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NUR 181 Chapter 13 Summary
This is a comprehensive and detailed summary on Chapter 13: Head,Face, Neck and Regional Lymphatics - Physical Examination & Health Assessment. *Essential Study Material!!
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Chapter 13: Head,Face, Neck and Regional LymphaticsI. The Head
A. Skull: rigid bony box that protects the brain and special sense organs
B. Cranial bones: frontal, arietal, occipital and temporal
C. Sutures: meshed immovable joints
1. Coronal: crowns the head from ear to ear
2. Sagittal: separates the head lengthwise
3. Lambdoid suture: separates the parietal bones crosswise from occipital bone
D. Facial bones: 14, i.e nasal bone, zygomatic bone and maxilla/mandible
E. Cervical support - C7; important landmark when processing anatomical structures
F. Glands
1. 2 pairs of salivary glands on the face
2. Parotid glands are in the cheeks over the mandible
3. Submandibular glands are below mandible at angle of jaw
4. Sublingual lie in the floor of the mouth
G. Temporal artery
II. The Neck
A. Conduit for the passage of
1. Blood vessels
2. Muscles
3. Nerves
4. Lymphatics
5. Viscera (respiratory/digestive)
B. Neck muscles
1. Sternocleidomastoid - enables head rotation and flexion
2. Trapezius - move shoulders and turn head
a) Both are innervated by cranial nerve XI
C. Thyroid gland
1. An endocrine gland that secretes T4 and T3; hormones that stimulate the rate of
cellular metabolism
2. Highly vascular
D. Thyroid cartilage : the adam's apple
1. Beneath the adam's apple is the cricoid cartilage
E. Hyoid bone
III. Lymphatics
A. Drain the head and neck of excess interstitial fluid via lymph nodes
B. Lymph nodes line the cervical spine and neck regions as well as along the face and jaw
1. Nodes slowly filter the lymph and engulf pathogens, preventing harmful
substances from entering the circulation
C. Nodes are accessible to examination only in four areas
1. Head and neck (greatest supply)
2. Arms
3. Axillae
4. Inguinal area
, D. Drainage pattern of lymph nodes
1. When nodes are enlarged, check the area they drain for the source of the
problem. Explore the area proximal (upstream) for the source of the problem.
2. All head and neck structures eventually drain into the deep cervical chain.
E. There are 60-70 lymph nodes
F. Lymph nodes of head and neck ^^
IV. SUBJECTIVE DATA
A. Headache (use PQRSTU)
1. frequency/severity
a) Any unusually frequent or unusually severe headaches?
2. Character
a) Throbbing, pounding, shooting, aching, pressure, dull
3. Course and Duration
a) What time do they occur, how long, daily?
4. Associated factors
a) Any other symptoms like nausea or vomiting?
B. Head Injury
1. LOC (loss of consciousness) and then fall? (LOC before fall can indicate cardiac
issue)
C. Dizziness
1. “I feel like I'm going to faint” = presyncope
a) Light headed swimming sensation caused by decreased blood flow to the
brain or heart irregularity causing decreased CO
2. “I feel like I’m spinning” = vertigo
a) True rotational spinning often from labyrinthine vestibular disorder in
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