Based on SAS/Review Sessions Flashcards
Swelling of the false vocal cords is likely to result in stridor in which phase of breath?
Inspiratory
The false vocal cords are just superior to the glottis. Obstruction here leads to inspiratory stridor
- Inspiratory => supraglottic or glottic obstruction
- Biphasic => glottic or subglottic obstruction
- Expiratory => bronchotracheal obstruction
If an infection develops in the orbit, it will pass from ophthalmic veins into what vascular structure?
Where might it go from there?
The cavernous sinus
Drainage from the ophthalmic vein:
- Ophthalmic vein
- -> Cavernous sinus
- -> Superior petrosal sinus or inferior petrosal sinus
- If inferor sinus -> straight sinus then
- -> Transverse sinsus
- -> Sigmoid sinus
- -> internal jugular
Which nerve provides sensation to the middle ear?
Tympanic nerve
Branch of CN IX, goes on to become the lesser petrosal nerve -> parotid gland secretion
(note: tympanic never is NOT associated with CN VIII; VIII is special senosry for hearing and balance)
Which artery is labeled by #13?
Superior thyroid artery
(The first branch off of the external carotid artery)
Damage to the sympathetic trunk would result in what eye symptoms?
- Ptosis (loss of superior tarsus)
- Miosis (loss of pupil dilator)
Also - loss of hemifacial sweating
Which nerve innervates tensor veli palatini?
V3 (mandibular)
The artery labeled #3 is the branch of the ______ artery, destinded for the ______ muscle
The artery labeled #3 is the branch of the occipital** artery, destinded for the **sternocleidomastoid muscle
If the frontonasal and maxillary processes fail to fuse, what is the result in the developing child?
Cleft lip or cleft primary palate
Which artery is labeled by #2?
Ascending pharyngeal artery
Which artery is labeled by #10?
Maxillary artery
(A terminal branch of the external carotid artery)
What does a (-) Rhinne test mean?
(-) Rhinne = BC > AC - this is abnormal
Indicates condutive hearing loss
Note: (+) Rhinne, where AC > BC, could occur in normal hearing or sensorineural hearing loss
Describe the flow of blood from the common carotid artery to the middle meningeal artery
- Common carotid artery
- -> External carotid artery
- -> Maxillary artery
- -> Mandibular branch of the maxillary artery
- -> Middle meningeal artery
Damage to which bony structure could result in loss of sense of smell?
Cribiform plate of the ethmoid bone
(this is where the olfactory nerves hang out)
Which passageway connects the nasal cavity and the infratemporal fossa?
Which structures pass through this passage?
Sphenopalatine foramen
- Sphenopalatine artery and vein
- Nasopalatine, lateral nasal nerves
These structures supply the posterior and inferior parts of the nasal cavity as well as the front of the palate
Tumors can use this path to get from the nasal cavity to the infratemporal fossa
What is developmental origin of the orbicularis oculi?
What nerve supplies it?
What is its function?
Pharyngeal arch 2
Supplied by the facial nerve (CN VII)
Closes the eyelid
Which primordial tissue gives rise to the superior parathyroid glands and thyroid C-cells?
Endoderm from pharyngeal pouch 4
What pathology is shown in this CT?
Tumor in the nsasopharynx
This patient has a tumor in their nasal cavity
If they have trouble opening their mouth, which space has been invaded by the tumor?
- Infratemporal fossa
- Pterygopalatine fossa
- Oral cavity
- Maxillary sinus
Infratemporal fossa
The lateral pterygoid is necessary for jaw opening, and it is located in the infratemporal fossa
Which muscle is labeled by #4?
Digastric
What is the most common etiology of acute sinusitis?
Viral
(Much more likely than bacterial)
Faulty development of which embryonic tissue results in small zygomatic bones?
Pharyngeal arch 1 mesenchyme
Which dural sinus receives CSF?
Via which structures?
Superior saggital sinus
Via arachnoid granulations
What are the 3 most common bacterial causes of acute otitis media?
Strep. pneumonia
Haemophilus influenzae
Moraxella catarrhalis
Note - same as the most common bacterial causes of rhinosinusitis! The nose and the middle ear are connected by the eustachian/auditory tube
E - Cheek numbness
This is the infraorbital foramen
Contains the infraorbital nerve, which provides cutaneous sensation to the cheek
Which artery is labeled by #11?
Facial artery
If the left and right palatine processes fail to fuse, what is the result in the developing child?
Cleft secondary palate
What innervates the pharyngeal constrictor muscles?
Pharyngeal branch of the vagus nerve
Loss of parasympathetic innervation to the eye would result in what symptoms?
