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Flashcards in Week 210 - Asthma Deck (124):
0

How many people are affected by Asthma?

There are 300 million individuals of all ages, ethnic groups and countries that are affected by Asthma worldwide.

1

What is Atopy?

A genetic predisposition towards the development of immediate hypersensitivity reactions against common  environmental antigens .

2

What are the two general types of Asthma?

  1. Extrinsic (otherwise known as Atopic)
  2. Intrinsic (otherwise known as Non-atopic)

3

Which sub-type of T-Helper cell is Pro- atopic - Th1 or Th2?

Th 2 - pro atopic; pro asthmatic.

Th 1 is non atopic.

4

Are Eosinophils "acid loving" or "base loving"?

Eosinophils are "acid loving" white cells. They stain brick red with Eosin staining.

5

What are the main inflammatory cells in the airway??

  1. Mast cells: These are the key cell of the innate immune system. They produce a variety of pre-formed and newly-formed inflamatory mediators.
  2. B lymphocytes: These produce antigen specific IgE (immunoglobulin E), in response to stimulation by interleukin-4 and interleukin-13 cytokines.

Of less importance....

  1. Dendritic cells - Antigen presenting cells. 
  2. Epithelial cells - Secrete pro-inflammatory mediators (Thymic stromal lymphopoietin)
  3. Macrophages - Also express receptors which bind IgE and IgG

6

Antigen specific IgE (immunoglobulin E) is produced by what?

B lymphocytes.

7

What are the typical early phase clinical signs of Asthma?

Patient develops:

  • wheeze
  • cough
  • SOB
  • mucus production.

8

What are the typical late stage signs of Asthma?

Patient presents with:

  • Initial response, but later symptom recurrence.
  • Chest tightness
  • Worsening SOB
  • Bronchodilators do not fully reverse the airway obstruction.

9

What is the hygiene hypothesis?

It is hypothesized that exposure to certain microbes by early infection or from the  environment may drive T cell production towards the non atopic (Th 1) phenotype, thereby reducing the occurence of Asthma. 

10

What is Sodium cromoglycate used for?

Sodium Cromoglycate is:

  • A mast cell stabiliser
  • Used in the treatment of Asthma (usually in children).

11

Which drug should an Asthmatic taking Salbutamol not be taking, and why?

  • What: Beta-Blockers (i.e. Atenolol)
  • Why: Salbutamol is a Beta-Agonist. Beta-blockers are Beta-Antagonists. These drugs will be acting in opposition, rendering them both ineffective.

12

What is Omalizumab used for?

  • This is a recombinant DNA- derived humanised monoclonal antibody
  • Specifically binds to free human IgE (immunoglobulin E)
  •  AKA: Anti IgE antibody that aids atopic (not non-atopic) asthmatics.

13

Why does Omalizumab not help obese asthmatics?

  • IgE  (immunoglobulin E) is an inflammatory mediator released in atopic asthma.
  • Omalizumab blocks production of IgE.
  • Asthma caused by obesity does not trigger IgE release as part of an immune cascade.
  • This monoclonal antibody anti-IgE treatment will therefore be ineffective.

14

How does Omalizumab work?

  • Binds to free Ige (Immunoglobulin E), decreasing the amount of cell bound IgE
  • Decreases expression of receptors that have a high affinity for IgE (i.e. FceRI receptors)
  • Decreases the amount of inflammatory mediators released by cells such as mast cells, Basophils, or Eosinophils.
  • These collectively decrease allergic inflammation, and prevent exacerbation of asthma.

15

What is Mepoluzimab?

Mepoluzimab is a...

  • Humanised monoclonal antibody
  • Recognises IL 5 (Interleukin 5 - this is a cytokine of the innate immune response). 
  • Reduces Eosinophil production and proliferation.

16

For which respiratory conditions are leukotrine receptor antagonists used in treatment?

Leukotrine antagonists are Helpful in:

  • Cold air induced asthma
  • Exercise induced asthma
  • Aspirin induced asthma

 

17

How is aspirin thought to induce Asthma?

  • A very complex question that is still being researched
  • One theory suggests pharmacological effect on COX enzymes.
  • Inhibition of COX enzymes inhibits synthesis of bronchodilatory prostaglandins

18

What spirometry result is diagnostic of COPD?

  • Ratio of FEV (Forced expiratory volume)/FVC (forced vital capaciity) = less than 0.7
  • This question is covered in MI WEEK in my year 2 library.

