Anatomy clinical

Question 1

Cutting of the facial nerve would result in loss of muscles including. What gland would not be affected?

Answer 1

Muscles of facial expression:
temporal, zygomatic, buccal, marginal mandibular, cervical

Posterior belly of digastric muscle
Stylohyoid muscle
Stapedius muscle

Also orbicularis oculi and lacrimal gland

Parotid gland wouldn’t be affected

Question 2

Craniosynostosis

Answer 2

premature closer of the sagittal, lambdoid, and coronal (pinhead/oxycephaly) sutures leading to deformities and impaired brain growth

Question 3

Le fort fractures:
I
II
III

Answer 3

I: separated maxillary teeth from the rest of the face (John Waters)

II: separated upper maxillary teeth and nose from the rest of the face
(Hannibal Lecter)

III: fracture through the upper portion of the orbits separating the face from rest of the skull (Riff Raff sunglasses)

Question 4

Artery that could cause epidural hem

Answer 4

Middle meningeal artery.

blood between dura and bone

Question 5

Subdural hem

Answer 5

deep to dura but outside the arachnoid layer

Question 6

Subarachnoid hem could present with?

Answer 6

Severe headache
Stiff neck
LOC
Paralytic strokes from intracerebral hem

blood in CSF

Question 7

What could cause a herniation of the brain through the tentorial incisure?

Answer 7

pathological increased intracranial presure

Question 8

arachnoid villi hypertrophy could lead to

Answer 8

arachnoid granulations

Question 9

Whiplash affects what ligament in front of the vertebral bodies and the anterior neck muscles can be torn/stretched

Answer 9

Anterior longitudinal ligament

Question 10

Whiplash/hyperextension of the neck could result in breakage of the posterior arch of the axis (C2) which is referred to as

Answer 10

Hangman’s Fracture

Question 11

Orbital blow out involves which bone

Answer 11

Maxillary bone

Question 12

Papilla edema

Answer 12

Excessive CSF from increased intracranial pressure because optic nerve is covered in dura therefore brain pressures are reflected in the central artery of the retina before it enters the fundus of the eye.

Optic disc can swell and blood (venous) can pool in the veins of the surface of the retina

Question 13

Internal sty (hordeolum)

Answer 13

meibomian gland infection (staph aur)

Question 14

External sty

Answer 14

hair follicle cyst

Question 15

Periorbital puffiness

Answer 15

normal fat that migrates into lower lid

Question 16

Chalazion is a lump as a result of chronic blockage of what glands?

Answer 16

Tarsal glands

Question 17

Allergic conjunctivitis vs bacterial

Answer 17

Allergic is itchy bacterial has marked grittiness and irritation, stringy and opaque mucopurulent discharge

prophylactic silver nitrate drops in newborns

Question 18

If you lose facial nerve innervation to the orbicularis oculi for some reason what wouldn’t you be able to do and what would be at risk?

Answer 18

The OO Closes the eyelid so the corneal would be at risk of dryin out

Question 19

a patient has just been punched and cant look up above the horizon due to trapping of the inferior rectus muscle. This could be what tyoe of fracture

Answer 19

Orbital blow out, fracture to the maxillary bone and protrusion of orbital contents into the max sinus

Question 20

Exophthalmos seen in

Answer 20

Graves disease

Question 21

Exophthalmos could be due to increased size of ____ muscles which could be due to____

Answer 21

Extraocular muscles.

to autoimmune reaction to TSH R Ag expressed in retro-orbital tissues including extraocular muscles

Question 22

What is the more common form of strabismus?

Answer 22

Esotropia. Both eyes turn inward.

Question 23

One eye deviating outwards is known as

Answer 23

Exotropia strabismus

Question 24

Oculomotor CNIII lesion can lead to 4 things. What are they?

Answer 24

Lateral strabismus from unopposed Lateral Rectus and seperior Oblique

Ptosis from levator palpebrae superioris paralysis

Mydriasis (dilation of the pupil)

Loss of the Accomodation of the lens

Question 25

What could cause sudden CN III palsy?

Answer 25

Aneurysm within the posterior communicating artery cavernous sinus thrombosis

Question 26

CN IV (Trochlear lesion) the patient will tilt head slighly to what side? And what muscle is affected?