- Ptosis (due to loss of levator palpebrae superioris, parasympathetics from CN III)
- Dilated pupils (due to loss of pupil constrictor innervation, parasympathetics from CN III)
- Decreased lacrimal gland secretion (due to lost parasympathetics from CN VII)
Describe the movement of a bolus relative to the laryngeal vestibule during swallowing
The bolus moves around the laryngeal vestubule, alongy the aryepiglottic folds
Group A Strep is responsible for ____% of childhood pharyngitis
Group A Strep is responsible for 20-30% of childhood pharyngitis
What syndrome is associated with cleft lip or palate, ocular vision problems, hearning loss, and joint abnormality?
Stickler syndrome
Which artery is labeled by #9?
Transverse facial artery
(Sneaky because it isn’t included in the pneumonic??)
Which artery is labeled by #5?
Occipital artery
Where would you have a patient look to test the integrity of the inferior oblique muscle?
In then up
(Inferior oblique abducts and elevates the eye)
What syndrome is associated with cleft lip or palate, hemifacial craniofacial abnormalities, vertebral abnormalities, auricular abnormalities, and agenesis of the parotid gland?
Goldenhar syndrome
The primary route for deep lympatics from the head and neck is:
An alternative pathway is along:
The primary route for deep lympatics from the head and neck is in the jugular trunk aka deep cervical nodes
An alternative pathway is along CN XI, posterior to the primary pathway
If infection of the mastoid air cells spreads anteriorly, which nerve is in danger?
Facial nerve (CN VII)
Between which fascial layers is the “danger space” that would allow infection to spread from the neck to the mediastinum?
Between the alar and prevertebral fascia
(The retropharyngeal space is between the pretracheal and alar fascia; infections in this space will be unilateral)
Which primordial tissue gives rise to the thymus and inferior parathyroid glands?
Endoderm of pharyngeal pouch 3
What is the most likely tympanogram result if a child’s ear looks like this?
Type B - flat, indicates fluid in the middle ear
What is the start and end point of the mandibular condyle as the jaw moves from closed to open?
Which muscle pulls the condyle of the mandible forward to open the jaw?
- Start: Mandibular fossa of the temporal bone (zygomatic process)
- End: Articular eminence of the temporal bone (zygomatic process)
- Muscle: Lateral pterygoid innervated by CN 5.3
What syndrome is associated with cleft palate or palate and small bilateral indentations of the lower lip?
Van der woude syndrome
Autosomal dominant
What syndrome is associated with cleft lip or palate, coloboma, heart abnormalities, genitourinary abnormalities, ear abnormalities, and hearing loss?
CHARGE syndrome
Coloboma
Heart defects
Atresia (choanal blockage or narrowing entry to nasopharynx)
Retardation of CNS development (intellectual disabilities)
Genitourinary abnormalities
Ear anomalies pathognomonic linear antihelical fold also typical inner ear features
Which artery is labeled by #12?
Lingual artery
Which suture prematurely fused in this child?
How can you tell?
Sagittal
Premature fusion of the sagittal sutre -> lateral narrowing
(Whereas premature fusion of the coronal suture -> crown shape)
Which artery is labeled by #6?
Posterior auricular artery
Which intrinsic laryngeal muscles are closest to the vocal cords?
Why is this significant?
Thyroarytenoid
The vocal cords and thyroarytenoid traverse the larynx. Swelling in this area during a cold or sore throat -> hoarseness
In general, bony structures of the face derived from develop [intramembranously/endochondrally]
In general, bony structures derived from phyaryngeal arches develop intramembranously
Note: pharyngeal-arch derived structures develop from neural crest mesenchyme
Bony structures of the basicranium develop endochondrally
Which muscle must be lateralized during a thyroidectomy?
Sternohyoid
(Runs anterior to the thyroid gland)
Which artery is labeled by #7?
Internal carotid artery
In which triangle of the neck is this lesion located?
Submandibular triangle
Which artery is labeled by #1?
External carotid artery
An orbital floor fracture would bleed into which sinus?
Maxillary
What is penetration vs. aspiration?
- Penetration
- Ingested material sneaks by the epiglottis but is stopped above the level of the true vocal folds
- Aspiration
- Ingested material ends up below the true vocal folds
All of the infrahyoid strap muscles are supplied by _______, except the _______, which is supplied by _____
All of the infrahyoid strap muscles are supplied by ansa cervicalis** (from the cervical plexus), except the **thyrohyoid** , which is supplied by **C1 fibers travelling in the hypoglossal nerve
Which artery is labeled by #8?
Superficial temporal artery
(A terminal branch of the common carotid)