19

In which age group do most asthmatics first present to the GP?

0-4 years (67.7%).

20

When taking a focussed history from a patient you suspect to have asthma, what are the key points to cover?

  • Exercise induced?
  • Wheeze?
  • SOB (shortness of breath) and/or tight chest? 
  • Nocturnal cough
  • "Tummy ache" (Paeds)
  •  History of URTIs (Upper Respiratory Tract infections)?
  • Are there any nasal symptoms?
  • Is this Atopic? (i.e., any eczema, hayfever, allergies, smoking history, Family history)

21

What are the (important to remember) differential diagnosis for a presenting wheeze in a child under 1 year?

- Viral - Recurrent URTIs - Bronchiolitis - see slide for others (lecture 2 wednesday)

22

What is the commonest Acute lower respiratory tract infection (LRTI) in infancy?

Bronchiolitis.

 

 

23

What are the clinical signs of Bronchiolitis?

  • Respiratory distress:
  • Tachynopea
  • Grunting
  • Subcostal and Intercostal recession -

Also:

  • Tracheal tug
  • Nasal flaring
  • Hyperinflation with palpable liver edge.
  • Widespread fine crepitations throughout respiratory cycle.
  • Hypoxia
  • Fever in most (<38.5C)

24

What is Harrison Sulcus?

 Harrison's sulcus is a horizontal groove along the lower border of the thorax corresponding to the costal insertion of the diaphragm; It is usually caused by chronic asthma or obstructive respiratory disease. 

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25

What is the salute sign in children with wheeze?

The allergic salute sign is the upward rubbing of the nose (often in children), in allergic rhinitis, asthma, or other conditions of the respiratory tract productive of nasal mucus.

 

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26

What are the side effects of steroids used for the treatment of Asthma?

  • Infections in and around the mouth (Candida)
  • Cushings syndrome
  • Adrenal Suppression (high dose exogenous steroids inhibit endogenous production)
  • Reduced resistance to chickenpox

27

What is a "PEEP sign" in a child?

Positive End Expiratory Pressure.

  • In a child, this may present as constant crying or an O shaped mouth, which keeps the airway open a little bit.

28

What is the definition of Asthma?

"Asthma is a chronic inflammatory disorder of the airways in which many cells and cellular elements play a role.

The chronic inflammation causes an associated increasein airway hyperresponsiveness that leads to recurrent episodes of wheezing, breathlessness, chest tightness, and coughing, particularly at night or in the early morning.

These episodes are usually associated with widespread but variable airflow obstruction that is often reversible either spontaneously or with treatment."

29

What is the estimated number of people that die prematurely each year as a result of Asthma?

It is estimated that around 250,000 people die prematurely each year as a result of asthma.

 

30

What is the difference between atopic and non-atopic Asthma?

Cause:

  • Atopic - ID'able inducing agent
  • Non-Atopic - No obvious cause

Who gets it:

  • Atopic - Majority in children and young adults
  • Non-atopic - Often more persistent into adulthood/later life, often more severe

 

31

Which % of Asthma is related to atopy?

It is estimated that approximately 30-60% of asthma is related to atopy.

32

Which immunoglubulin is usually elevated in patients with atopic asthma?

IgE (Immunoglobulin E)

33

Are concordance rates for atopic asthma higher in monozygotic twins, or dizygotic twins?

Concordance rates for atopic asthma are higher in monozygotic twins than dizygotic  twins.

34

Name three Environmental risk factors for developing Asthma

  1. Smoking
  2. Pollution
  3. Occupation

 

35

Which Cytokines do T-Helper-1 cells produce?

  • IFN Gamma
  • IL2 (Interleukin 2)
  • IL 10 (Interleukin 10)
  • TNF (Tumour necrosis factor) alpha/beta

 

36

Which cytokines to T-Helper-2 cells help to produce?

  • IL3
  • IL4
  • IL5
  • IL6
  • IL13
  • GM-CSF

37

38

Week 210. According to epidemiological studies list 2 environmental factors that may increase your risk of developing asthma 

• Childhood antibiotic use
• Childhood use of
paracetamol?
• Exposure allergen
• Sedentary life style
• Obesity
• Maternal smoking
• Pollution

39

Week 210

List 3 pathological features of asthma that may be found at post mortem?

