Deck 10: Head and Neck

Question 1

Which is the best way to position a patient's neck for palpation of the thyroid?

A) Flexed away from the side being examined
B) Flexed directly forward
C) Flexed toward the side being examined
D) Hyperextended directly backward

Answer 1

Flexed toward the side being examined

Question 2

Mr. Black is a 44-year-old patient who presents to the clinic with complaints of neck pain that he thinks is from his job involving computer data entry. As the examiner, you are checking the range of motion in his neck and note that the greatest degree of cervical mobility is at:

A) C1 to C2.
B) C2 to C3.
C) C3 to C4.
D) C4 to C5.

Answer 2

C4 to C5.

Question 3

Mr. Mathews is a 47-year-old patient who presents for a routine physical examination. On examination, you noted a bruit heard over the thyroid. This is suggestive of:

A) hypothyroidism.
B) hyperthyroidism.
C) thyroid cancer.
D) thyroid cyst.

Answer 3

hyperthyroidism.

Question 4

An inconsequential finding on the head of an adult is a palpable:

A) embryonic remnant.
B) posterior fontanel.
C) sagittal suture ridge.
D) skull indentation.

Question 5

The brown or tan pigmentation on the forehead, nose, and malar prominence of some pregnant women is called:

A) hormonal acne.
B) erythema.
C) alopecia.
D) chloasma.

Question 6

During a physical examination of a 30-year-old Chinese man, you notice a slight asymmetry of his face. The cranial nerve examination is normal. Your best action is to:

A) ask the patient if this characteristic runs in his family.
B) perform monofilament testing on the face.
C) consult with the physician regarding the laboratory tests needed.
D) record the finding in the patient's chart.

Question 7

Mrs. Britton brings her 16-year-old son in with a complaint that he is not developing correctly into adolescence. Which structures disproportionately enlarge in the male during adolescence?

A) Coronal sutures
B) Hyoid and cricoid cartilages
C) Mandible and maxilla bones
D) Nose and thyroid cartilages

Question 8

Spasmodic muscular contractions of the head, face, or neck are called:

A) torticollis.
B) tics.
C) dimpling.
D) webbing.

Question 9

The parotid, submandibular, and sublingual salivary glands:

A) impair carbohydrate digestion.
B) inhibit dental caries.
C) lubricate nasal surfaces.
D) promote dry mouth.

Question 10

A bruit, or blowing sound, over the skull or temporal region of an adult indicates a:

A) degenerative change.
B) hyperthyroid storm.
C) skull fracture.
D) vascular anomaly.

Question 11

During a head and neck assessment of a neonate, it is important to screen for:

A) the presence of torticollis.
B) signs and symptoms of cerebral palsy.
C) uneven movement of the eyes.
D) unilateral movement of the tongue.

Question 12

Which of the following is an expected change in the assessment of the thyroid during pregnancy?

A) Palpation of the gland becomes difficult.
B) A bruit is auscultated.
C) Inspection reveals a goiter.
D) The gland is tender on palpation.

Question 13

Observation during history taking is the best way to examine for:

A) head position.
B) scalp lice.
C) thyroid size.
D) tracheal alignment.

Question 14

Coarse, dry, and brittle hair is associated with which metabolic disorder?

A) Hypothyroidism
B) Diabetes mellitus
C) Addison disease
D) Cushing syndrome

Question 15

When examining the skull of a 4-month-old baby, you should normally find:

A) closure of the anterior fontanel.
B) closure of the posterior fontanel.
C) ossification of all sutures.
D) overlap of cranial bones.

Question 16

Spaces between the cranial bones accommodate:

A) brain growth.
B) cartilage formation.
C) muscular expansion.
D) nerve regeneration.

Question 17

Ms. Galvan is a 22-year-old secretary who comes to the clinic with headaches of 6 weeks' duration. She tells the office assistant about her heavy schedule, including part-time work and evening classes. Her vital signs are normal. Which information is most appropriate to Ms. Galvan's history?

A) Current medications
B) Elimination patterns
C) Immunization status
D) Previous pregnancies

Question 18

To detect bruits in the head and neck region, you should place the bell of the stethoscope:

A) above the temporal and sagittal regions.
B) below the eyes and on the coronal suture.
C) near the zygomatic and nasal areas.
D) on the temporal region and below the occiput.

Question 19

In examining the neck of a 34-year-old female patient, you note that the uppermost ridge of the tracheal cartilage is at the:

A) cricoid.
B) hyoid.
C) thyroid.
D) sternocleidomastoid.

Question 20

Which cranial nerves innervate the face?

A) II and V
B) III and VI
C) V and VII
D) VIII and IX

Question 21

Which of the following is a chronic autoimmune disorder?

