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BDS3 Head & Neck Anatomy > PPQ Clinical Relevance > Flashcards

PPQ Clinical Relevance Flashcards

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1
Q

damage to what nerve would cause numbness in the pinna of the right ear

A

great auricular nerve

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2
Q

what areas does the great auricular innervate

A

pinna/auricle of the ear; surface over parotid gland and the angle of the mandible

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3
Q

surgery to the side of the neck has resulted in drooping eyelid and lack of sweating on the same side; what is damaged to have caused this?

A

damage to sympathetic cervical trunk

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4
Q

name the signs of Horner’s Syndrome

A

ptosis - drooping of eyelid
anhydrous - lack of sweating
miosis - constricted pupils

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5
Q

where does submandibular duct enter the mouth

A

at summit of small papilla at side of frenulum of tongue

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6
Q

if there is surgery to area where submandibular duct lies, what nerve could be damaged

A

lingual & hypoglossal nerves

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7
Q

what vessel causes excessive bleeding when the lip is lacerated

A

inferior labial branch of facial artery can be ruptured which is where the left and right side anastomose

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8
Q

what muscle is responsible for the majority of protraction movements of the TMJ

A

lateral pterygoid muscle

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9
Q

what muscle tendon inserts into coronoid process

A

temporalis tendon inserts into the coronoid process of the mandible

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10
Q

a stroke affecting the RHS will affect what 2 muscles and where

A

facial muscles of the left lower face and left side of the tongue will be paralysed

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11
Q

what nerves innervate motor supply of the tongue when testing motor innervation

A

hypoglossal nerve supplies motor function to tongue

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12
Q

what muscle is responsible for protrusion of the tongue

A

genioglossus is responsible for protrusion of the tongue

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13
Q

what is the name of a long standing ear ache

A

chronic otitis media which is an infection of the middle ear that is likely to cause perforation of the tympanic membrane, if pus is resent it may leak into external auditory meatus

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14
Q

what nerves are at risk of damage when there is an operation to the middle ear

A

facial nerve and chorda tympani

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15
Q

what is the carotid sinus

A

a dilated area at base of ICA just superior to the bifurcation area of CCA that contains baroreceptors that monitor blood pressure

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16
Q

which nerve innervates the carotid sinus

A

glossopharyngeal CN IX carries messages from the carotid sinus to the brain regarding blood pressure status

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17
Q

where do fishbones get stuck readily

A

piriform fossa and vallecula

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18
Q

what haemorrhage has occurred when someone comes to A&E with bruising to the side of the head

A

extradural haemorrhage as there is an enlarging haematoma on the side of the head

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19
Q

what blood vessel is damaged in an extradural haemorrhage

A

middle meningeal artery which results in blood accumulating in the epidural space. usually as a result of head trauma to area of pterion

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20
Q

what cranial nerve supplies the larynx

A

vagus nerve CN X

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21
Q

what epithelium covers the majority of the larynx and what covers the true vocal folds

A

pseudostratified columnar respiratory epithelium covers the majority of the larynx except from true vocal folds which are covered in stratified squamous epithelium

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22
Q

in full dentures, where should they extend in accordance with the mylohyoid line

A

they should be extended and finish above the mylohyoid line

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23
Q

where do nodes from the maxillary sinus drain to

A

drain to submandibular lymph nodes

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24
Q

what can occur when there is a difficult maxillary molar extraction with roots close to the maxillary sinus

A

oroantral fistula due to oroantral communication as when the roots are removed it can leave an opening between the maxillary sinus floor and oral cavity so fluid and food then can come out of the nose during swallowing