Any of the following
• Inflammation: eosinophilic
• Mucus plugging
Airway remodelling:– Airway wall thickening:

50-300% (Bronchial smooth muscle hypertrophy
+ airway oedema)
– Mucus gland hyperplasia
– Loss of surface epithelium
– Sub-epithelial fibrosis

 

40

Week 210

List 2 mediators, released by mast cells, which cause
bronchoconstriction clinically.

  • Histamine
  • Prostaglandin D2
  • Leukotrienes (D4, E4)
     

41

Week 210

T-helper 2 lymphocytes release the cytokine IL-5
which promotes the differentiation of which inflammatory cell type?

Eosinophils

42

 Week 210

In some individuals Non Steroidal Anti-inflammatory
Drugs (NSAIDS) may worsen asthma. Which enzyme
does this class of medication inhibit?

Cycloxygenase (II) 

(Otherwise known as the COX 2 enzyme)

43

Week 210

Mr X is an 34 year old asthmatic on inhaled budesonide (200mcg bd) and PRN salbutamol. He attends your surgery as he is not sleeping at night due to cough and wheeze.What step of the asthma ladder is he currently on?

Step 2: low dose inhaled steroid + PRN B2 agonist

44

Week 210

Mr X is an 34 year old asthmatic on inhaled budesonide (200mcg bd) and PRN salbutamol. He attends your surgery as he is not sleeping at night due to cough and wheeze.  If you were to increase his treatment name a class of drugs that you would add to his therapy?

Try LABA first and if ineffective consider increasing Inhaled CorticoSteroid then theophylline or leukotriene receptor antagonist.

45

Week 210

You are the A&E SHO on call. Miss B is a known
asthmatic
who presents with cough and SOB. On arrival the paramedics show you her ambulance card. Observations are as follows. Pulse 120, RR 26, Sats 94% on air. When you review her she has marked expiratory wheeze and is not able to talk full sentences.Grade her asthma severity.

Severe

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46

Week 210

You are the A&E SHO on call. Miss B is a known
asthmatic who presents with cough and SOB. On arrival the paramedics show you her ambulance card.
Observations are as follows. Pulse 120, RR 26, Sats
94% on air. When you review her she has marked
expiratory wheeze and is not able to talk full sentences. Name 3 meds you would consider starting her on. 

  • Salbutamol 5mg nebulised
  • Ipratropium bromide 500mcg nebulised
  • Prednisolone 40mg od po

47

Week 210

You are the A&E SHO on call. Miss B is a known
asthmatic who presents with cough and SOB. On arrival the paramedics show you her ambulance card.
Observations are as follows. Pulse 120, RR 26, Sats
94% on air. When you review her she has marked
expiratory wheeze and is not able to talk full sentences.You do a blood gas. what concernes you about this blood gas?

Q image thumb

Normal pCO2 with worsening hypoxia

48

Week 210

Mrs A is a 44 year old atopic asthmatic. She currently
taking symbicort tubohaler 400/12 (eformoterol +
budesonide 400). She is also taking uniphyllin
(theophylline). What step of the Asthma ladder is she on?

Step 4: on high dose inhaled steroids, LABA and
theophylline

49

Week 210

What enzyme do theophylline tablets inhibit?

 

Phosphodiesterase: inhibiting the breakdown of cAMP.

50

Week 210

State the side effects you are most likely to see in a
patient taking a beclometasone inhaler?

 

  • Sore throat
  • Candidiasis
  • Hoarse voice

 

51

Week 210

For approximately how long would you expect to see
the bronchodilatation effects of salmeterol?

12 hours

 

52

Week 210

 

Which of the inflammatory mediators does
montelukast block from reaching its receptor?

Leukotriene

53

Week 210

Name a drug or condition which can increase the half life of theophylline? And what symptoms could this cause?

 

Conditions:

  • Hepatic cirrhosis
  • CHF
  • Acute pulmonary oedema

Drugs: 

  • Erythromycin
  • Fluconazole
  • Other drugs also inhibit metabolism of theophylline – check Appendix 1 of BNF for details

Side Effects

  • N&V
  • arrhythmias
  • restlessness
  • convulsions
  • coma

 

54

Week 210

Mary has come to her GP and described worsening
asthma
symptoms, what would you discuss before
making changes to her drug treatment?

Possible triggers for worsening symptoms
Inhaler technique and compliance.

