Head, Face, and Neck, including Regional LymphaticsStructure and FunctionStructure and Function (cont.)Slide 4Slide 5Slide 6Slide 7Structures of NeckSlide 9Drainage Patterns of Lymph NodesSlide 11Slide 12Locations of Lymph NodesSlide 14Slide 15Subjective Data: Health History QuestionsSubjective Data: Health History Questions (cont.)Slide 18Slide 19Slide 20Objective Data: Physical ExaminationObjective Data: Physical Examination (cont.)Slide 23Slide 24Slide 25Slide 26Slide 27Slide 28Slide 29Slide 30Slide 31Sample ChartingSample Charting (cont.)Slide 34Abnormal FindingsAbnormal Findings (cont.)Slide 37Slide 38Slide 39Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Head, Face, and Neck, Head, Face, and Neck, including Regional Lymphaticsincluding Regional LymphaticsChapter 13Chapter 13Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 13: Head, Face, and Neck, including Regional LymphaticsChapter 13: Head, Face, and Neck, including Regional LymphaticsStructure and FunctionStructure and FunctionHeadHeadSkull is rigid box that protects brain and is Skull is rigid box that protects brain and is supported by cervical vertebrasupported by cervical vertebraCranial bonesCranial bones•FrontalFrontal•ParietalParietal•OccipitalOccipital•TemporalTemporalFacial expressions formed facial muscles which Facial expressions formed facial muscles which are mediated by cranial nerve VII, the facial nerveare mediated by cranial nerve VII, the facial nerveSlide 13-2Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 13: Head, Face, and Neck, including Regional LymphaticsChapter 13: Head, Face, and Neck, including Regional LymphaticsStructure and Function (cont.)Structure and Function (cont.)Head (cont.)Head (cont.)Two pairs of salivary glands are accessible to Two pairs of salivary glands are accessible to examination on the faceexamination on the face•Parotid glands are in cheeks over mandible, anterior to Parotid glands are in cheeks over mandible, anterior to and below ear; the largest of salivary glands they are not and below ear; the largest of salivary glands they are not normally palpablenormally palpable•Submandibular glands beneath mandible at angle of jawSubmandibular glands beneath mandible at angle of jawThird pair, sublingual glands, lie in floor of mouth Third pair, sublingual glands, lie in floor of mouth Slide 13-3Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 13: Head, Face, and Neck, including Regional LymphaticsChapter 13: Head, Face, and Neck, including Regional LymphaticsStructure and Function (cont.)Structure and Function (cont.)HeadHead (cont.) (cont.)Cranial bonesCranial bonesSuturesSuturesFacial bonesFacial bonesFacial musclesFacial musclesSalivary glandsSalivary glandsSlide 13-4Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 13: Head, Face, and Neck, including Regional LymphaticsChapter 13: Head, Face, and Neck, including Regional LymphaticsStructure and Function (cont.)Structure and Function (cont.)NeckNeckNeck delimited by base of skull and inferior border Neck delimited by base of skull and inferior border of mandible above, and by manubrium sterni, of mandible above, and by manubrium sterni, clavicle, first rib, and first thoracic vertebra belowclavicle, first rib, and first thoracic vertebra belowThink of neck as conduit of many structuresThink of neck as conduit of many structures•Vessels, muscles, nerves, lymphatics, and viscera of Vessels, muscles, nerves, lymphatics, and viscera of respiratory and digestive systemsrespiratory and digestive systems•Internal carotid branches off common carotid and runs Internal carotid branches off common carotid and runs inward and upward to supply braininward and upward to supply brain•External carotid supplies face, salivary glands, and External carotid supplies face, salivary glands, and superficial temporal areasuperficial temporal areaSlide 13-5Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 13: Head, Face, and Neck, including Regional LymphaticsChapter 13: Head, Face, and Neck, including Regional LymphaticsStructure and Function (cont.)Structure and Function (cont.)Neck (cont.)Neck (cont.)Major neck muscles sternomastoid and trapezius Major neck muscles sternomastoid and trapezius are innervated by cranial nerve XIare innervated by cranial nerve XISternomastoid enables head rotation and flexion Sternomastoid enables head rotation and flexion and divides each side of neck into two triangles: and divides each side of neck into two triangles: anterior and posterior trianglesanterior and posterior trianglesTwo trapezius muscles move shoulders and Two trapezius muscles move shoulders and extend and turn headextend and turn headSlide 13-6Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 13: Head, Face, and Neck, including Regional LymphaticsChapter 13: Head, Face, and Neck, including Regional LymphaticsStructure and Function (cont.)Structure and Function (cont.)Neck (cont.)Neck (cont.)Thyroid gland an important endocrine gland Thyroid gland an important endocrine gland straddles trachea in middle of the neckstraddles trachea in middle of the neckSynthesizes and secretes thyroxine (T4) and Synthesizes and secretes thyroxine (T4) and triiodothyronine (T3), which are hormones that triiodothyronine (T3), which are hormones that stimulate rate of cellular metabolismstimulate rate of cellular metabolismThyroid cartilage above that, with small palpable Thyroid cartilage above that, with small palpable notch in upper edge, the “Adam’s apple” in males notch in upper edge, the “Adam’s apple” in males Slide 13-7Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by Saunders, an imprint of Elsevier Inc. Chapter 13: Head, Face, and Neck, including Regional LymphaticsChapter 13: Head, Face, and Neck, including Regional LymphaticsStructures of NeckStructures of NeckSlide 13-8Elsevier items and derived items © 2012, 2008, 2004, 2000, 1996, 1992 by