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25
what does the vagus nerve supply
motor supply - pharynx, larynx, palate, thorax, GIT sensory supply - tongue and external auditory meatus
26
what is the sentinel node and if infected what does it mean
it is the first node to be biopsied to check for infection of malignancy. it is it positive then the cancer is not localised
27
what are the 3 types of haemorrhage
extradural subdural subarachnoid
28
what is a cavernous sinus thrombosis and how does it occur
infection in the oral cavity or face where bacteria spread through the pterygoid venous plexus via sphenoid emissary veins to the cavernous sinus. slow flow in the veins means that bacteria can multiply and proliferate much faster leading to a thrombus. symptoms include: swollen eye as blood cannot drain from the eye via ophthalmic veins and a high temperature
29
what is the cause of sudden sharp unilateral facial pain
can be trigeminal neuralgia which has no known cause other than it may be caused by compression of the nerve around the foramen ovale. treatment is with carbamazepine, necrosis of nerve with alcohol or peripheral neurectomy
30
what may be damaged when there is a blow to the parietal lobe of the brain
broca's area which controls motor speech wernicke's area which controls understanding of language
31
when there is damage to CN XII during a stroke, what occurs
paralysis of the opposite side of the tongue. the pyramid's decussation in the lower medulla where the nerve passes from one side of the brain to innervate the other is no longer functional so paralysis of the opposite side of the body. however it depends on the lesion: 1. upper motor neuron lesion - will affect corticospinal pathway so tongue will curve away from damaged side 2. lower motor neuron lesion - direct damage to the specific nerve which will result in tongue deviating to weak side
32
what does the pineal gland do
located behind 3rd ventricle under corpus callosum bathed in CSF. it controls melatonin secretion for modulating sleep patterns and also circadian rhythms
33
what is vertebral basilar ischaemia
compression of one of the vertebral arteries branching off the basilar artery in the circle of Willis. this can be caused by osteoarthritis where osteophytes (bony projections) compress the vessels or when you turn your head which blocks blood supply thus dizziness is a symptom
34
what might exaggerated reflex's suggest
common sign in stroke - usually an upper motor neuron lesion
35
what is the Babinski effect
a plantar reflex and is when the sole of the foot is stimulated with a blunt instrument. normal results mean the big toe will go down but in positive results the big toe will go up and this is a sign of stroke due to damage to the pyramidal tracts of the CNS
36
what nerve has been damaged when the pupils do not constrict
oculomotor CN III as constrictor papillae not functioning
37
what are the functions of the muscles of mastication
temporalis - elevates and retrudes masseter - elevates and retrudes medial pterygoid - elevates and moves mandible laterally lateral pterygoid - depresses, protrudes and moves mandible laterally
38
what is glue ear
it is serious otitis media. occurs in infection of nasopharynx which causes overgrowth of tubular tonsils resulting in proliferation of goblet cells, thus increased mucous production. blocks auditory canal increasing pressure. treated with grommet insertion into tympanic membrane which allows air into middle ear
39
what can occur when doing a biopsy of the pharyngeal recess
can be a common site for occult tumours which will require biopsy or surgery. ICA at risk of being damaged
40
give the clinical name for a nosebleed, what artery causes it and how it is treated at the scene
epistaxis which is caused by the sphenopalatine artery. treatment includes ptx sitting upright to reduce venous pressure and pinching bridge of nose
41
what causes a blockage of the auditory tube
otitis media
42
what are the 3 common causes of deafness
1. osteosclerosis - calcification of the annular ligament which connects the base of the stapes to the fenestra vestibula 2. wax build up from cerumenous glands 3. chronic otitis media
43
explain referred pain in a heart attack
pain is felt in neck due to sympathetic fibres of cervical sympathetic trunk travelling up from the heart. can also be due to the homunculus model
44
what emergency airway access can be carried out during anaphylactic shock
cricothyroidectomy - hole pierced using 1mm needle through cricothyroid ligament to bypass mouth and allow air to enter lungs
45
why is a systolic bruit
medium to low pitched noise heard during systole. generated by turbulent blood flow through an artery due to partial obstruction (atherosclerosis) or a localised high rate of blood flow through an unobstructed artery. linked with peripheral vascular disease, stroke, carotid artery stenosis, aortic aneurysm
46
what can cause a distended extended jugular vein
may bulge and pulsate due to heart disease or hypertension caused by smoking
47
why does a laceration to the scalp bleed profusely
rich blood supply of connective tissue
48
what is diplopia
double vision - can occur due to blow out fracture, sinusitis, MS, temporal arteritis which damages CN III, IV, VI. can be spotted by a squint
49
what is Virchow's node
supraclavicular node in the supraclavicular fossa located above the left clavicle. drains the thorax and abdomen and when it is hardened or inflamed it can be a sign of abdomen malignancy
50
what does the parotid, mental, submandibular, jugulo-digastric, deep cervical, jugulo-omohyoid lymph nodes all drain
parotid - side of face above angle of mandible mental - anterior tongue, lower lip, incisal teeth submandibular - oral cavity, nasal cavity, maxillary sinus jugulo-digastric - tonsils jugulo-omohyoid - tongue deep cervical - deep structures of head e.g. posterior tongue, middle ear, nasopharynx
51
what is Hodgkin lymphoma compared with non Hodgkin lymphoma
