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AA Sal Neuro > Cara's Neuro flashcards > Flashcards

Cara's Neuro flashcards

1
Q

most common primary petrous apex lesion

A

cholesterol granuloma (T1 + T2 bright)

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2
Q

“smoothly marginated lobulated cystic expansion of the petrous apex”

A

herniation of Meckel s cave into the superomedial aspect of the petrous apex

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3
Q

what s another name for an cholesteatoma in the petrous apex?

A

basically an epidermoid (T1 dark, T2 bright, restricts diffusion)

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4
Q

classic triad of Grandenigo syndrome

A

otomastoiditis + face pain (trigeminal neuropathy) + lateral rectus palsy (unilateral cross eye)

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5
Q

petrous apex/CPA tumor with internal calcs on CT + T2 bright/intense enhancement

A

endolymphatic sac tumor - very vascular with flow voids and tumor blush on angio

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6
Q

most common presenting symptom in glomus jugulare/paraganglioma?

A

hoarseness from vagal nerve compression

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7
Q

large vesitbular aqueduct syndrome is associated with what type of hearing loss?

A

progressive sensioneural hearing loss (90% association with absence of bony modiolus)

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8
Q

who gets labyrinthitis ossificans?

A

kids (2-18 months) s/p meningitis - also get sensineural hearing loss

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9
Q

what s a better term for osteosclerosis

A

“otospongiosus” b/c bone becomes more lytic, not sclerotic

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10
Q

findings in fenestral ostosclerosis

A

bony resorption anterior the oval window

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11
Q

findings in retro-fenestral ostosclerosis

A

more severe form, demineralization around the cochlea, bilateral/symmetric nearly 100%

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12
Q

4 complications of otitis media

A
  1. coalescent mastoiditis 2. facial nerve palsy 3. dural sinus thrombosis 4. meningitis/labrynthitis
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13
Q

order of destruction in cholesteatoma

A
  1. the scutum 2. the ossicles (long process of the incus) 3. lateral segment of the semi-circular canal
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14
Q

most common type of cholesteatoma

A

Pars flaccida (the flimsy, whimpy part of the ear drum)

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15
Q

potential complication of cholesteatoma

A

labryrinthine fistula - bony defect between inner ear + tympanic cavity (usually lateral SCC)

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16
Q

“noise induced vertigo” or “tulio s phenomenon”

A

superior semicircular canal dehiscence (aunt minnie)

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17
Q

what causes abnormal enhancement of the facial nerve?

A
  1. Bell s Palsy! 2. Lyme 3. Ramsay hunt 4. cancer
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18
Q

what kind of trauma involves the facial nerve?

A

transverse T-bone fracture

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19
Q

“osteolysis circumscripta”

A

Paget skull changes - well-defined large radiolucent region favoring front/occipital bones (inner table > outer)

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20
Q

4 skull base Paget related complications

A
  1. deafness! 2. cranial nerve paresis 3. basilar invagination -> hydro -> brainstem compression 4. 2/2 (high gr) osteosarcoma
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21
Q

2 most common locations of chordoma

A
  1. sacrum 2. clivus
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22
Q

clivus lesions: chordoma vs. chrondrosarcoma

A

chordoma = midline, chondrosarcoma = lateral to midline (both T2 bright)

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23
Q

primary vascular supply of JNA (juvenile nasal angiofibroma)

A

ascending pharyngeal artery and/or internal maxillary artery

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24
Q

origin/location of JNA (juvenile nasal angiofibroma)

A

centered on the sphenopalantine foramen

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25
Q

10% of inverting papillomas harbor a

A

squamous cell CA

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26
Q

“cerebrifom pattern” (sinus lesion)

A

inverting papilloma

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27
Q

class location of inverting papilloma

A

lateral wall of the nasal cavity - most frequently related to middle turbinate

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28
Q

dumbbell shaped lesion centered at cribiform plate and ethmoid sinuses with AVID enhancement.

A

esthesioneuroblastoma - malignant tumor of olfactomy mucosa.

Waist of dumbbell at cribiform plate. extends into superior nasal cavity and anterior cranial fossa lobulations. May also have foci of hemorrhage and margin cyst formation.

