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xD2 Oral Path Final Exam > OPF Facial Pain and NMD (Ch18) > Flashcards

OPF Facial Pain and NMD (Ch18) Flashcards

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1
Q

What are 3 symptoms with dysfunction of motor nerves?

A
  1. Lack of motion
  2. Weakness
  3. Loss of function
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2
Q

What is the term for loss of sensation?

A

Anesthesia

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3
Q

What is the term for partial loss of sensation?

A

Hypoesthesia

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4
Q

What is the term for change of sensation?

A

Paresthesia

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5
Q

What is the term for increased sensation?

A

Hyperesthesia

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6
Q

CNVII (facial nerve) is mostly what type of nerves? It also contains some of what other type?

A

Mostly motor with some sensory

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7
Q

What disorder is unilateral paralysis of CNVII?

A

Bell’s Palsy

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8
Q

What systemic disease has a high rate of Bell’s Palsy?

A

Multiple sclerosis

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9
Q

75% of Bell’s palsy is caused how?

A

Trigger event (viral infection, exposure to cold, pregnancy)

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10
Q

Is it called Bell’s palsy if the the paralysis is secondary to surgical or traumatic severance of the nerve

A

Nope

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11
Q

What is a syndrome that can have Bell’s Palsy associated?

A

Melkesson – Rosenthal

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12
Q

What is the age group for most people with Bell’s Palsy?

A

Middle-aged

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13
Q

What is usually the cause of Bell’s Palsy in children?

A

Secondary to viral infection, Lyme disease, or earache

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14
Q

What is the clincial appearance of Bell’s Palsy?

A

Mask like appearance, inability to smile, close one eye or wink, raise one eyebrow, corner of mouth droops

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15
Q

Is there a universal treatment for Bell’s Palsy?

A

No

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16
Q

What is the recovery rate for Bell’s Palsy?

A

82% recover slowly within six months

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17
Q

These may mimic pain of dental origin so you must rule out dental inflammatory disease.

A

Neuralgias and headaches

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18
Q

How will patients act/feel with neuralgias and headaches?

A

Confused, frustrated, afraid

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19
Q

What is often called Tic douloureux, affecting the trigeminal nerve (CN V)?

A

Trigeminal neuralgia

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20
Q

What are symptoms of Tic Douloureaux (Trigeminal Neuralgia)?

A

Extremely severe, electric shock, sharp, lancinating pain in one or more trigeminal branches

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21
Q

What is the most common of all the neuralgias?

A

Tic douloureux/trigeminal neuralgia

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22
Q

What are the 3 divisions of CN V?

A
  1. Opthalmic
  2. Maxillary
  3. Mandibular
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23
Q

Trigeminal neuralgia most commonly involves which branches?

A

Mostly middle (maxillary) and lower (Mandibular), but can be all 3 divisions

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24
Q

What criteria are necessary to reach a diagnosis of trigeminal neuralgia/tic douloureux?

A

Abrupt attack, initiated by a light touch and specific, constant trigger . Duration of single spasm <2 min

