Overview 2 Flashcards
1
Q
What are the four paranasal air sinuses?
A
Ethmoid
Frontal
Sphenoid
Maxillary
2
Q
Three functions of paranasal air sinuses are?
A
Humidify the air
Lighten the weight of the skull
Enhance resonance
3
Q
Which paranasal air sinus is the most superiorly located?
A
Frontal sinus
4
Q
Which paranasal air sinus is the most inferiorly located?
A
Maxillary sinus
5
Q
Which paranasal air sinus is the most posteriorly located?
A
Sphenoid sinus
6
Q
Which paranasal air sinus is just medial to the eyes?
A
Ethmoid sinus
7
Q
Which paranasal air sinus is just lateral to the nose?
A
Maxillary sinus
8
Q
Which paranasal air sinus is superior to the eyes?
A
Frontal
9
Q
Which sinus cannot be seen in the coronal view and why?
A
Sphenoid sinus - most superiorly located
10
Q
What is the ethmoid sinus known as?
A
Ethmoid air cells
11
Q
What are the two main arteries that supply the nose (origins)?
A
External carotid artery
Internal carotid artery
12
Q
What is the blood supply to the nose from the internal carotid artery?
A
Opthalmic artery
13
Q
What are the five arteries that supply the nose?
A
Anterior ethmoidal artery Posterior ethmoidal artery Sphenopalatine artery Greater palatine artery Septal branch of the superior labial artery
14
Q
What are the three main arteries that provide the blood supply to the nose?
A
Opthalmic artery x2
Maxillary artery x2
Facial artery x1
15
Q
What is epistaxis?
A
Nose bleed
16
Q
Majority of epistaxis is anterior or posterior? and what percentage?
A
Anterior - 90%
17
Q
Posterior nose bleeds are more common in whom? x2
A
Elderly
Those with clotting disturbance
18
Q
Most common cause of epistaxis?
A
Kisselbach’s plexus
19
Q
What is sinusitis? Which sinus is affected?
A
Inflammation in the maxillary sinus
20
Q
Consequence of sinusitis?
A
Inflammation can cause swelling and this can then block drainage of the sinuses
21
Q
Which sinus is very closely associated with the pituitary gland?
A
Sphenoidal air sinus
22
Q
First line treatment for sinusitis is?
A
Vasoconstrictors to reduce blood flow - reduces swelling
23
Q
Second line treatment for sinusitis and inidications for this?
A
Antibiotics
If sinusitis is bad with a high fever
24
Q
What is at the midline of the oral cavity?
A
Uvula
25
What is lateral to the uvula on both sides?
Tonsils
26
What are the two arches of the oral cavity?
Palatoglossal arch
| Palatopharyngeal arch
27
Where are the arches of teh oral cavity in relation to each other?
Palatoglossal - more anteriorly located
| Palatopharyngeal - more posteriorly located
28
Where does the frontal sinus exit into the nasopharynx?
Into the middle conchae
29
Where does the ehtmoid sinus exit into the nasopharynx?
Directly into the posteiror wall of the nasopharynx
30
Where does the maxillary sinus exit into the nasopharynx?
Into the middle conchae
31
What is the Kisselbach area?
This is where five facial arteries anastomose in the nose
32
What is the significance of Kisselbach area?
Trauma here can result in epistaxis
33
What is Waldeyer's ring?
Four tonsils in the mouth organised into a ring
34
What are the four tonsils of Waldeye's ring?
```
Superior to inferior:
Adenoid tonsil
Tubal tonsil
Palatine tonsil
Lingual tonsil
```
35
When is treatment required for tonsillitis?
When very severe - antibiotics
36
Indication for tonsil removal?
When very very very severe
37
Adverse effect of removal of tonsils?
Post tonsillectomy bleeding - very vascular region
38
Fatal complication of tonislitis is? (rare)
Quinsy - abscess formation in the peritonsilar space
39
Three components of the pharynx are?
Nasopharynx
Oropharynx
Laryngopharynx
40
Innervation to the pharynx is?
Sensory - glossopharyngeal IX
| Motor - vagus X
41
Most superior bone of the larynx is?
Hyoid bone
42
Which cartilage ring is the only one that goes all the way around the trachea?
Cricoid cartilage
43
Which level is the cricoid cartilage at?
