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SF2 - Test 1 > 0 - Clinical Examples > Flashcards

0 - Clinical Examples Flashcards

1
Q

Paralysis of Orbicularis Oculi

A

Unable to close eye, damage to cornea

Sagging of face can also accompany

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2
Q

**Bell’s Palsy

A

CN VII

Paralysis of all facial muscles on one side

  1. Facial paralysis
  2. Drooling (Buccinator)
  3. Inability to close eye (Orbicularis)
  4. Loss of taste to ant. tongue
  5. Pain in/behind ear (V, VII, IX, X)
  6. Hyperacousia - paralyze Stapedius
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3
Q

Paralysis of Buccinator Muscle

A

CN VII

Facial paralysis can paralyze buccinator

Difficulty in chewing food; paralyze unable to hold food between teeth

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4
Q

Paralysis of Stapedius Muscle

A

Damage to VII

Hyperacousia - sounds seem too loud

Stapedius dampens sound

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5
Q

Innervation of Outer Ear?

Effect on Bell’s Palsy Patients?

A

Almost all sensory to face is V1, V2, V3; but external ear is also: CN VII, IX, X

Somatic Sensory - Acute Pain and Earaches

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6
Q

Clinical Issues with Venous Drainage of Face

A

Facial Veins have few or no valves

To Ophthalmic Veins: Supraorbital V., Supratrochlear V.

To Facial Vein: Straight course anastomose with branches of Ophthalmic V.

ANASTOMOSES SPREAD INFECTION

Clinical: Infection can spread into the cranial cavity (cavernous sinus) and can result in DIPLOPIA; infections lateral to nose dangerous

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7
Q

Cleft Lip

A

Failure of fusion of Medial Nasal Process and Maxillary Process

At philtrum of lip

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8
Q

Parasympathetics in Cranial Nerves

A

CN III - Ciliary Ganglion - Sphincter Pupillae M. (constrictor), Ciliary M.

CN VII - Pterygopalatine Ganglion - Lacrimal Gland, Mucous Glands of oral, nasal cavities, palate

CN VII - Submandibular Ganglion - Submandibular Gland, Sublingual Gland

CN IX - Otic Ganglion - Parotid Gland

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9
Q

Clinical zygomatic fractures of skull?

A
  1. Zygomatic Bone
  2. Maxillary Bone - Zygomatic Process
  3. Temporal Bone - Zygomatic Process
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10
Q

Clinical Relevance for Scalp?

Layers?

A

Infections can readily spread through loose areaolar layer deep to epicanial aponeurosis

Allows movement of skin on face

- - -

  1. Skin
  2. Connective Tissue
  3. Epicranial Aponeurosis
  4. Loose Areolar Tissue
  5. Periosteum
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11
Q

Orbit - Foramina

Contents of Ant. and Post. Ethmoidal Foramina?

Opening for what duct?

***What can orbit tumors affect?***

A

Ant. and Post. Ethmoidal Foramina (two openings in eye socket)

Contents: Ant. and Post. Ethmoidal N., A. , and V. (V1 and Opthalmic A., V.)

Opening of nasolacrimal duct

***Orbit tumors can affect nasal cavity***

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12
Q

Clinical: Obstructed Duct

A

Failure of duct to canalize, tears will flow onto face.

Opened surgically to drain to nasal cavity

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13
Q

Obstruction of Sebaceous Gland in Subcutaneous Layer of eyelid?

Obstruction of Tarsal Gland of eyelid?

What controls open / close of eyelid?

A

Obstruction of Sebaceous Gland = Stye

Obstruction of Tarsal Gland = Chalazion

Close = CN 7

Open = CN 3 / Sympathetics

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14
Q

Drainage of Tears

Innervation?

A

Lacrimal Gland is Innervated by parasympathetics CN VII, Pterygopalatine Ganglion

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15
Q

Accommodation of Lens in Eye

A

Thicken lens for near vision (viewing object close up)

Parasympathetic Control - CN III (Short Ciliary Nerves)

When these contract, ligaments relax and lens becomes thicker

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16
Q

Smooth Muscles of the Eye: Constriction / Dilation

A

Constrictor - Circular Smooth - Parasympathetics

Dilator - Radial Smooth - Sympathetics

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17
Q

Draw the eye movements diagram.

A
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18
Q

Abducens (VI) Damage

A

At rest: Medial Strabismus (cross-eyed) due to damage, paralyze lateral rectus

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19
Q

Trochlear Nerve Damage (IV)

A

Inability to turn eye down and out

Difficulty walking stairs

Head tilt (to opposite side) to level eye

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20
Q

Oculomotor (III) Nerve Damage

A

At rest:

  1. Lateral Strabismus (wall-eyed) due to paralyze medial rectus
  2. Ptosis - Drooping eyelid (paralyze Levator Palpebrae Superioris)
  3. Dilated Pupil (mydriasis) paralyze pupillary constrictor
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21
Q

Damage Short Ciliary Nerves

Location?

Type of Nerve?

A

Dilated pupil

Lateral to optic nerve

Type: Autonomic Parasympathetics

22
Q

Parasympathetics vs Sympathetics

A

Parasympathetics:

Do not innervated skin and peripheral blood vessels

Do not go to body wall

Sympathetics:

Skin / Peripheral Blood Vessels

23
Q

Skin Autonomic Innervation?

A

Sympathetics

Sweat Glands, Peripheral Blood Vessels, are ONLY innervated by Sympathetics

24
Q

Horner’s Syndrome

A

Damage to Sympathetic Pathways

Symptoms:

  1. Miosis - Contricted Pupil (no dilator)
  2. Ptosis - Drooping eyelid (no Lev. Palp. Sup.)
  3. Anhydrosis - Lack of sweating (no sweat gland)
25
Q

What level to sympathetics to head depart from?

