clinical LOs

Question 1

what sxs are associated with infection in the retopharyngeal space

Answer 1

dysphagia, dysphonia

Question 2

under what circumstances does a hyoid fx usually occur

Answer 2

strangulation

Question 3

what are the sxs of hyoid fx

Answer 3

dysphagia, difficulty maintaining separation btwn GI and respiratory tracts

Question 4

under what circumstances does fx of laryngeal cartilage occur

Answer 4

anterior blow to the neck

usually in sports or MVA

Question 5

what are the sxs of congenital torticullus

Answer 5

face looking away from affected side

Question 6

what complication can arise from congenital torticullus

Answer 6

development of a hematoma which can impinge CN XI

Question 7

what are the sxs of laryngeal cartilage fx

Answer 7

submucosal hemorrhage and edema
respirtatory obstruction
hoarseness/temporarily ability to speak

Question 8

what is spasmodic torticullis

Answer 8

abnormal tonicity of cervical ms

Question 9

what CN is affected in a stroke/intracranial hematoma

what are the associated sxs

Answer 9

CN VII

facial paralysis on contralateral side

Question 10

lesions in what area are associated w/ olfactory hallucinations

Answer 10

temporal lobe of the cerebral hemisphere

Question 11

how will the optic disc appear on ophthalmic exam in pts with optic neuritis

Answer 11

pale and unusually small

Question 12

increasing intracranial pressure from an extradural hematoma often compressed what nerve against what structure

Answer 12

CN III compression against petrous part of temporal bone

Question 13

why would CN VI be affected by an atherosclerotic internal carotid

Answer 13

they closely related in the cavernous sinus

Question 14

which CN is most frequently paralyzed

Answer 14

CN VII

Question 15

what structures are affected in conductive deafness

Answer 15

external and middle ear

Question 16

what structures are affected in sensorineural deafness

Answer 16

cochlea, pathway from the cochlea to the brain

Question 17

what is an acoustic neuroma

Answer 17

a slow-growing, benign tumor of the internal acoustic meatus

Question 18

what structure is damaged in Horner’s syndrome?

Answer 18

cervical sympathetic trunk

Question 19

what are the sxs of Horner’s syndrome

Answer 19

ptosis
miosis
anhydrosis
vasodilation

Question 20

structures affected in le fort I

Answer 20

maxillae above alveolar process (roots of teeth)
bony nasal septum
possibly pterygoid plates

Question 21

structures affected in le fort II

Answer 21

bridge of the nose
maxillary sinuses
hard palate & alveolar processed are separated from cranium

Question 22

structures affected in le fort III

Answer 22

superior orbital fissues
ethmoid and nasal bones
greater wings of sphenoid
frontozygomatic sutures

Question 23

what is the difference btwn craniotomy and craniectomy

Answer 23

in a craniotomy, the bone flap is replaced following surgery

in a craniectomy, a plastic or metal plate is put in its place

Question 24

where will aberrant thyroid glandular tissue be found

Answer 24

along the embryonic thyroglossal duct

Question 25

in what circumstances would a thyroglossal duct cyst need to be removed

Answer 25

if it is causing dysphagia or issues w/ hyoid bone

Question 26

what structure may be absent in a pt with a pyramidal gland lobe of the thyroid gland

Answer 26

isthmus of the thyroid gland

Question 27

from what three structures might a thyroid ima a. arise

Answer 27

aorta brachiocephalic trunk common carotid

Question 28

why are children at increased risk of ear infection

Answer 28

pharyngotympanic tube lies flat until adulthood, allowing fluid to accumulate

Question 29

what is a cricothyrotomy and when is it performed

Answer 29

needle passed through cricothyroid membrane to permit air to enter emergency, when intubation is not possible

Question 30

what are the steps of tracheostomy

Answer 30

incision at 2nd or 3rd tracheal ring => separation of infrahyoid ms => removal/retraction of isthmus of thyroid => insert tube into trachea to establish airway

Question 31

what causes the voice to change at puberty

Answer 31

increase testosterone => increase in size of laryngeal cartilages

Question 32

what causes the voice to change with aging

Answer 32

calcification of the thyroid gland

Question 33

what is a brachial fistula a remnant of

Answer 33

2nd pharyngeal pouch & groove

Question 34

what is a brachial sinus a remnant of

Answer 34

cervical sinus

Question 35

what structures are removed in a tonsilectomy

Answer 35

palatine tonsils, pharyngeal tonsils usually removed also

Question 36

what is a complication of adenoiditis?

Answer 36

pharyngeal tonsils can obstruct nasal passageways => hearing impairment and otitis media

Question 37

where do tonsil stones form

Answer 37

crypts of palatine tonsils

Question 38

what is vertebra-basilar insufficiency

Answer 38

decreased posterior circulation due to occlusion of vertebral a

Question 39

sxs of vertebra-basilar insufficiency

Answer 39

``` syncope, vertigo, dizziness slurred speech diplopia/vision loss loss of coordination n/v ```

Question 40

what is subclavian steal syndrome

Answer 40

proximal stenosis or occlusion of subclavian => reversal of blood flow through vertebral a. to supply UE => decreased blood flow to the brain

Question 41

sxs of subclavian steal syndrome

Answer 41

syncope, neurologic defecits | can be associated w cervical rib

Question 42

why do scalp wounds bleed profusely

Answer 42

arteries of the peripheral scalp have abundant anastomoses | arteries are held open by dense CT

Question 43

through which layer of the scalp does infection spread

Answer 43

loose CT layer | can enter cranial cavity via emissary vs

Question 44

what nerve is usually affected in herpes zoster

Answer 44

CN V1 => painful corneal ulceration

Question 45

what causes an auricular hematoma

Answer 45

localized collection of blood btwn the perichondrium and auricular cartilage => distortion of the auricle

Question 46

what complication can arise from otitis media?

Answer 46

perforation of tympanic membrane => middle ear deafness

Question 47

what is myringotomy

Answer 47

incision to release pus from middle ear abscess

Question 48

where should the incision be made in myringotomy and why

Answer 48

incision made posterio-inferiorly to avoid injury to chorda tympani, ossicles and blood vessels

Question 49

what is meniere syndrome

Answer 49

recurrent attacks of tinnitus, hearing loss, vertigo due to excess endolymph production or blockage of endolymphatic duct

Question 50

what causes anterior mandible dislocation

Answer 50

excessive contraction of lateral pterygoids w yawning or chewing

Question 51

why are posterior mandible dislocations rare

Answer 51

postglenoid tubercle and intrinsic lateral ligament stabilize TMJ posteriorly

Question 52

what structures do you need to watch for during surgery of the TMJ

Answer 52

facial n | auriculotemporal ns

Question 53

what nerve should be blocked to anesthetize the upper mouth

Answer 53

infra-orbital n

Question 54

where should you pass the needle to perform an infra-orbital nerve block

Answer 54

btwn oral mucosa and gums at superior oral vestibule => into infraorbital foramen

Question 55

what is the source of bleeding in most cases of epitaxis?

Answer 55

anterior 1/2 of the nose

Question 56

what is the venous drainage of the nasal cavity

Answer 56

sphenopalatine v facial v ophthlamic v

Question 57

what as. come together in the kiesselbach area

Answer 57

``` branches of maxillary a: greater palatine a anterior and posterior ethmoidal a sphenopalatine a branches of facial a: superior labial a lateral nasal branches ```

Question 58

what CN is most susceptible to impingment by a thrombus & why

Answer 58

abducent (CN VI) b/c it is free-floating in venous blood of the cavernous sinus