 

55

Week 210

Jack, aged 31 years is using a Seretide 125 evohaler
(fluticasone and salmeterol) regularly and a salbutamol inhaler when required. His asthma has been well controlled for many years, with him rarely using his salbutamol inhaler and he has come for a review of his treatment. You decide that stepping down his treatment would be appropriate. Which of his drugs should be discontinued?

 

Salmeterol- But patient should remain on fluticasone and when required salbutamol so no reduction in dose count.

56

Week 210

Bronchiolitis only affects children over 2 years of age. True or false?

FALSE

57

Week 210

"Haemoptysis is a common symptom of childhood
asthma." True or false?

False

58

Week 210

"Congenital lung abnormalities can present as old as 5
years age". True or False?

True.

59

Week 210

"Toddlers are the commonest age group for inhaled
foreign bodies ". True or false?

True

 

60

Week 210

 

"Nocturnal cough is a sign of asthma". True or False?

True.

61

Week 210

"A child who is not wheezing by 3 years of age will not
develop asthma. " True or False?

False

62

Week 210

"Cross country running is usually more of a problem
than football for children with asthma." True or False?

True

63

Week 210

"A high organic content or insufficient chlorine in a
swimming pool can trigger asthma " True or False?

True

64

Week 210

"Swimming is well tolerated in most children with
asthma" True or False?

True 

65

Week 210

"Warming up before exercise can have a ‘protective
effect’ for children with asthma " True or False?

True

66

Week 210

"Professional athletes do not have asthma " True or False?

False.

67

Week 210

"10-12 puffs of salbutamol via a spacer is usually as
effective as the appropriate dose via a nebulizer in
acute asthma in children" True or False?

True

68

Week 210

"Oral steroids are not given in acute asthma preteenage years due to their effect on growth"

True or False?

False

69

Week 210

"Teachers have a legal requirement to give children
their medication in school " 

True or False?

False

70

Week 210

 

"Stress/emotion is not a trigger in primary school
children" True or False?

False

71

Week 210

"Toddlers with a tight chest may complain of ‘tummy
ache’ " True or False?

True

72

Week 210

True or False?

A) Washing and air drying a spacer in ‘fairy’ washing
up liquid significantly reduces its static
B) An MDI and spacer is the first choice for inhaled
treatment in children under 5 years
C) A dry powder inhaler is first choice for inhaled
steroid treatment in children aged 6 – 12 years
D) Children 3 years and over are able to give reliable
PEFRs
E) An MDI directly into the mouth should be used for
bronchodilators in Teenagers
F) PEFRs in children are charted against their height

 

A TRUE

B TRUE

C FALSE

D FALSE

E FALSE

F TRUE

73

WEEK 210

 

Name some of the differences between Immunological and Non-Immunological Occupational Asthma.

  • Onset - Immunuologcal may have lag, NI may be within minutes or hours of exposure. 
  • NI is usually irritant asthma or REACTIVE AIRWAY DYSFUNCTION SYNDROME (RADS)
  • Immunological improves with time away from work. 

74

Week 210

What are the advantages and disadvantages of treating Asthma with inhaled drugs?

Advantages:

  • Large surface area 
  • Good blood flow
  • Reduce systemic absorption
  • Proteins not degraded by acid

Disadvantages

  • Small proportion of dose absorbed
  • Technically difficult
  • Mucus – reduces absorption
  • Cough & local effects

75

Week 210

Name the drug class for each of the drugs listed.

  1. Salbutamol
  2. Beclametasone
  3. Salmeterol
  4. Montelukast
  5. Theophylline

 

  1. Beta-2 Agonists
  2. Corticosteroids
  3. Long acting Beta 2 agonists
  4. Leukotrine receptor antagonists
  5. Xanthines

76

How do Beta-2 agonists cause smooth muscle relaxation?

Increases cAMP production to relax bronchial
smooth muscle.

 

 Also:
• Inhibits release of inflammatory mediators
• Increase mucus clearance

77

Week 210

How do corticosteroids aid in the treatment of Asthma?

  • Reduction in numbers of immune system cells e.g eosinophils, T-lymphocytes
  • Reduction in inflammatory mediators
  • Reduced vascular permeability

78

Week 210

 

Describe the inflammatory effects of Mast Cells in as much detail as you can. 

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79

80

Week 210

Define Asthma.

A chronic inflammatory disorder of the airways,
characterised by airways hyper-responsiveness
with airflow obstruction that is reversible either
spontaneously or with treatment.

81

Week 210.

What does this slide of an airway show? Which condition is this associated with?