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29
Q

demographic of esthesioneuroblastoma

A

bimodal - 20s and 60s

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30
Q

most common location of SNUC vs. squamous

A

SNUC(sinonasal undifferentiated carcinoma) large! ethmoid > maxillary; Squamous cell: maxillary antrum

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31
Q

“male teenager with nose bleeds”

A

JNA (juvenile nasal angiofibroma)

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32
Q

main vascular supply to the posterior nose (for uncontrolled nosebleeds)

A

sphenopalatine artery (terminal internal maxillary artery) - watch out for anastomosis btw ECA and ophthalmic

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33
Q

midline “sack of marbles” in the mouth

A

floor of mouth dermoid/epidermoid - fluid sack with globules of fat/midline

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34
Q

what s another term for ranula

A

mucous retention cyst

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35
Q

from whence do ranula arise?

A

sublingual gland/space

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36
Q

when do you use the term “plunging” for a ranula?

A

when it s under the mylohyoid muscle

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37
Q

“grandma s dentures won t stay in”

A

torus palatinus - bony exostosis

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38
Q

submandibular gland proper name

A

Wharton s (most common location for stones)

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39
Q

most common cause of odontogenic infection

A

extracted tooth (not an intact one)

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40
Q

what muscle separates the sublingual vs. submandibular space (and thus where infections go)?

A

mylohyoid (below the mylohyoid are the 2nd and 3rd molars - infections go to submandibular space)

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41
Q

most common masticator space “mass” in adult

A

odontogenic abscess

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42
Q

most common cause of Ludwig s angina

A

odontogenic infection

43
Q

floor of mouth cellulitis + gas everywhere!

A

ludwig s angina

44
Q

3 causes of osteonecrosis of the jaw

A
  1. bisphosphonate treatment 2. prior radiation 3. licking a radium paint brush
45
Q

cancer of the mouth in a younger person

A

HPV-related SCC

46
Q

“young adult with new level 2 neck mass”

A

HPV-related SCC - large necrotic level 2a node

47
Q

most common salivary gland tumor

A

pleomorphic adenoma aka benign mixed tumor

48
Q

2nd most common benign tumor of the parotid

A

warthins - only occurs in parotid

49
Q

4 things to know about warthins

A
  1. usually cystic 2. male 3. bilateral (15%) 4. smoker 5. takes up pertechnetate
50
Q

most common malignant tumor of the minor salivary glands

A

mucoepidermoid carcinoma

51
Q

only salivary gland with lymph nodes

A

parotid (so it s the only one that can get lymphoma)

52
Q

“bilateral parotid lymphoma”

A

Sjogrens

53
Q

“bilateral mixed solid/cystic parotid lesions + HIV”

A

benign lymphoepithelial disease, painless

54
Q

what s in the carotid space?

A

carotid artery, jugular vein, CN 9, 10, 11, and some nodes

55
Q

glomus tympanicum: location

A

confined to middle ear, “overlying the cochlear promontory”

56
Q

glomus vagale: location

A

above carotid bifurcation, but below the jugular foramen

57
Q

glomus jugulare: location

A

skull base (destruction of jugular foramen)

58
Q

carotid body tumor: location

A

carotid birfucation (splaying of ICA and ECA)

59
Q

what s in the masticator space?

A

muscle of mastication, angle/ramus of the mandible, inferior aveloar nerve

60
Q

angry masticator space mass in a kid

A

rhabomyosarcoma (less angry could be chondrosarc from the TMJ)

61
Q

masticator space mass + phleboliths

A

cavernous hemangiomas (can also have venous/lymphatic malformations)

62
Q

nerve sheath tumor in the masticator space

A

schwannoma or neurofibroma of V3

63
Q

what s in the paraphyngeal space?

A

mostly fat, few branches of the trigeminal nerves and pterygoid veins

64
Q

Grisel s syndrome

A

torticollis with atlanto-axial joint inflammation seen in H&N surgery or retropharyngeal abscess

65
Q

nasopharyngeal SCC demographics

A

more common in Asians and bimodal - group 1 = 15-30yo/Chinese group 2 = >40yo

66
Q

most common location of nasopharyngeal SCC

A

Fossa of Rosenmuller (causing unilateral mastoid effusion/blocking eustaschian tube)

67
Q

3 subtypes of laryngeal SCC

A
  1. supraglottic 2. glottic 3. infraglottic 4. “transglottic” (aggressive, crosses laryngeal ventricle, T3)
68
Q

fixation of the cords indicates what T?

