Papers Flashcards

1
Q

What are the papers relating to the accessory nerve

A

Symes et al 2005

  • Cervical plexus communication w/ XI (36%)
  • motor inptut (known proprioceptive output)

Tubbs et al 2011

  • Cervical nerve supply to trap muscles (C2,3,4)
  • retained function after XI lesion

Benninger and McNeil 2010

  • Molecular evidence to show cranial and spinal XI separate
  • Internal ramus XI joins X and contributes to pharyngeal plexus
  • Mixed evidence as to whether SCM and Trap derived from branchial arches or somites

Brinzeo and Sindu 2017

  • Cranial XI innervates vocal cords
  • Spinal XI does not

Ryan et al 2007
-1/12 demonstrated distinct communication between X and spinal XI

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2
Q

What papers relate to cervical plexus

A

Ella et al 2015

  • angle of mandible innervated by Greater auricular nerve
  • anastamoses w/ V causing hypersensitivity

Bitner et al 2015

  • IA n block - inadequate anaethesia
  • Transverse cervical and greater auricular block ^ success
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3
Q

What papers relate to root of neck

A

Kuhn et al 2015

  • compression of brachial plexus
  • vascular
  • Neurogenic (95%)

Treatment

  • non surgical - activity modification, analgesia
  • surgical - decompression

Aetiology

  • cervical rib
  • variation in scalene origin
  • hypertrophy

Complications
-venous - sig. upper limb swelling

Weiglein

  • Thyrocervical trunk
  • 20% normal
  • 16% thyrocervical trunk
  • 20% trifurcation
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4
Q

What papers relate to phrenic nerve

A

Sharma et al

  • accessory phrenic in 65%
  • C5
  • Lateral to phrenic in 90%
  • Comes off n to subclavius and joins phrenic around internal thoracic
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5
Q

What papers relate to the trigeminal nerve

A

Khan et al 2014

  • Trigemino - parasympathetic reflex - Increased intra/extracranial blood flow
  • Neurostimulator - modulate pain

Robbins et al 2016
-pterygopalatine ganglion blockade supported in treatment of medically intractable headache

Piagka

  • Pterygopalatine: major post ganglionic fibre source to vascular bed of cerebral hemispheres
  • Might be protective in stroke

Tubbs
-Zygomaticotemporal nerve
: Course over pteryon out of zygomaticotemporal formen, through temporalis
: Might be damaged in craniotomies -> headache –> lack of awareness due to lack of literature
-Musculovascular entrapment of ZTN –> migraine (surgical depression shown to improve)
-Inadvertent traction during craniotomy may damage post ganglionic fibres to lacimal gland (desiccated cornea)

Scotts
-60% ZTN enter lacrimal gland directly

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6
Q

What papers relate to ICA

A
Bouthillier et al 1996
- reclassification of ICA into 7 segments
-new classification in direction of blood flow
C1 - cervical
C2 - petrous
C3 - lacerum
C4 -cavernous
C5 - clinoid
C6 -opthalmic
C7 - communicating

Chapman et al 2013

  • vascular structures can be displaced, invaded or encased by neoplastic, inflammatory, or infectious causes
  • increased surgical complications
  • MRI angiogram best
  • persistent trigeminal artery (fetal carotido-basillar communications)
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7
Q

What papers relate to TMJ disorders

A

Durham et al 2013

  • Arthrlagia w/ myalgia (73%)
  • Pain may radiate

Tx

  • education
  • Physio
  • CBT -chronic pain (strongly associated with chronic fatigue)
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8
Q

What papers relate to parotid

A

Sood et al 2015
-EMG proposed to help preserve VII
Electromyography shows significant decrease in immediate post op weakness in parotidectomy
-non significant affect in long term weakness

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9
Q

What papers relate to the pharynx

A

Pengo and Steier 2015

  • Decreased tone to Upper airway dilators (genioglossus) result in sleep apnoea
  • XII simulation shows sig. improvment, invasive
  • Transcutaneous electrical stimulation proposed
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10
Q

What papers relate to the larynx

A

kark et al 1984

  • Voice changes common after thyroidectomy, even extubation carries risk of 3%
  • most common nerve (external laryngeal)
  • damage occurs when the supraclavicular vessels are ligated
  • visualisation via retraction of infrahyoids and upper pole improve outcomes

Sanudo et al 1999
-anastomsis of internal and recurrent laryngeal

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11
Q

What papers relate to the mouth and tongue

A

Mun et al 2014

  • Sublingual normally drains via small ductules (Risinus’s ducts)
  • Variation: 1 main duct (Batholin’s )

Chen et al
-Recurrent ranula due to iatrogenic damage to Batholin’s duct

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12
Q

What papers relate to the nasal cavity

A

Rodnik and smith 2012

Intractable spontaneous epistaxis most commonly due to a posterior bleed (sphenoplatine artery)

  • Trasnasal endoscopic sphenopalatine artery ligation offers superior complication risks to arterial embolisation
  • both preferable to posterior packing and admission

Brushcini et al 2010

  • Hereditary haemorrhagic telangiectasia
  • Severe cases - surgical closure of nares or nasal swabs
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13
Q

What papers relate to the infratemporal fossa

A

Nussek et al

  • extracranial -intracranial bypass
  • restore perfussion via maxillary artery MCA bypass
  • Shorter graft length than radial artery commonly used
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14
Q

What papers relate to spaces

A

Dehnam 2012

  • Retropharyngeal space inaccessible for clinical inspection
  • MRI mainstay for imaging
  • Diseases in prevertebral and retropharyngeal spaces result in significant morbidity
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15
Q

What papers relate to the facial nerve

A

Gatta

  • 100% show bifurcation into cervicofacial and temporofacial trunks
  • 30% have one branch connecting the two

Kanatas and McCaul

  • Deep landmarks of facial: Post. sup. post belly digastric, tympanomastoid suture
  • Superficial: mastoid process, cartilagenous tragal pointer
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16
Q

What papers relate to trinangles

A

Deep investing layer not continuous between SCM’s
LA applied above fascia still causes cervical n block
Strap muscles, SCM, Traps all have own fascial sheet

17
Q

What paper is on the orbit

A

Occulo-cardiac reflex

  • entrapment of IR - Look upwards - bradycardia, nausea vomiting
  • Trigeminal ganglion - chief nucleus - visceral motor nucleus vagus