Q image thumb

This slide is from a patient that suffered a fatal Asthma attack. Note the inflammatory plug that is blocking the airway. There is bronchial wall inflammation, and a denuded epithelium. There is also bronchoconstriction. 

 

The disease is, of course, Asthma

82

Week 210.

What is Churg-Strauss syndrome?

Churg–Strauss syndrome (CSS, also known as eosinophilic granulomatosis with polyangiitis [EGPA] or allergic granulomatosis) is an autoimmune condition that causes inflammation of small and medium-sized blood vessels (vasculitis) in persons with a history of airway allergic hypersensitivity (atopy). 

83

Week 210

What is Hyperventilation Syndrome? How might it present?

Hyperventilation syndrome (HVS); also chronic hyperventilation syndrome (CHVS) and dysfunctional breathing hyperventilation syndrome is a respiratory disorder, psychologically or physiologically based, involving breathing too deeply or too rapidly (hyperventilation). HVS may present withchest pain and a tingling sensation in the fingertips and around the mouth (paresthesia) and may accompany a panic attack.

84

Week 210

How would Bronchiectasis present?

The classic clinical manifestations of bronchiectasis are cough and daily mucopurulent sputum production, often lasting months to years. Blood-streaked sputum or hemoptysis may result from airway damage associated with acute infection. Less specific symptoms include dyspnea, pleuritic chest pain, wheezing, fever, weakness, and weight loss.

85

Week 210

What is Allergic bronchopulmonary aspergillosis, and how does it typically present?

Allergic bronchopulmonary aspergillosis (ABPA) is a condition characterised by an exaggerated response of the immune system (ahypersensitivity response) to the fungus Aspergillus (most commonly Aspergillus fumigatus). It occurs most often in patients with asthma or cystic fibrosis.

Presentation clues:

  • Predisposing lung disease—most commonly asthma or cystic fibrosis
  • symptoms of recurrent infection such as fever
  • Do not respond to conventional antibiotic therapy.
  • Poorly-controlled asthma
  • Wheezing and hemoptysis 

86

Week 210

 

What is the (basic) difference between Extrinsic and Intrinsic Asthma?

Extrinsic Asthma is IgE mediated (It's an immune response).

Intrinsic Asthma is non-immune i.e an infection, cold, stress or excersie induced Asthma.

87

Week 210

What is Urticaria?

This is a raised, itchy rash on the skin. 

88

Week 210

What is PEF/FEV1 ratio in Intermittent (step 1) Asthma?

>80% Predicted.

89

Week 210

What is the PEF/FEV1 ratio in STEP 2 (Mild Persistent) Asthma?

>80% Predicted, with a variability of 20-30%.

90

Week 210

What is the PEF/FEV1 ratio in Moderate persistent Asthma (Step 3)?

Between 60 and 80% of the predicted value.

91

Week 210

What is the PEF/FEV1 ratio in Severe Persistent (Step 4) Asthma?

< 60% of the predicted value, with 30% Variability

92

Week 210

Which Immunoglubulin do Omaluzimab/Xolair work against?

These are Anti-IgE.

93

Which immunoglobulin does Mepoluzimab work against?

This is an Anti-IL5.

94

Week 210

Label these parts of the tongue.

Q image thumb

  • A - LINGUAL SEPTUM
  • B - SUPERIOR LONGITUDINAL (INTRINSIC)
  • C - TRANSVERSE AND VERTICAL (INTRINSIC)
  • D - INFERIOR LONGITUDINAL (INTRINSIC)
  • E - STYLOGLOSSUS (EXTRINSIC)
  • F - HYOGLOSSUS (EXTRINSIC)
  • G - GENIOGLOSSUS (EXTRINSIC)

95

Week 210

Name the Extrinsic muscles of the tongue.

Q image thumb

  • A  - STYLOID PROCESS
  • B - STYLOHYOID LIGAMENT
  • C - STLOGLOSSUS
  • D - HYOPGLOSSUS
  • E - HYOID BONE
  • F - GENIOGLOSSUS

96

Week 210

Label This image of the tongue.

Q image thumb

  • A - SUP. LONGITUDINAL
  • B - APEX OR TIP OF TONGUE
  • C - GENIOGLOSSUS
  • D - MENTAL SPINE OF MANDIBLE
  • E - GENIOHYOID
  • F - MYLOHYOID
  • G - DIGASTRIC
  • H - HYOID BONE

97

WEEK 210

From which cranial nerve does the lingual nerve arise?

