HAS MIDTERMS

• Normocephalic


  Round and is of normal size or head circumference, in proportion with gross body structure, with smooth skull contour
• Deviations from normal head shape

  • Disproportionate
  • Asymmetric parietal and temporal prominences; with more prominent nose and forehead; longer mandible
  • Increased head circumference
  • Square-head
  • Bulging / depressed bone
  • Abnormal increase in head size in young child: may indicate hydrocephalus
  • Inconsistently large head size in adolescent or adult: may indicate acromegaly
• Normal palpation of head


  Smooth, uniform consistency; absence of nodules or masses
• Deviations from normal palpation of head

  • Sebaceous cysts
  • Local deformities from trauma
  • Masses
  • Nodules
• Normal facial movements


  Symmetric facial movements: Raise or lower both eyebrows, blink both eyes, close both eyes tightly, smile and show the teeth, frown, puff the cheeks
• Deviations from normal facial movements

  • Asymmetric facial movements
  • Drooping of lower eyelid and mouth
  • Involuntary facial movement
• Normal facial features


  Symmetric facial features, eyebrow hair equally distributed, palpebral fissures equal in size
• Deviations from normal facial features

  • Asymmetric features
  • Increased facial hair; thinning of eyebrows; exopthalmos; moon face
• Normal eye appearance


  No edema, eyes not sunken

  
• Deviations from normal eye appearance


  • Periorbital edema
  • Sunken eyes, cheeks and temples (indicative of dehydration, starvation, and illness)
• Normal temporomandibular joint range of motion


  No edema, eyes not sunken
• Deviations from normal temporomandibular joint range of motion


  • Abnormal
  • Swelling
  • Tenderness
  • Crepitation
• Normal neck inspection


  Neck erect, midline, no lumps, bulges, or masses. Thyroid not visible. No masses, swelling, or hypertrophy in mid to lower half of anterior neck.
• Deviations from normal neck inspection

  • Enlargements
  • Lymphadenopathy, lymphoma, or other malignancy
  • Torticollis: deviation of neck to one side caused by spasmodic contraction of neck muscles
  • Enlarged, visible thyroid
  • Goiter or malignant mass
• Normal palpation of neck


  Supple, nontender, no masses
• Deviations from normal palpation of neck

  • Masses: Lymphadenopathy, malignancies, thyroid masses
• Cervical Nodes: Occipital, Post-auricular, Pre-auricular, Tonsillar, Submandibular, Submental, Superficial cervical, Posterior cervical, Deep cervical, Supraclavicular, Infraclavicular
• Normal lymph nodes


  Normally not palpable especially the deep and clavicular nodes. If a node is palpable, normal characteristics include small, 1 cm, mobile, soft, nontender, and usually superficial.
• Deviations from normal lymph nodes

  • Palpable nodes (1 cm or greater): Malignancy, inflammatory, or infectious process of glands or area they drain.
• Normal palpation of thyroid


  Generally nonpalpable. If some tissue is palpable, consistency is firm, smooth, and meaty, with no nodularity, enlargement, or tenderness.
• Deviations from normal palpation of thyroid

  • Enlarged thyroid
  • Nodular thyroid tissue
  • Tender thyroid
• Normal auscultation of thyroid


  No sounds detected
• Deviations from normal auscultation of thyroid

  • Increased vascularity of hyperthyroidism
• BACHELOR OF SCIENCE IN NURSING: HEALTH ASSESSMENT COURSE MODULE COURSE UNIT WEEK 2 7 7 Adult Physical Assessment: Eyes
• 70 % of all sensory information reaches the brain through the eyes
• External Structures of the Eye: Extraocular Muscles, Lacrimal Apparatus

  
• Anatomy of the Eye: Choroid, Vitreous Humor, Cornea, Pupil, Lens, Retina, Sclera

  
• Normal eyebrows


  Hair evenly distributed; skin intact, Symmetrically aligned; equal movement
• Deviations from normal eyebrows

  • Loss of hair
  • Scaling and flakiness of skin
  • Unequal alignment and movement of eyebrow
• Normal eyelashes


  Present and curving outward, no crusting or infestation
• Deviations from normal eyelashes

  • Absence of eyelashes
  • Lice or ticks at base of eyelashes
  • Inflammation
  • Inverted eyelashes
  • Everted eyelashes: Ectropion; can lead to excessive drying of eyes
• Normal eyelids


  Upper eyelid normally covers one-half of upper iris, palpebral fissures symmetrical, eyelids in contact with eyeball, no lesions

  
• Deviations from normal eyelids

  • Asymmetry of lids: CN III damage, stroke
  • Ptosis of both eyelids: Myasthenia gravis
  • Lesions on eyelids: Basal cell carcinoma, Squamous cell carcinoma, Xanthelasma, Chalazion, Hordeolum / Stye
• Snellen chart


  Tests the ability to discern letters or numbers at a given distance
• Snellen chart procedure


  1. Have client stand 20 ft. away

  2. Cover up 1 eye

  3. Uncovered eye reads top letter

  4. Test each eye separately, then together with and without corrective lenses
• Normal visual acuity


  20 / 20 is the Normal acuity, 20 / 15 is a better vision
• Deviations from normal visual acuity

  • 20 / 200 – legally blind
  • Smaller fraction eg. 20 / 40
• Jaeger test


  Tests near vision acuity, client holds print at 14 inches
• Normal near vision acuity

  14 / 14

  
• Deviations from normal near vision acuity

  • Smaller fraction (e.g., 14/18)
  • Myopia – Nearsigthedness
  • Hyperopia – Farsightedness
  • Presbyopia – Farsightedness due to aging