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Colin Neuro > B Wright Clinical Correlations > Flashcards

B Wright Clinical Correlations Flashcards

1
Q

What is an Epidural Hematoma?

A

If you hit your head and fracture the skull, and manage to break the Middle Meningeal A., you can bleed into the Epidural space (outside dura mater)

Blood fills up and compresses the brain away from the bleed.

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2
Q

What happens to vertebral artery when you turn your head?

A

It stretches.

Specifically, the effect of rotation causes the vertebral artery to stretch forwards

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3
Q

What is Vertebrobasilar Insufficiency?

A

Syncope, vertigo, dizziness, double vision, loss of vision, numbness or weakness in hands or feet, slurred speech, nausea and vomiting, loss of coordination

All due to Athersclerosis of the Basilar A. OR Rotation/Extension of the Head

Risk Factors:

  • Smoking
  • Hypertension
  • Diabetes/obesity
  • Over 50 years old
  • Family history
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4
Q

What is Subclavian Steal Syndrome?

A

Occlusion of the Subclavian causes reverse blood flow through the vertebral artery of the affected side, to supply blood to the upper extremity

Causes a decrease in blood flow to the brain

Symptoms:

  • Presyncope/Syncope
  • Different blood pressures in Upper Extremities
  • Neurologic Deficits/memory problems

Causes:

  • Athersclerosis
  • Cervical Rib (extra rib)
  • Baseball Pitchers hypertrophy Anterior Scalene, which blocks subclavian a.
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5
Q

Why do cuts to scalp bleed profusely?

A

Dense connective tissue of the scalp holds the damaged arteries open, causing excessive bleeding

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6
Q

What layer of the scalp, if infected, can allow for spread of infection quickly?

A

Loose Connective Tissue layer

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7
Q

What is a gaping wound?

A

When a wound cuts through the aponeurosis layer, the muscles pull the wound open

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8
Q

Mumps in the Parotid Gland

A

Mumps is more painful in the cheek region because of the Parotid Gland is infected

Does not swell because it is covered in fascia

Structures that travel through the parotid gland:

  • Facial N. (does not innervate)
  • External Carotid A.
  • Retromandibular V.

Parotid Gland has parasympathetic innervation from CN IX (glossopharyngeal N.)
Sensory Innervation from Auriculotemporal and Great Auricular N.

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9
Q

What nerve is responsible for opening the eye, which one closes it?

A

CN III (Occulomotor N.) opens eye

CN VII (Facial N.) closes eye

(Orbicularis Oculi M.)

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10
Q

What nerve innervates the Muscles of Mastication?

A

CN V3 (Mandibular Branch of Trigeminal N.)

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11
Q

Branches of the Motor Root of the Facial N.

A

Tiny Zebra Bit My Cheek

Temporal Branches
Zygomatic Branches
Buccal Branches
Mandibular Branches
Cervical Branches
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12
Q

What does the Chorda Tympani do?

A

Chorda Tympani is a branch off the Facial N.

Taste, anterior 2/3 of tongue
Also carries Parasympathetics to the Sublingual and Submandibular Glands

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13
Q

What does the Greater Petrosal N. do?

A

Parasympathetic Innervation of the Lacrimal Gland

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14
Q

What is Bell’s Palsy?

A

Damage to the Facial N.

  • Cannot wrinkle the forehead
  • Cannot Smile
  • Cannot close eye
  • Cannot spread tears across the cornea, eye dries out.

Symptoms depend on site of lesion

In severe cases, eye lid is sutured closed until resolved

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15
Q

What presentation would you see of Bell’s Palsy where the lesion is just after the Facial N. exits the Stylomastoid Foramen?

A

All facial expression muscles would be paralyzed on affected side.

  • Cannot close eyes
  • Cannot Smile
  • Cannot wrinkle forehead
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16
Q

What presentation would you see of Bell’s Palsy where the lesion is in the Facial Canal, before the Chorda Tympani branches?

A

All facial expression muscles paralyzed on affected side.

  • Cannot close eyes
  • Cannot smile
  • Cannot wrinkle forehead

Cannot sense taste on anterior 2/3 of tongue on affected side

Cannot secrete saliva from Submental and Submandibular glands on affected side

Taste and saliva loss will not be noticed, as the normal side will continue to function normally

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17
Q

What presentation would you see of Bell’s Palsy where the lesion in the Facial Canal, before the nerve to the Stapedius M. branches?

A

All facial expression muscles paralyzed on affected side.

  • Cannot close eyes
  • Cannot smile
  • Cannot wrinkle forehead

Cannot sense taste on anterior 2/3 of tongue on affected side

Cannot secrete saliva from Submental and Submandibular glands on affected side

Cannot dampen loud sounds in ear of affected side - Stepdius M. dampens loud sounds

18
Q

What presentation would you see of Bell’s Palsy where the lesion is at the Internal Acoustic Meatus?

A

All facial expression muscles paralyzed on affected side.

  • Cannot close eyes
  • Cannot smile
  • Cannot wrinkle forehead

Cannot sense taste on anterior 2/3 of tongue on affected side

Cannot secrete saliva from Submental and Submandibular glands on affected side

Cannot dampen loud sounds in ear of affected side - Stepdius M. dampens loud sounds

Cannot secrete tears from Lacrimal Gland of affected side

19
Q

What is Herpes Zoster?