Answer 26

Superior oblique muscle is affected and the patient will tilt head to unaffected side to help accommodate

Question 27

Abducens nerve palsy is a lesion that paralyzes what muscle which causes eye to turn inwards? Is this common?

Answer 27

Lateral rectus affected, increased intracranial pressure. This is most common esp w/ DM pts.

Question 28

Glaucoma is excessive pressure of the eye and is due to the blockage of fluid draining from the eye at _______

Answer 28

Canal of Schlemm

Question 29

2 different classes of glaucoma?

Answer 29

Open-Angle | Closed-Angle (iris bulges forward)

Question 30

Why is it so easy to transplant corneaS?

Answer 30

It is avascular so WBCs that would reject the transplant are unlikely to get to that area

Question 31

The ciliary muscle contracts and does what?

Answer 31

Rounds up the lens old age: Presbyopia caused by lens getting less elastic and less able to round up

Question 32

The corneal reflex tests the sensory fibers of the

Answer 32

Ophthalmic (V1) branch of the Trigeminal Nerve (V)

Question 33

The corneal reflex tests the motor fibers of the

Answer 33

Facial Nerve (CN VII)

Question 34

Acoustic Neuromas grows on CN

Answer 34

CN VIII within the interal acoustic meatus This can block the CN VII which runs in the same area

Question 35

Unilateral hearing loss, depression of ipsilateral direct closing of the eyelid

Answer 35

Acoustic Neuroma growing on Vestibulocochlear CN VIII

Question 36

Unilateral hearing loss, depression of ipsilateral direct closing of the eyelid

Answer 36

Acoustic Neuroma growing on Vestibulocochlear CN VIII

Question 37

Jaw Dislocation from excess contraction of what muscle causing the head of the mandible to slide too far over what tubercle?

Answer 37

Lateral Pterygoid muscle head of the mandible slides over the articular tubercle

Question 38

Inferior Alveolar Nerve block. Why would the chin and lower lip feel numb?

Answer 38

anesthestize the teeth around the opening of the mandibular foramen to target the inf alveolar nerve. The Mental nerve is a continuation of the inf alveolar nerve

Question 39

Broken jaw

Answer 39

often at the neck. secured with arch bar

Question 40

Gleek happens when you yawn because the ________ muscle contracts and squeezes part of the submandibular gland against the intrinsic superior tongue muscles

Answer 40

mylohyoid

Question 41

Why babies shouldn't be given a bottle while they lay flat within cribs

Answer 41

something about negative pressure and increasing likelihood fluids are pulled into the auditory tube

Question 42

Mandibular tor are bony protrusions from the medial wall of the mandible. Are these worrisome?

Answer 42

They are benign

Question 43

Sleep apnea from

Answer 43

dropping of the tongue enlarge tonsils soft palate blocking normal airflow

Question 44

Deviation of the Uvula to the unaffected side could indicate lesions of the

Answer 44

CN X (vagus)

Question 45

Febrile patient with inflamed structure in the posterior pharynx most often caused by what bacteria?

Answer 45

Group A Strep most common cause of uvulitis

Question 46

Bifid Uvula associated with what syndrome that is also associated with aneurysm of the aorta as a child

Answer 46

Loeys-Dietz syndrome

Question 47

Bifid Uvula associated with what syndrome that is also associated with aneurysm of the aorta as a child

Answer 47

Loeys-Dietz syndrome

Question 48

Evidence of CHF

Answer 48

JVD from engorged external jugular vein

Question 49

Placing a central venous line most often placed in what vein to because of its direct path to the SVC

Answer 49

The Internal Jugular Vein on the right side Needed for administration of caustic drugs to preserve endothelial lining

Question 50

Typical sites of ectopic thyroid tissue

Answer 50

anywhere along the course of the thyroglossal duct, sometimes in the neck and mediastinum

Question 51

Erb's point located midway up the sternoclediomastoid is important for anesthesia of what cutaneous nerves

Answer 51

Lesser occipital Greater Auricular Transverse cervical Supraclavicular Nerves

Question 52

Carotid Sinus Massage increases parasympathetic outflow by way of what cranial nerve that reflexively causes CN ___ to slow the heart?

Answer 52

CN IX simulates high effective pressure---> CN X

Question 53

Thryoglossal duct are typically _______ below the _____ bone

Answer 53

Midline masses below the hyoid bone common in children 2-10

Question 54

What type of thyroid arteries are responsible for why ER tracheotomies are not frequently done below the isthmus of the thyroid gland?

