Nursing 3320 – Holistic Health Assessment
Exam 3 Study Guide
For every chapter: know the specific Structure & function (pay attention to ... [Show More] my slides and the info below for areas I emphasize) and this is taken into the context of how it applies to the assessment. Include Subjective data, including abnormal findings; Objective data – Exam across the lifespan; age specific findings and exam techniques, normals and abnormals. ALWAYS pay attention to my slides. Unless I indicate that something below is excluded from the material, info on my slides could be covered on the exam. Know HOW to perform the physical assessment. Always know the normal/expected findings AND the abnormal findings in the right shaded column) – for each chapter. This outline will give specific details, as well as those abnormals at the end of each chapter – narrowed down a bit.
Ch. 13 – Head & Neck, Including Regional Lymphatics
Structure & Function:
o Cranial bones – frontal, parietal, occipital and temporal
o Facial bones – Zygomatic, maxilla, mandible -Refer to above picture.
o Symmetry of facial structures – eyebrows, eyes, ears, nose, mouth, palpebral fissures, nasolabial folds
-Facial structures also 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.
o Temporal artery
-The temporal artery lies superior to the temporalis muscle. (Abnormal finding: The artery looks tortuous, feels hardened and tender with temporal arteritis.)
o Neck muscles – sternomastoid & trapezius-innervated by cranial nerve XI, spinal accessory nerve
- The sternomastoid muscle arises from the sternum and the clavicle and extends diagonally across the neck to the mastoid process behind the ear. It accomplishes head rotation and head flexion. The two trapezius muscles on the upper back arise from the occipital bone and the vertebrae and extend fanning out to the scapula and clavicle. The trapezius muscles move the shoulders and extend and turn the head.
o Thyroid gland
-The thyroid gland is an important endocrine gland with a rich blood supply. It straddles the trachea in the middle of the neck. This highly vascular endocrine gland synthesizes and secretes thyroxine (T4) and triiodothyronine (T3), hormones that stimulate the rate of cellular metabolism. The gland has two lobes, both conical in shape, each curving posteriorly between the trachea and the sternomastoid muscle. The lobes are connected in the middle by a thin isthmus lying over the second and third tracheal rings.
• Know the names and location of each lymph node
• Preauricular, in front of the ear
• Posterior auricular (mastoid), superficial to the mastoid process
• Occipital, at the base of the skull
• Submental, midline, behind the tip of the mandible
• Submandibular, halfway between the angle and the tip of the mandible
• Jugulodigastric, under the angle of the mandible
• Superficial cervical, overlying the sternomastoid muscle
• Deep cervical, deep under the sternomastoid muscle
• Posterior cervical, in the posterior triangle along the edge of the trapezius muscle
• Supraclavicular, just above and behind the clavicle, at the sternomastoid muscle
• Focus on Fig 13-7 and the direction of drainage patterns
-When nodes are abnormal, check the area they drain for the source of the problem. Explore the area proximal (upstream) to the location of the abnormal node.
• Developmental Competence:
o Infants & children – Fontanels: membrane-covered “soft spots” allow for growth of the brain during the 1st year. The posterior fontanel closes by 1-2 months; anterior fontanel closes between 9 months and 2 years. o Pregnant female – Thyroid gland slightly enlarges [Show Less]