Anterior or frontal will ossify by 18-24 months

  7. LEARNING OBJECTIVE ONE • Head Facial bones Facial muscles • Expression of emotion • Neck movement • Controlled by cranial nerves V and VII

  8. FACIAL BONES • 14 Facial Bones articulate at sutures except for the mandible • NASAL-forms part of bridge of nose • PAIRED MAXILLAE- Unite to form upper jaw bone • ZYGOMATIC- Commonly called cheekbones • MANDIBLE- Lower jawbone; largest, strongest facial bone; only skull bone that moves • LACRIMAL- Smallest bones in face; lateral to nasal bones

  9. FACIAL MUSCLES • Facial expressions are formed by the facial muscles • Mediated by cranial nerve VII, the facial nerve • Facial muscle is symmetrical bilaterally, except for an occasional quirk or wry expression

  10. Figure 13-2 pg 273

  11. LEARNING OBJECTIVE • Neck • Carotid and temporal arteries • Supported by vertebra and muscles • Neck muscles • Anterior and posterior triangles • Hyoid bone • Thyroid gland

  12. ** The Neck: • from base of the skull to manibrium, clavicle, 1st rib,1st thoracic vertebra below. • Structures are: vessels, muscles, nerves, lymphatics & viscera of the respiratory and digestive system. • Carotid artery, jugular vein(internal & external).

  13. NECK VESSELS • TEMPORAL ARTERY-Lies superior to the temporalis muscle, and its pulsation is palpable anterior to the ear • CAROTID ARTERY-Right and left arise from the aorta and are the principal blood supply to the head and neck; each of these two arteries divide to form the external and internal carotid arteries

  14. NECK VESSELS

  15. NECK VESSELS • JUGULAR VEIN- External-Lies superficial to the sternocleidomastoid muscle as it passes down the neck to join the subclavian vein; receives blood from the exterior of the cranium and the deep parts of the face; INTERNAL- Directly continuous with the transverse sinus, accompanying the internal carotid as it passes down the neck; Receives blood from the brain and superficial parts of the face and neck

  16. NECK MUSCLES • STERNOMASTOID- Arises from the sternum and the medial part of the clavicle and extends diagonally across the neck to the mastoid process behind the ear; Accomplishes head rotation and flexion • TRAPEZIUS- Two muscles that form a trapezoid shape on the upper back arising from the occipital bone and extends fanning out to the clavicle and scapula; moves the shoulders and extends and turns the head

  17. Muscles : • sternomastoid ( head rotation & head flexion)& trapezius( moves shoulders &extend & turn head).

  18. MUSCLES OF THE NECK • Muscles of the Neck Figure 13-4. p 274.

  19. LANDMARKS • Vertebra Prominens-C7 vertebra; has a long spinous process that can be felt when the neck is flexed • Temporal Artery-Pulsation is palpable anterior to ear

  20. Thyroid gland: • in the middle of the neck, has 2 lobes, separated by isthmus, secrete T3&T4 hormones(stimulate metabolism)

  21. Cricoid cartilage: above thyroid isthmus, thyroid cartilage above that(adam’s apple) in males, highest is hyoid bone.

  22. * The Lymphatic's 1. preauricular: in front of ear 2. posterior auricular: superficial to mastoid process 3. occipital: at the base of the skull 4. submental: midline 5. submandibular: halfway between the angle & tip of the mandible.

  23. The Lymphatic's: 6. superficial cervical: overlying sternomastoid muscle 7. deep cervical: under sternomastoid muscle 8. posterior cervical: at the edge of the trapezius 9. supraclavicular: above clavicle, at sternomastoid

  24. THANK YOU

  25. LEARNING OBJECTIVE TWO • Focused Interview • General questions

  26. * Subjective Data: 1.Headache: onset- when did this kind of headache start? Location- where do you feel it? • Is pain localized on one side or all over? • Character: throbbing(shooting) or aching (dull)? • Is it mild, moderate, or sever? • Duration- what time of day do the headaches occur: morning, evening?

  27. 1.Headache: cont • How long do they last? • Precipitating factors- what brings it on? • Associated factors- as nausea or vomiting? • Do you have any other illness? Do you take any medications?

  28. Types of headaches • Headaches • Migraine • Cluster • Tension

  29. 2.   Head injury: • onset-when? describe exactly what happened? • Setting- any hazardous conditions as(wearing helmet)? • Any hx of illness as DM? • Duration- how long were you unconscious? • Associated symptoms- as vision change?

  30. 3. Dizziness: • onset- abrupt or gradual? Associated factors? As nausea or vomiting or tinnitus 4. Neck Pain: • onset- how did the pain start? injury – accident…etc • location- does the pain radiate? to shoulder, arms? • Associated symptoms- limitations to range of motion • Precipitating factors-what movements cause pain?

  31. 6. Lumps or swelling: • how long have you had it? has it changed in size? • Any difficulty swallowing? • Do you smoke? • Ever had a thyroid problem? 7. history of head or neck surgery: • for what condition? when did the surgery occur?

  32. Specific Questions • Illness, infection, or injury • Symptoms • Pain • Behaviors • Infants and children • Environment

  33. THANK YOU

  34. ** Objective Data: The Head:

  35. LEARNING OBJECTIVE THREE Assessment of the Head and Neck Techniques Inspection Palpation Auscultation

  36. LEARNING OBJECTIVE THREE • Areas of the Head • Palpation of the head and scalp • Observation of the skin and tissue integrity • Palpation of the temporal artery

  37. Areas of the Head • Inspection and palpate of the head and scalp • Inspection and palpateof the face • Observation of movements of the head, face, and eyes

  38. * INSPECT & PALPATE SKULL • 1- size & shape: Normocephalic, round symmetric skull, related to body size. for shape palpate scalp, no tenderness(symmetric & smooth). • 2- temporal area: palpate temporal artery, palpate joint tempomandibular joint- as the person opens mouth, no limitation or tenderness.

  39. Figure 12.10 Palpating the temporal artery.

  40. Abnormalities of the Skull and Face

  41. Hydrocephalus

  42. Acromegaly

  43. Down syndrome

  44. ** INSPECT THE FACE: • facial structures: facial expression appropriate to behavior CN VII , symmetric same for eye brows, nasolabial folds & sides of the mouth. note any involuntary movements.

  45. Abnormal Facial Features • TICS- Abnormal facial movements • Exophthalmos- bulging eyeballs • Acromegaly- Gradual enlargement of the bones of the face and jaws

  46. Abnormalities of the Skull and FaceParalysis following brain attack

  47. Abnormalities of the FaceBell’s palsy

  48. The Neck: ** INSPECT & PALPATE THE NECK:

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