Answer 54

Thryoid Ima arteries

Question 55

Bilateral paralysis of the posterior cricoarytenoid mucsles may require ______

Answer 55

surgical cricothyrotomy, cricotomy, tracheostomy, or intubation to allow air in the lungs vocal cords close too tightly

Question 56

Bilateral paralysis of the posterior cricoarytenoid mucsles may require ______

Answer 56

surgical cricothyrotomy, cricotomy, tracheostomy, or intubation to allow air in the lungs vocal cords close too tightly

Question 57

Why are the vocal cords at increased risk for cancer development?

Answer 57

transition of epithelial type

Question 58

Abnormal breathing sounds, difficulty swallowing could possibly be

Answer 58

Epiglottitis

Question 59

Laryngitis can be caused by

Answer 59

Acid reflux or viral infection of the respiratory epithelium Edema within the submucosa can typically cause increased mass of the vocal cord limiting ability to vibrate

Question 60

Unilateral paralysis from loss of the superior laryngeal nerve only effects the

Answer 60

cricothyroid muscle Patients will have a weak, rough, easily fatiguing voice

Question 61

loss of ALL innervation to laryngeal muscles will cause what that will require endotracheal tube?

Answer 61

Passive closure of the glottis

Question 62

Tracheostomy vs Tracheotomy

Answer 62

Tracheostomy: emergency airway created below cricoid cartilage to bypass larynx and upper airway Tracheotomy: incising the trachea, usually temporary; upper (right below cricoid cartilage) and lower

Question 63

Innervatio for Ka La Ma

Answer 63

Ka: soft palate elevation (CN X Vagus) La: tongue fx (CNXII Hypoglossal) Ma: opening mouth with orbicularis oris (CN VII Facial)

Question 64

Food stuck at what junction can cause reflex closure of the epiglottis?

Answer 64

Junction of the pharynx with esophagus just below the laryngeal pharynx

Question 65

Food stuck at what junction can cause reflex closure of the epiglottis?

Answer 65

Junction of the pharynx with esophagus just below the laryngeal pharynx Heimlich increases intrabdominal pressure to aid in expelling stuck food.

Question 66

Food stuck at what junction can cause reflex closure of the epiglottis?

Answer 66

Junction of the pharynx with esophagus just below the laryngeal pharynx Heimlich increases intrabdominal pressure to aid in expelling stuck food.

Question 67

nosebleed as a result of what arteries breaking?

Answer 67

Anterior ethmoidal artery, sphenopalatine artery, greater palatine artery, superior labial artery

Question 68

Kiesselbach's area

Answer 68

formation of superficial anastomotic network no nasal septum posterior to the vestibular area

Question 69

Deviated nasal septum

Answer 69

septum isn't in the center of the nose

Question 70

Anosmia can be a result of the olfactory nerves shearing off as they pass through the

Answer 70

cribriform plate

Question 71

Cribriform plate fracture would result in what draining into the nose

Answer 71

CSF

Question 72

Sinusitis usually refers to bacterial infection of the sinuses, secondary to viral infections or allergic rhinitis. Frontaland maxillary sinusitis will produc pain upon tapping on the bone superficial to the sinus. Maxiallary sinusitis can have referred pain to the

Answer 72

maxillary teeth

Question 73

Cribriform plate fracture would result in what draining into the nose

Answer 73

CSF

Question 74

which arteries can be manually compressed to stop a nosebleed?

Answer 74

Greater palatine artery or the superior labial artery

Question 75

what do you pinch to stop a nosebleed?

Answer 75

Upper lip and hard palate behind the incisors Blocks - septal branch of the superior labial artery - greater palatine artery

Question 76

What fossa holds the parasympathetic ganglia that stimulates the nose and paranasal sinuses and lacrimal gland?

Answer 76

Pterygopalatine fossa

Question 77

Virchow's node is a firm supraclavicular lymph node that is found especially on the ______ side. It is critical for detecting posibility of metastatic neoplasm

Answer 77

Left

Question 78

Virchow's node is a firm supraclavicular lymph node that is found especially on the ______ side. It is critical for detecting posibility of metastatic neoplasm

Answer 78

Left

Question 79

ddx for Virchow's node?

Answer 79

lymphoma, non-hodgkins, breast cancer, lung esophageal cancer.