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25
Is there motor deficit in trigeminal neuralgia/tic douloureux?
No
26
What can decrease pain in trigeminal neuralgia/tic douloureux?
Carbamazepine
27
What is a common trigger point for trigeminal neuralgia/tic douloureux?
1. Nasolabial folds 2. Vermillion border 3. Periorbital skin
28
What is the treatment for trigeminal neuralgia/tic douloureux?
1. Topical/systemic meds 2. Decompress nerve 3. Destroy nerve
29
If paroxysmal facial pain is accompanied by excess lacrimation, conjunctival injection, and intense headache, what should be considered instead of trigeminal neuralgia/tic douloureux?
SUNCT syndrome
30
What does SUNCT syndrome stand for?
``` S = Short lasting U = Unilateral N = Neuralgiform headache C = conjuctival injection T = Tearing ```
31
What disorder is similar to trigeminal neuralgia except that the 9th CN is affected?
Glossopharyngeal Neuralgia
32
What are the anatomical locations of Glossopharyngeal Neuralgia that is different from trigeminal neuralgia/tic douloureux?
Intra-auricular area, tonsil, base of tongue, posterior mandible, lateral wall pharynx
33
If the patient has neuralgia triggered by talking, chewing, or swallowing, what is the diagnosis?
Glossopharyngeal Neuralgia
34
What disorder includes chronic pain associated with Vericella-Zoster virus/ Shingles characterized by constant burning sensation over nerve distribution with episodic stabbing pains?
Postherpectic Neuralgia
35
What disorder includes facial paralysis seen in association with herpes zoster of the face or external auditory canal also associated with facial paralysis, hearing deficits, vertigo, and other auditory and vestibular symptoms?
Ramsay-Hunt Syndrome
36
What are the treatment options for Ramsay-Hunt syndrome?
1. Antiviral meds (acyclovir) 2. Antihistamines or vasodilators 3. Systemic corticosteroids 4. Ocular antibiotics and artificial tears
37
What is the recovery rate for Ramsay Hunt Syndrome?
82% of patients recover completely in 6 months
38
What is the term for persistent maxillofacial pain that doesn’t fit any of the other patterns (diagnosis by exclusion), but need to rule out sinus problems, cracked tooth, headache, infection, ischemia, myofascial pain, typical neuralgias, TMD, trauma, or tumors?
Atypical facial pain
39
What are the demographics for atypical facial pain?
Women > men, 40-50 years old
40
What are 3 treatments of atypical facial pain?
1. Gabapentin (anticonvulsants) 2. Opiod analgesics 3. Tricyclic antidepressants
41
What is the term for the degeneration and death of marrow and bone from a slow or abrupt decrease in marrow blood flow, will not be picked up on radiograph, only way to diagnose is to inject bone marrow with local anesthetic?
Neuralgia – Inducing Cavitational Osteonecrosis (NICO)
42
What is the treatment for Neuralgia-Inducing Cavitational Osteonecrosis?
Curettage
43
What are 4 types of headaches?
1. Sinus 2. Cluster 3. Tension 4. Migraine
44
In what type of headache is the pain behind browbone and/or cheekbones?
Sinus headache
45
In what type of headache is the pain in and around the eye?
Cluster
46
In what type of headache is the pain like a band squeezing the head?
Tension
47
In what type of headache is there pain, nausea, and visual changes?
Migraine
48
What headache affects males more than females, mostly people 30-40 years old, has vasodilation related to head trauma and abnormal hypothalamic function (also called an alarm clock headache)?
Cluster headache
49
What is the demographic for Cluster/alarm clock headaches?
African-Americans, 80% smokers
50
What is the character of cluster headaches?
Upper face near eye, abrupt onset, no trigger zone, recurs at same time, lasts for weeks then has long remission
51
What nerve and how is the cluster headache associated?
Unilateral; associated with ophthalmic division trigeminal
52
What are 2 types of migraine (disabling unilateral headache)?
1. Migraine with aura | 2. Migraine without aura
53
What is a vasospasm/vasoconstriction of cerebral arteries in response to reduced serotonin activity followed by vasodilation?
Migraine
54
What is the demographic for migraines?
Women affected more commonly and more severely
55
What is the best treatment for migraines?
Recognize and avoid triggers
56
What are 3 medications used to treat migraines?
1. Ergotamine 2. Beta blockers 3. Serotonin receptor agonists
57
What is the pain/burning sensation in mouth including gingival, unattached mucosa and tongue, found in post- menopausal women, with a strong associating with depression and anxiety. Will build in intensity and can have altered taste?
Burning mouth syndrome
58
What is the technical name for burning mouth syndrome and is there one known cause?
Glossopyrosis. There are multiple causes and multiple treatments.
59
What is the capasin treatment for Glossopyrosis?
Have the patient swish red hot sauce
60
What is the term for persistent abnormal taste?
Dysgeusia
61
75% of taste is made up of what other sense?
Smell
62
According to Dr Burns, what is the most common altered taste patients report?
Metallic taste
63
What is the disorder that results from injury to auriculotemporal nerve which leads to flushing and sweating along its distribution after gustatoary stimuli and can occur as a result of parotidectomies?
Frey syndrome/auriculotemporal syndrome/gustatory sweating
64
What is an autoimmune nonsupparative inflammatory destruction of joings due to cross reacting antibodies, usually have symmetrical large joints?
Rheumatoid arthritis
65
What is the term for wear and tear inflammation leading to destruction of cartilage, then bone?
Osteoarthritis/degenerative joint
66
What is the only bone in the body that has to cross the midline and work in unison with the other side?
Mandible
67
Radiographically, what is indicative of degenerative osteoarthritis of the TMJ?
If the condyle has a flat appearance
68
TMD is a problem of what part of the masticatory system?
The entire masticatory system (teeth, jaws, joints, muscles)
69
TMD that is associated with dysfunction more than pain, having a clicking, popping, disarticulation or lack of opening falls into what category?
Arthrogenic disorders
70
What are some conservative treatments of TMD?
``` Rest Heat/cold Immobilize Occlusal splint Occlusal adjustment Physical therapy ```

xD2 Oral Path Final Exam (6 decks)

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