C6
44
Which level is the hyoid bone at?
C3
45
Laryngeal prominence formed by which cartilage?
Thyroid cartilage
46
Potential space located in the neck is called?
Retro-pharyngeal pouch
47
When can the potential space of the neck become a real space?
Name?
Infection of the larynx
Retro-pharyngeal pouch
48
Relation of vocal fold and vestibular fold
Vocal fold - more medial
| Vestibular fold - more laterally located
49
Function of primary cricothyroid tensor muscles?
Increases the length and tension of the vocal folds
| Increases the pitch of the voice
50
Central to the vocal folds is?
Rima glottidis
51
Function of the internal laryngeal nerve?
Sensation - cough reflex
52
Function of the external laryngeal nerve?
Motor to the cricothyroid muscles - increase the pitch of voice
53
Function of the recurrent laryngeal nerve?
Motor to all intrinsic muscles apart from cricothyroid muscle
Sensory below vocal folds
54
Innervation to the cricothyroid muscle is?
External laryngeal nerve (from superior laryngeal nerve)
55
Innervation to all motor muscles of larynx is? Apart from?
Recurrent laryngeal nerve
Apart from the cricothyroid muscle
56
What is the nerve of phonation?
Recurrent laryngeal nerve
57
What is the nerve of pitch?
External laryngeal nerve - cricothyroid muslce
58
Nerve sensory to the larynx is?
Internal laryngeal nerve
59
Damage to the recurrent laryngeal nerve presents as?
Hoarseness of voice
60
Damage to the superior laryngeal nerve presents as?
Loss of choking
| Monotonous
61
Left recurrent laryngeal nerve loops under what?
Aorta
62
Right recurrent laryngeal loops under what?
Right subclavian artery
63
What can you look for in relation to the sphenoidal sinus to determine which sinus is the sphenoidal sinus?
The sella turcica - this has a very close relation to the sphenoidal air sinus
64
What is just posterior to the thyroid cartilage?
The vocal folds and the rima glottidis
65
Aschoff bodies are found in which layer of the heart?
Epicardium
66
Atheroma develops in which layer of the heart?
Tunica intima
67
How can you recognise an infarct region on a heart?
This region will appear bright red
68
Tissue at the centre of heart valves is?
Dense irregular connective tissue
69
Cells at the edge of heart valves are?
Endothelial cells
70
In venous valves, what is the direct of normal blood flow?
Right to left
71
Pericarditis occurs where on the heart?
Over the pericardium - outer layer casing the heart
72
Endocarditis will be seen where on the heart?
Within the heart on the edge of the valve cusps
73
Myocarditis will form where on the heart and how can this be recognised?
Forms at the myocardium layer
| Aschoff bodies will be present
74
What is pancarditis?
This is when pericarditis, endocarditis and myocarditis are all present at the heart
75
Aschoff bodies are composed of what two cells?
Epitheloid macrophages
| Lymphocytes
76
Myocardial infarct histology - the older the infarct, what colour will it appear?
The older the infarct, it will appear pinker
77
Myocardial infarct - what cells infiltrate the infarcted region?
Neutrophils
78
Myocardial infarct - the muscle is replaced by what tissue type?
Granulation tissue
79
Myocardial infarct region is at it's weakest/most likely to rupture when?
Between 5-10 days post infarct
80
What tissue replaces the granulation tissue of myocardial infarct?
Collagen tissue - forms consolidated scar
81
Epithelium in the trachea and most respiratory airways is?
Pseudostratified columnar epithelium
82
Epithelium in the bronchioles is?
Simple columnar
83
What is metaplasia?
Change in tissue type from one mature type to another
84
What is anaplasia?
Lack of differentiation and loss of mature cells of tissue type
85
Psuedostratified columnar epithelium - what is secreted and by what cells?
Mucous secreted by goblet cells
86
Metaplasia of the respiratory epithelium can occur due to?
Presence of irritants e.g. cigarette smoke
87
Squamous cell carcinoma of the lung usually occurs after what has happened?
Metaplasia of the respiratory epithelium
88
Two types of lung carcinoma are?
Which is malignant
Small cell - malignant
| Non-small cell
89
TB in lung will typically be contained in what?