What can lesions in the neck produce?

A

T1-T2

Ptosis (Eyelid Droop)

26
Q

Membrane at Palatoglossal Arch?

A

Oropharyngeal Membrane

Boundary between Oral Cavity (precise sensation - somatic sensory) and Pharynx (imprecise sensation - visceral sensory)

27
Q

Branchial Pouch Derivatives

A

Pouch 1 - Tubotympanic Recess - Auditory Tube, Tympanic Cavity

Pouch 2 - Lining of palatine tonsils

Pouch 3 - Inferior Parathyroid Gands and Thymus Gland

Pouch 4 - Suprior Parathyroid Glands and C-Cells of Thyroid

***Pouch 3 migrates caudal to Pouch 4***

28
Q

Branchial Cleft Cysts (Fistulae)

Thryroid Development Errors?

A

Opens anterior to Sternocleidomastoid Muscle

Three Loactions:

1st - Auditory tube

2nd - palatine tonsils (most common)

3rd - piriform recess, Thyrohyoid membrane to clavicle region

4th - Thyroid can develop in tongue (lingual), thyroglossal duct, or pyramiidal lobe

29
Q

Torticollis

A

Face opposite of Sternocleidomastoid contraction (head locked in turned position)

CONTRACTURE, NOT PARALYSIS

30
Q

Accessory Nerve test?

A

Shoulder Shrug

31
Q

Fascia and Compartments of Neck

Location or Retropharyngeal Space?

A
  1. Investing Layer of Deep Cervical Fascia
  2. Precertebral Layer
  3. Pretracheal Layer
  4. Carotid Sheat: Common and Internal Carotid, Internal Jugular and CN X (Vagus) NOT sympathetic chain

- - -

Retropharyngeal Space between PreTrach and PreVert layers; infection from head (tonsillitis) can spread to mediastinum

32
Q

Retropharyngeal Abscess

A

Difficult to diagnose, no external swelling, life-threatening as abscess can block airway

33
Q

Craniovertebral Joint (draw diagram)

**Written, Not Practical**

A
  1. Rectus Capitis - Posterior Minor - Extend
  2. Rectus Capitis Posterior Major - Extend/Rotate
  3. Obliquus Capitis Superior - Extend
  4. Obliquus Capiti Inferior - Rotate only
34
Q

Otitis Media

Innervation of Middle Ear?

A

Spread of infection from Respiratory System can damage Auditory Ossicles, hearing loss

Prolonged infection can damage Tegmen Tympani to Brain

Innervation: IX - Glossopharyngeal - Visceral Sensory

Children can not localize pain (imprecise)

35
Q

Damage Chorda Tympani

A

Lose taste to ant. 2/3 of tongue due to Cranial Nerve VII; parasympathetics to Submandibular, Sublingual Salivary glands

36
Q

Muscles of Larynx to Raise or Lower Pitch?

A

Cricothyroid = Increase Pitch

Thryoarytenoid = Lower Pitch

37
Q

Muscles of Larynx to Open or Close Rima Glottidis?

A

Open: Posterior Cricoarytenoid

Close: Lateral Cricoarytenoids, Arytenoideus

38
Q

Damage to Recurrent Laryngean Nerve

Branches?

A

Damage can occur in Thyroid surgery; paralyze all muscles one side except Cricothyroid; permanent hoarse voice

- - -

A. Superior Laryngeal Nerve:

  1. Internal Laryngeal N. (Sensory)
  2. External Laryngeal N. (Branchiomotor to Cricothyroid)

B. Recurrent Laryngeal N (Sensory AND Branchiomotor to all other larynx muscles)

39
Q

Suffocation in Anaphylactic Shock

Treatment?

A

Mucosa tightly attached to vocal folds, Anaphylactic Shock can swell vestibular folkds and leath to suffoication.

Treatment: Cricothyrotomy + less bleeding yay!

40
Q

Popcorn Locations in Pharynx?

A

“Tongue” - Oropharynx - Valleculae

“Throat” - Laryngopharynx - Piriform Recess

41
Q

Superior Constrictor is Continuous with?

A

Buccinator

42
Q

Reflex has what effect on same action muscles and opposit action muscles?

A

Excite Synergist

Inhibit Antagonists

43
Q

Flexor Reflex

A

Excite Flexors, Inhibit Extensor in same leg

Inhibit Flexors, Excite Extensors in opposite leg

“Cross Extension Reflex”

44
Q

Babinski Sign

A

Normal: Flex Toes

Abnormal: Extend big toe, fan other toes

Seen after Upper Motor Neuron Lesion

45
Q

Clasped Knife Reflex

A

Upper Motor Neuron Lesion

Golgi Tendon Organ

Inhibit Synergist Muscles, Excites Antagonist Muscles (protect muscles and tendons from damage)

Clasped Knife - Resist to a point, then sudden collapse

Example of Autogenic inhibition; high tonus in muscle

46
Q

Pupillary Light Reflex (CN II - III)

A

Sensory: CN II (sense light)

Motor: Parasympathetics of CN III (constrict pupil)

47
Q

Direct vs Consensual Reflex in Eyes?

A

Direct - Pupil constricts in same eye

Consensual - Pupil constricts in opposite eye

48
Q

Corneal Reflex - CN V and VII

A

Sensory: Long Ciliary Nerves (V1) - Somatic Sensory

Motor Response: Branchiomotor VII - Branchiomotor

49
Q

Gag Reflex IX to X

A

Sensory: CN IX - Sensory Innervation to Oropharynx - Visceral Sensory

Motor: CN X - Innervates all muscles of pharynx (except Stylopharyngeus)

50
Q
A

SF2 - Test 1 (20 decks)

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