The Lingual nerve arises from the Third branch (V3) of the Trigeminal nerve.

98

Week 210

Label the sensory and motor nerves of the tongue.

Q image thumb

  • A - INTERNAL LARYNGEAL NERVE (CN X)
  • B - GLOSSOPHARYNGEAL NERVE (CN IX)
  • C - VALLATE PAPILLAE
  • D - OVERLAPPING NERVE SUPPLY
  • E - LINGUAL NERVE (CN V3), CHORDA TYMPANI (CN VII)
  • F - ALL OTHER MUSCLES - HYPOGLOSSAL (CN XII)
  • G - PALATOGLOSSUS (VAGUS NERVE CN X)

99

Week 210

Which nerve supplies the main muscles of mastication (Mylohyoid, anterior Digastric, tensor Tympani, tensor veli palatini)?

The 3rd Branch of the Trigeminal Nerve (CN V3)

100

Week 210

Which nerve supplies the main muscles of facial expression (post. Digastric, Stapedius, Stylohyoid)?

The Facial nerve (CN VII)

101

Week 210

Which nerve supplies the Stylopharyngeas muscle?

CN IX (Glossopharyngeal)

102

Week 210

Which nerve supplies the Pharyngeal constrictors, cricothyroid, levator veli and palatini muscles?

The superior branch of the Vagus nerve (CN X)

103

Week 210

Which nerve supplies the Intrinsic muscles of the Larynx?

The Recurrent laryngeal, and Vagus nerves.

104

Week 210

What does the Otic Ganglion innervate?

The Parotid Gland - for salivation. 

105

Week 210

Where is the Otic Ganglion located?

Immediately below the Foramen ovale in the infratemporal fossa. 

106

Week 210

Through which nerve do secretomotor fibres reach the parotid gland from the Otic Ganglion?

The Auriculotemporal nerve. 

107

Week 210

 

Why does the tongue deviate after a Hypoglossal nerve injury?

Upon protrusion, the tongue will deviate TOWARD the side of the LMN lesion (i.e., same side). This is due to the unopposed action of the genioglossus muscle on the normally innervated side of the tongue (the genioglossus pulls the tongue forward). Remember, the genioglossus arises laterally in the tongue and inserts on the midline of the mandible.

108

Week 210

 

In which gland do most salivary stones form?

80% Form in the Submandibular Gland. 

109

Week 210

In which duct are 85% of Submandibular stones found?

Wharton's Duct.

110

Week 210

 

Through which duct does the Parotid Gland secrete Saliva?

The Stenson Duct.

111

Week 210

Through which duct does the Sublingual gland secrete?

Ducts of Rivinus

112

Week 210

 

Secretions from the Parotid gland are rich in _____.

Amylase.

113

Week 210

 

Secretions from the Submandibular Gland are more ____ than those from other glands in the oral cavity. 

Mucinous. 

114

Week 210

 

Where does Stensons Duct appear?

Opens upon a small papilla opposite upper 2nd
molar
tooth

115

Week 210

 

Which Cranial Nerve supplies the Parotid Gland?

Glossopharyngeal (IX)

116

Week 210

 

What supplies parasympathetic secretomotor innervation to the Submandibular Gland?

The Chorda Tympani of the Facial Nerve (CN VII)

117

Week 210

 

The "Presulcal" Region of the tongue is the ___ section. 

Anterior. 

118

Week 210

Label these Papillae regions. 

Q image thumb

1. Vallate papillae
2. Foliate papillae
3. Filiform papillae
4. Fungiform papillae

 

119

Week 210

 

What attaches the tongue to the floor of the mouth?

The Frenulum.

120

 

Week 210

All muscles of the tongue excluding the palatoglossus receive motor innervation from the _________nerve. The palatoglossus recieves innervation from the ____ nerve.

All muscles of the tongue excluding the palatoglossus receive motor innervation from the hypoglossal nerve.The Palatoglossus is a palatine muscle supplied by the vagus nerve (CN X).

121

Week 210

 

The special taste sense "Umami" drives our appetite for what?

Amino Acids. This is why Bacon tastes so good!

122

Week 210

 

What happens to tongue deviation after an UMN Lesion, and a LMN Lesion?

UMN - tongue deviates AWAY from the lesion (to the opposite side).

LMN - tongue deviates TOWARDS the lesion (To the same side).

123