A

Shingles (AKA Chicken Pox)

Stays in sensory ganglia for life (dormant virus)

20
Q

Why is plastic surgery so successful in healing?

A

Anastemoses in the face and scalp

21
Q

What is Tic Douloreux?

A

Trigeminal Neuralgia

Impingement/compression on a trigeminal nerve causing brief episodes of sharp pain over area of face innervated by either the CN V1, CN V2, CN V3

22
Q

What is Auricular Hematoma?

A

Trauma to ear can cause bleeding

Blood accumulates in the space between the cartilage and the Perichondrium

Causes ear to swell

If blood is not drained, abnormal cartilage forms and you get CAULIFLOWER EAR

23
Q

What is Otitis Externa?

A

Swimmer’s Ear

Infection of External Acoustic Meatus

Risk Factors:

  • Excessive moisture
  • Trauma (excessve cleaning/scratching)
  • Devices that occlude the ear canal
  • Dermatologic conditions
  • Prior Radiation Therapy
24
Q

What is Otitis Media?

A

Infection of the Middle Ear

Inflammation and swelling of mucous membrane of tympanic cavity may block pharyngotympanic tube

Tympanic membrane is red and bulges

25
Q

What is Tympanostomy Tube Placement?

A

Ear Tubes

Treatment for chronic ear infections

First, Myringotomy - Lesion to open up ear drum in the Posterior Inferior Quadrant of the Tympanic Membrane and drain fluid.

Second Tympanostomy - Ear tube placement

26
Q

What quadrant of the Tympanic Membrane will you find the cone of light?

A

Anterior Inferior Quadrant

27
Q

What happens if an Otitis Media infection spreads and erodes through the Roof of the Tympanic Cavity?

A

Infection will spread to the Middle Cranial Fossa (brain)

Meningitis

28
Q

What happens if an Otitis Media infection spreads and erodes through the Anterior Wall of the Tympanic Cavity?

A

Infection will spread to the Internal Carotid A.

29
Q

What happens if an Otitis Media infection spreads and erodes through the Floor of the Tympanic Cavity?

A

Infection will spread to the Bulb of the Internal Jugular V.

30
Q

What happens if an Otitis Media infection spreads and erodes through the Posterior Wall of the Tympanic Cavity?

A

Infection spreads to the Mastoid Air Cells or compromises the Facial N.

31
Q

What happens if an Otitis Media infection spreads and erodes through the Medial Wall of the Tympanic Cavity?

A

Infection spreads to the inner ear

Also causes Meningitis

32
Q

Orbital Blow Out Fracture

A

Fracture of orbital walls usually caused by indirect trauma

Blowout usually occurs medially and inferiorly involving the maxillary bone

Orbital Contents may prolapse and become entrapped in the maxillary sinus

Can result in:

  • Diplopia (Affected eye does not, while normal eye does, causing double vision)
  • Globe ptosis (eyeball enters the maxillary sinus)
  • Exophthamlos (protrusion of the eyeball)
33
Q

What is Trochlear Pasly?

A

Eye Lesion

Trochlear N. (CN IV) is responsible for innervating the Superior Oblique M., which normally makes eye depress, abduct, and Intorsion (medial rotation)

Head Tilts away from affected side

Diplopia worse on downward gaze

34
Q

What is Abducens Palsy?

A

Eye Lesion

Abducens N. (CN VI) is responsible for innervating Lateral Rectus M.

Affected eye cannot look laterally

35
Q

What is Occulomotor Palsy?

A

Occulomotor N. (CN III) normally:

  • Opens eyelid
  • Eye Looks up (superior rectus)
  • Eye Looks down (inferior rectus)
  • Eye Looks Medially (medial rectus)
  • Eye is elevated, abducted, and laterally rotated (Inferior Oblique)

Occulomotor palsy presents with affected eyelid closed and eye looking laterally

36
Q

Subconjuntival Hemorrhage

A

Bleeding underneath the Bulbar Conjunctiva

37
Q

What is Complete vs Partial Ptosis?

A

Complete Ptosis:
- Levator Palpebrae Superioris M. cannot open eyelid (innervated by CN III, occulomotor)

Partial Ptosis:

  • Tarsal M. (of Muller) cannot hold eyelid open (innervates by postganglionic sympathetics)
  • Horner’s syndrome involves paralysis of Tarsal M.
38
Q

What is Papilledema?

A

Increased intracranial pressure (ICP)

- Bulging optic disc

39
Q

Central Retinal V. occulsion

A

Ketchup on opthalmoscope, blotches of red everywhwere

40
Q

Central Retinal A. occlusion

A

Pale and Cherry red spot (macula)

41
Q

Blockage of Schlem’s Canal

A

Scleral Venous sinus collects aqueous humor from anterior chamber.

If it is occluded, pressure can build in the eye and cause glaucoma

42
Q

What is hyphema?

A

Rupture of vessels causing blood to fill in anterior chamber

Colin Neuro (15 decks)

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