hodgkin - malignancy of lymphatic system with multiple nodes affected. reed-sternerg cells found non hodgkin - lymphocytes become abnormal
52
what can cause inflammation of parotid gland
caused by mumps or LA into parotid gland. very painful as dense fascia puts pressure on glossopharyngeal & facial nerves
53
what causes submandibular duct calcifications
stones due to upwards travel of saliva. can be removed but risk of damage to lingual nerve
54
what is an oro-antral communication and when does it become a fistula
see other card. becomes a fistula when epithelium covers it
55
what is sinusitis
sinus infection of mucous membrane. can result in maxillary or frontal sinuses. headaches and foul smelling discharge. cloudy mass on radiograph. usually when frontal sinus is infected so is the maxillary as they both open into the hiatus semilunaris
56
what is the trans sphenoidal approach
used to reach pituitary tumours by entering the sphenoidal sinus
57
what happens to excess tears when crying or when it is cold
excess tears drain through the nasolacrimal duct into vestibule of nose to cause a runny nose
58
what is chronic rhinitis
inflammation of the nose which can be caused by allergies or irritants. results in nasal drip, cough, sore throat etc.
59
what can occur with a blowout fracture to the zygomatic bone
orbit floor can fracture and spill into maxillary sinus causing double vision and possible infraorbital nerve damage
60
what happens when the cheek is fractured
infraorbital nerve can be damaged at infraorbital foramen and other vessels ruptured
61
what is trismus
reduced opening of the jaw caused by injection of LA into medial pterygoid
62
what are osteophytes
bony projections that grown on joints where they can then press on nerves and vessels
63
what can be seen in substantia nigra of a parkinson's patient
death of dopamine generating cells in substantial nigra - black substance around the cerebral peduncle. results in tremors and lack of expression. generally a patient will be given dopamine replacement
64
what is meningitis
viral or bacterial infection of the meninges. causes severe headache, nausea and vomiting. bacterial is life threatening and requires treatment ASAP
65
what is an occult tumour in the pharyngeal recess
deep pocket in the fossa of rosenmuller which is the most common site for nasopharyngeal carcinomas. located posterior to the auditory tube where the ICA lies close to. requires treatment and diagnosis early as it progresses quickly. hoarseness is a common sign of this type of tumour
66
what artery is at risk of rupture during tonsillectomy
ascending pharyngeal and facial artery branches
67
what is waldeyer's ring and what is its function
ring of lymphoid tissue in pharynx including the pharyngeal, palatine, lingual and tubular tonsils. serves to protect the respiratory system from infections
68
what is the function of the 2 muscles found in the middle ear
tensor tympani - supplied by CN V which pulls the malleus to reduce movement and thus sound stapedius of triangle - supplied by CN VII which contracts and reflexes the stapes which dampens sound and reduces movement
69
what is osteosclerosis
most common cause of progressive deafness. fibrous annular ligament forms a band around the base of the stapes and fenestra vestibuli becomes calcified and held in this window meaning it lacks movement and thus restricts movement of stapes into the cochlea
70
what is otitis externa
swimmer's ear - when there is a inflammation of external acoustic meatus resulting in ear ache, pus discharge and temporary hearing loss
71
what causes goitre
when thyroid gland becomes enlarged. generally caused by autoimmune e.g. Grave's in hyperthyroidism or by iodine deficiency in hypothyroidism
72
what is facial palsy
LA injected into parotid anaesthetising muscles of facial expression. can also be caused by haemorrhage, stroke, MS, tumours. unable to move eyebrows
73
what is Bell's palsy
facial palsy with unknown cause affecting the whole excitability of the facial nerve. unilateral paralysis including eyebrows
74
what is hydrocephalus
accumulation of fluid in brain, usually CSF. caused by tumour in cerebral aqueduct so CSF cannot drain through to 4th ventricle so pressure increases in cranium
75
what can occur when toys are lodged in the nose
foul smelling breath and neutrophils and pus begin to gather
76
what is plunging ranula
an extravasation of saliva from sublingual gland due to trauma or obstruction of duct. results in slow growing, soft moveable mass located on floor of mouth
77
what is temporal arteritis
form of vasculitis - can affect superficial temporal artery which causes inflammation to arterial branches of head. results in inadequate oxygen supply to head leading to blindness and stroke. can be treated with steroids
78
what is paget's disease
caused by excessive breakdown and formation of bone, followed by disorganised thickening of bone. can case blindness and deafness - effect on ossicles and pressure on vestibulocochlear nerve
79
what occurs when there is damage to the ethmoid sinus in surgery
CSF leakage and arterial bleeding
80
extra dural haemorrhage
- rupture to middle meningeal artery due to skull fracture or blow to head - causes enlarging haematoma - 24hr deterioration as blood gathers in epidural space - haemorrhage looks like lens shape on scan
81
subdural haemorrhage
- usually occurs in older generation when a fall knocks the head - results in perforation / laceration / rupture of cerebral vein - causes blood to form in subdural space which can take days / weeks to deteriorate - haemorrhage looks like sickle shape on scan
82
subarachnoid haemorrhage
- usually occurs in middle aged patients - affects one of the cerebral arteries - cause of berry aneurysm which is an out-pouching of one of the cerebral arteries which can rupture spontaneously - high mortality rate and high deterioration rate - haemorrhage conforms to shape on sulci on scan

BDS3 Head & Neck Anatomy (25 decks)

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