A) Microcephaly
B) Hashimoto disease
C) Salivary gland tumor
D) Down syndrome

Question 22

Which of the following is true regarding caput succedaneum?

A) It is a subperiosteal collection of blood.
B) It is firm and its edges are well defined.
C) It develops several days after delivery.
D) It is seen over the presenting part of the head.

Question 23

Which of the following is true regarding a cephalohematoma?

A) It is bound by suture lines.
B) The affected part feels soft.
C) It is obvious at birth.
D) The margins are poorly defined.

Question 24

What structure is located in the upper third of the sternocleidomastoid muscle?

A) Branchial cleft cyst
B) Cricoid cartilage
C) Lacrimal duct
D) Thyroid gland

Question 25

Which type of headache usually occurs at night, is precipitated by alcohol consumption, and occurs more often in men than in women?

A) Classic migraine
B) Temporal arteritis
C) Cluster
D) Hypertensive

Question 26

A stethoscope is used in a head and neck examination to assess:

A) intracranial fluid.
B) pulsating fontanels.
C) skull bone development.
D) thyroid vascular sounds.

Question 27

You are palpating a patient's thyroid and find that its broadest dimension measures 4 cm. The right lobe is 25% larger than the left. These data would indicate:

A) a congenital anomaly.
B) a multinodular goiter.
C) a normal thyroid gland.
D) thyroiditis.

Question 28

Tracheal tug suggests the presence of a(n):

A) enlarged thyroid.
B) swallowing disorder.
C) aortic aneurysm.
D) thoracic carcinoma.

Question 29

You are examining Ms. L, age 78 years. You find a sunken appearance of her eyes, cheeks, and temporal areas. Her skin is dry, and her nose appears sharp. This description of Ms. L's facies is associated with:

A) cutis laxa syndrome.
B) Hurler syndrome.
C) old age.
D) terminal illness.

Question 30

Mr. Donaldson is a 64-year-old patient with complaints of headaches. As the examiner, you are palpating his head during your physical examination. Which of the following would be your first step?

A) Palpate the patient's hair, noting texture, color, and distribution.
B) Palpate the temporomandibular joint.
C) Palpate the skull from front to back.
D) Palpate the temporal artery.

Question 31

Nuchal rigidity is most commonly associated with:

A) thyroiditis.
B) meningeal irritation.
C) Down syndrome.
D) cranial nerve V damage.

Question 32

The premature union of cranial sutures that involves the shape of the head without mental retardation is:

A) craniosynostosis.
B) encephalocele.
C) microcephaly.
D) myxedema.

Question 33

Moist skin with fine hair, prominent eyes, lid retraction, and a staring expression are characteristics associated with:

A) Cushing syndrome.
B) Graves disease.
C) myxedema.
D) systemic lupus erythematosus.

Question 34

The most common form of birth trauma of the scalp is:

A) caput succedaneum.
B) cephalohematoma.
C) cranial bossing.
D) torticollis.

Question 35

The correct way to transilluminate an infant's skull is to:

A) hold the light 18 inches from the skull.
B) move the light toward and then away from the head.
C) place the light firmly against the skull.
D) shine the light inside the infant's mouth.

Question 36

A 29-year-old woman presents to the urgent care center with a history of a severe headache of 2 hours' duration. She describes it as bandlike and constricting. In interviewing the woman about her complaint, you would ask:

A) whether she has experienced increased tearfulness.
B) the date of her last menstrual period.
C) whether these headaches started in childhood.
D) whether she is particularly stressed or overworked.

Question 37

The thyroid gland should:

A) be slightly left of midline.
B) have a clear vascular sound.
C) move when the patient swallows.
D) tug with each heartbeat.

Question 38

Mr. Johnson presents with a freely movable cystic mass in the midline of the high neck region, at the base of the tongue. This is most likely a:

A) parotid gland tumor.
B) branchial cleft cyst.
C) Stensen duct stone.
D) thyroglossal duct cyst.

Question 39

Which of the following findings would be consistent with fetal alcohol syndrome (FAS)?

A) Corneal clouding
B) Eye slanting
C) Mild ptosis
D) Symmetric, bulging fontanels

Question 40

When noting a bulging fontanel with marked pulsations in a 6-month-old, you suspect:

A) normal development.
B) congenital anomaly.
C) increased intracranial pressure.
D) fever response to a viral infection.

Question 41

The trapezius and sternocleidomastoid muscles and the clavicle form a landmark called the _________ triangle.

Question 42

The medial borders of the sternocleidomastoid muscles and the mandible form the _________ triangle.

Question 43

The largest endocrine gland in the body lies in the _________ triangle.

Question 44

Closure of the anterior skull fontanel should occur by ______________.