A

at least T3 laryngeal SCC

69
Q

only reliable sign of cricoid invasion in laryngeal SCC

A

tumor on both sides of cartilage

70
Q

implication of cricoid invasion in laryngeal SCC

A

contraindication to all types of laryngeal conservation surgery

71
Q

ipsilateral expanded (vocal cord) ventricle

A

vocal cord paralysis (tumor is contralateral)

72
Q

left-sided vocal cord paralysis should prompt

A

chest CT - for recurrent laryngeal nerve involvement at the AP window

73
Q

definition: coloboma

A

focal discontinuity of the globe (usually posterior)

74
Q

when I say “bilateral coloboma”, you say

A

CHARGE (coloboma, heart, GU, ears)

75
Q

“small eye with increases density of vitreous”

A

persistent hyperplastic primary vitreous (not calcification, but very dense on CT)

76
Q

Coat s disease

A

retinal telangiectasia with leaky blood and subretinal exudate (hyperdense back of eye)

77
Q

5 causes of retinal detachment

A
  1. PHPV 2. Coats 3. trauma 4. sickle cell 5. old age
78
Q

who gets optic glioma?

A

90% < 20 yo; if bilateral = NF-1

79
Q

what s the optic nerve look like in optic glioma?

A

expansion/enlargement of the entire nerve

80
Q

what s the optic nerve look like in optic nerve sheath meningioma?

A

“tram-track” calcification, circumferential enhancement around the optic nerve

81
Q

3 syndromes of IgG4

A
  1. orbital pseudotumor 2. Tolosa Hunt (cavernous sinus CN palsies) 3. lymphocytic hypophysitis (pituitary gland)
82
Q

typical findings of orbital pseudotumor

A

painful, unilateral, lateral rectus, does NOT spare myotendinous insertions (unlike thyroid)

83
Q

who gets lymphocytic hypophysitis

A

post-partum/3rd trimester woman - enlarged pituitary stalk (looks like adenoma with T2 dark rim)

84
Q

most common benign orbital mass

A

dermoid - usually superior and lateral, arising from frontozygomatic suture

85
Q

most common extraocular orbital malignancy in kids

A

rhabomyosarcoma

86
Q

“racoon eyes” on physical exam

A

metastatic neuroblatoma - periorbital tumor infiltration with proptosis (also, basilar skull fracture)

87
Q

cancer that causes enophlamos

A

metastatic breast causes a desmoplastic reaction and enophthalmos (primary orbitals cause proptosis)

88
Q

weird associated between Chlamydia psittaci + this orbital tumor

A

MALT lymphoma of the orbit (enhances homogenously and restricts diffusion)

89
Q

most common intra-ocular lesion in an adult

A

melanoma “collar button shaped”

90
Q

most common primary malignancy of the globe

A

retinoblastoma

91
Q

what is trilateral or quadrilateral retinoblastoma?

A

trilateral = both eyes + pineal gland, quadrilateral = both eyes + pineal + suprasellar

92
Q

most common cause of spontaneous orbital hemorrhage

A

varix (also distend with provocative maneuvers)

93
Q

2 types of carotid-cavernous fistulae

A
  1. direct = 2/2 trauma 2. indirect = randomly in post-menopausal females
94
Q

most common causes of pulsatile exophtalmos (2)

A
  1. C-C fistula 2. NF-1 from sphenoid wing dysplasia
95
Q

classic findings of C-C fistula

A
  1. prominent superior ophthalmic vein 2. prominent cavernous sinus 3. proptosis
96
Q

most common cause of pre-septal orbital cellulitis

A

adjacent structures (teeth/face)

97
Q

most common cause of post-septal orbital cellulitis

A

paranasal sinuses

98
Q

etiology of dacrocystitis

A

obstructon of lacrimal sac drainage –> bacterial infection (strep + staph)

99
Q

enhancement of the optic nerve WITHOUT enlargement

A

optic neuritis - usually unilateral and painful

100
Q

order of involvement of extraocular muscles in thyroid orbitopathy

A

I M SLOw (inferior, medial, superior, lateral, superior Oblique)

101
Q

thyroid orbitopathy vs. pseudotumor: symptoms

A

thyroid - not painful, pseudotumor is

102
Q

thyroid orbitopathy vs. pseudotumor: tendon involvement?

A

thyroid - enlargement of only muscle belly, spares tendon; pseudotumor - involves the whole thing

103
Q

Is pars flaccida or pars tensa more superior?

A

pars flaccida

AA Sal Neuro (7 decks)

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