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neurology FA > carvenous sinus - auditory - facial lesions > Flashcards

carvenous sinus - auditory - facial lesions Flashcards

1
Q

cavernous sinus is composed by

A
  1. superior ophthalmic vein

2. sphenoparietal sinus

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2
Q

cavernous sinus - collection of venous sinuses from

A
  1. either side of pituitary
  2. eye
  3. superficial cortex
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3
Q

cavernous sinus –> drained to

A

internal jugular vein

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4
Q

….passes through cavernous sinus

A
  • CN III, CN IV, CN V1, CN VI
  • occasionaly V2
  • postganglionic sympathetic pupillary fibers
  • carvenous portion of internal carotid artery
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5
Q

cavernous sinus syndrome present with

A
  1. variable ophthalmoplegia
  2. decreased corneal sensation
  3. Horner syndrome
  4. decreased maxillary sensation (occasionally)
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6
Q

cavernous sinus syndrome - most susceptible nerve to injury that pass through it

A

CN VI

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7
Q

cavernous sinus syndrome is secondary to

A
  1. pituitary tumor mass effect
  2. carotid - cavernous fistula
  3. cavernous sinus thrombosis related to infection
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8
Q

sinus medial and below carvnous sinus

A

sphenoid sinus

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9
Q

cavernous sinus - distribution of nerves and arteries through it

A

Internal carotid - III
VI IV
(left) V1
V2

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10
Q

it seperatess right from left cavernous sinus

A

hypophysis

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11
Q

structures that passes though subarachnoid space above the cavernous sinus

A

INTERNAL CAROTID and anterior cerebral artery

anterior cerebral is above

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12
Q

ear is divided to

A

outer ear
middle ear
inner ear

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13
Q

visible portion of ear

A

outer ear (pinna)

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14
Q

outer ear consists of

A

pinna (λοβός)
auditory canal
eardrum

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15
Q

outer ear - function

A

transfers sound waves via vibration of eardrum

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16
Q

middle ear - structure

A

air filled space with three bones called the ossicles (malleus, incus, stapes)

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17
Q

three ossicles

A
  1. malleus
  2. incus
  3. stapes
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18
Q

middle ear - function

A

ossicles (malleus, incus, stapes) conduct and amplify sound from eardrum to inner eye

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19
Q

middle ear is filled with

A

air

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20
Q

inner fluid is filled with

A

Fluid-filled cochlea

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21
Q

inner fluid - shaped

A

snail

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22
Q

inner fluid contains

A

basilar membrane

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23
Q

basilar membrane - function

A

vibrates 2ry to sound waves

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24
Q

vibration from basilar membrane to auditory nerve

A

vibration transduced via specialized hair cells to auditory nerve

25
Q

auditory signal - auditory nerve - next step?

A

brainstem

26
Q

auditory signal - pathway

A

sound –> sound waves into auditory canal –> vibration of eardrum –> ossicles conduct and amplify sound to inner ear –> basilar membrane vibration –> vibration transduced via specialized hair cells –> auditory nerve signaling –> brain stem

27
Q

tonotopy?

A

each frequency leads to vibration at specific location

28
Q

tonotopy - distribution?

A

low frequency heard at apex near helicotrema (wide and flexible)
high frequnecy heard at base of cochlear (thin and rigid)

29
Q

types of hearing loss

A
  1. conductive
  2. sensorineural
  3. noise-induced
30
Q

conductive hearing loss - Rinne test

A

abnormal (bone>air) negative

31
Q

conductive hearing loss - Weber test

A

localizes to affected air

32
Q

sensorineural hearing loss - Rinne test

A

normal (air>bone) positive

33
Q

sensorineural hearing loss - Weber test

A

localized to unaffected air

34
Q

noise-induced hearing loss - mechanism

A
  1. hearing loss due to damage sterociliated cells in organ of Corti
  2. hearing loss due to sudden extremely loud noises –> tympanic membrane rupture
35
Q

hearing loss due to damage sterociliated cells in organ of Corti - characteristic

A

loss of high frequency hearing first

36
Q

cholosteatoma?

A

overgrowth of desquamated keratin debris within middle ear space

37
Q

cholosteatoma - composed by

A

desquamated keratin debris

38
Q

colosteatoma - complication and mechanism

A

may erode ossicles and mastoid air cells, retraction or ruptures of tympanic membrane –> conductive hearing loss

39
Q

colosteatoma - otorrhoea characteristic

A

foul-smelling

40
Q

facial nerve lesion - types (according area)

A
  1. upper motor neuron (UMN) lesion

2. lower motor neuron (LMN) lesion

41
Q

UMN facial nerve lesion - area

A

lesion of motor cortex or connection between cortex and facial nerve nucleus in pons

42
Q

UMN facial nerve lesion - appearance

A

contralateral paralysis of lower face

forehead spared due to bilateral UMN innervation

43
Q

LMN facial nerve lesion - area of lesion and appearance

A
  • ipsilateral paralysis of upper and lower face
    hyperacusis
  • loss of taste sensation to antrior tongue
44
Q

facial UMN lesion is AKA

A

central facial palsy

45
Q

facial LMN lesion is AKA

A

facial nerve palsy

46
Q

facial nerve palsy?

A

destruction of facial nucleus or CN VII anywhere along its course

47
Q

peripheral ipsilateral facial paralysis - clinical characteristics

A

absent forehead creases and drooping smile with inability to close eye on involved side

48
Q

facial nerve palsy - treatment

A

corticosteroids
acyclovir
Most patients have gradual recovery of function

49
Q

MCC of facial nerve palsy (and frequency)

A

Bell palsy (idiopathic) (70%)

50
Q

causes of facial nerve palsy

A
  1. Bell palsy (idiopathic)
  2. Lyme diseae
  3. HSV
  4. sarcoidosis
  5. tumors
  6. diabetes
  7. HZV (Ramsey Hunt syndrome)
51
Q

three ossicles

A
  1. malleus
  2. incus
  3. stapes
52
Q

mastication muscles - number

A

4

53
Q

mastication muscles - innervation

A

V3 (mandibular)

54
Q

mastication muscles - names

A
  1. masseter
  2. temporalis
  3. medial pterygoid
  4. lateral pterygoid
55
Q

mastication muscle - function

A
  • 3 muscles close jaw (masseter, temporalis, medial pterygoid)
  • 1 muscle open the jaw (lateral pterygoid)
56
Q

Ramsay Hnat syndrome is caused by

A

HZV

57
Q

Trigeminal nerve divisions

A

V1: ophthalmic
V2: maxillary
V3: mandibular

58
Q

cavernous sinus syndrome is secondary to (and symptoms)

A
  1. pituitary tumor mass effect
  2. carotid - cavernous fistula
  3. cavernous sinus thrombosis related to infection
    symptoms: 1. variable ophthalmoplegia
    `2. decreased corneal sensation
  4. Horner syndrome
  5. decreased maxillary sensation (occasionally)
59
Q

Hyperacusis

A

increased sensitivity to certain frequency and volume ranges of sound

neurology FA (31 decks)

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