Caseous granuloma
90
Caseous granuloma of TB is surrounded by what two layers of cells?
Epitheloid macrophages
| These are then surrounded by lymphocytes
91
What are Langerhans giant cells?
Fused epitheloid macrophages surrounding caseous granuloma
92
Later stage of TB - what cells are activated and why?
Fibroblasts are activated to lay down collagen to case off the granuloma
93
Three cells involved with presence of TB in the lungs?
Macrophages
Lymphocytes
Fibroblasts
94
Why and when does the tubercle wall of TB thicken?
When the fibroblasts lay down the collagen and case off the TB
95
Primary TB - the lesions are located where on the lung and what is this called?
Gohn focus - middle lobe and at the hilum
96
Secondary TB - the lesions are located where on the lung and what is this called?
Assmann focus - superior lobe
97
Miliary TB - the lesions are located where on the lung?
Throughout the lobes of the lung
98
Primary/secondary TB - which lesion tends to be bilateral?
Assmann focus of secondary TB
99
Normal lung is what colour?
Dark brown
100
Pneumonia - area of consolidation of the lung will be what colour?
White ish
101
Defence cell normally found in alveolar spaces is?
Neutrophil
102
Most common organism causing lobar pneumonia is?
S. pneumoniae
103
What is meant by '-penia'?
Too little
104
What is meant by '-philia'?
Too much
105
What is meant by '-cytosis'?
Too much
106
What does neutrophil leycocytosis mean?
This is another term for neutrophilia
Increased numbers of neutrophils
107
Which blood cells have a blueish tint around them?
Reticulocytes
108
Three typical histological features of alcoholic liver disease?
Macrocytosis in the absence of anaemia
Thrombocytopenia
Target cells
109
Allergic rhinitis - increase in which lymphocyte?
Eoseinophil
110
Two lineages of WBCs?
Myeloid cells
| Lymphoid cells
111
What different cells can myeloid cells differentiate into?
Basophils
Neutrophils
Eosinophils
112
What different cells can lymphoid cells differentiate into?
B/T lymphocytes
Plasma cells
NK cells
113
Function of neutrophil? x3
First cell at the site of infection
Role in immune surveillance
Kills microbes via phagocytosis
114
Neutrophilia - more common in bacterial or viral infections?
Bacterial
115
Cause of eosinophilia? x2
Allergy/atopy e.g. hayfever, eczema, asthma
Parasitic infections
116
Function of eosinophils? x2
Involved in defence against parasitic infections - helminths (worms) and protozoa
Increased against allergy/atopy
117
Function of basophils?
Release of histamine and heparin in inflammatory responses
118
B12/folate deficiency macrocytic anaemia can be recognised by?
Macrocytic cells
| Hypersegmented neutrophils
119
Right marginal artery supplies blood to which region of the heart?
Right ventricle
120
Posterior inter ventricular artery supplies blood to which region of the heart?
Posterior 1/3 of interventricular septum
121
Left circumflex artery supplies blood to which region of the heart?
Left atrium and left ventricle
122
Left anterior descending artery supplies blood to which region of the heart?
Anterior 2/3 interventricular septum
| Front and bottom of L ventricle
123
How can you recognise a drug as a beta blocker?
Ends in -lol
Atenolol
Proparonolol
Bisprolol
124
Pleural effusion is where in the lungs?
Base of the lungs
125
Pulmonary oedema is where in the lungs?
In the alveoli
126
Two muscles used in forced exhalation are?
Internal intercostal muscles
| Abdominal muscles
127
Tremor seen in respiratory failure is?
Flapping tremor
128
Pa of O2 in hypoxemia is?
<8kPa
129
PaCo2 in hypercapnia is?
>6.5kPa
130
Cells involved in immediate response to asthma?
Mast cells
131
Cells involved in delayed response to asthma?
Eosinophils
132
Cells involved in bronchitis?
Squamous cells
133
Olamtuzimab works against which Ig?
IgE
134
Streptococcus pneumoniae most commonly causes what type of pneumonia?
Community acquired
135
Mycoplasma pneumoniae most commonly causes what type of pneumonia?
Atypical
136
Main difference in the symptoms of pneumonia vs. TB is?
Pneumonia - headache
137
Right of left diaphragm is higher?
Right diaphragm higher - liver is underneath
