ASSESSING THE SKULL AND FACE

Anatomy of the Head• Skull composed of 7 Bones

– 2 Frontal – 2 Temporal– 2 Parietal– 1 Occipital

• Brain Growth Continues Until Age 6 Years Ossification does not Occur Until Adulthood• Posterior Fontanel Closes by 2 Months of Age• Bones connected by Sutures

– Coronal – Sagittal– Lambdoidal– Squamous

• Anterior Fontanel Closes by 24 Months of Age• Fused Facial Bones:

– Frontal– Zygomatic– Nasal – Ethmoid – Lacrimal– Sphenoid– Maxillary

• Movable Facial Bone– Mandible

• Facial Landmarks– Palpebral Fissures– Nasolabial Folds

Assessing the Skull and Face1. Inquire if the client has any history of the following:

Past problems with lumps or bumps, itching, scaling or dandruff

History of loss of consciousness, dizziness, seizures, headache, facial pain or injury

When and how any lumps occurred Length of time any problem existed

2. Inspect the skull for size, shape and symmetry Rounded, normocephalic Smooth skull contour Lack of symmetry Longer mandible

3. Palpate the skull for nodules or masses and depressions

Smooth, uniform consistency4. Inspect facial features

Symmetric or slightly asymmetric facial features, palpebral features equal in size, symmetric nasolabial folds

Increased facial hair, thinning of eyebrows, assymetric features, exopthalmos, myxedema

5. Inspect the eyes for edema and hollowness Periorbital edema Sunken eyes

6. Note symmetry of facial movements Symmetric facial movements Drooping of lower eyelid and mouth Involuntary facial movements

Lifespan Considerations:Infants:

Newborns can have elongated, molded heads

Anterior and posterior fontanel Voluntary head control