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Neurological Medicine > CC - Anatomy > Flashcards

CC - Anatomy Flashcards

1
Q

Head Injuries

A

hemorrhage, infection, injury

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2
Q

Neuralgias

A

severe throbbing or stabbing pain caused by demyelinating lesion

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3
Q

Facial Neuralgia

A

diffuse painful sensations

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4
Q

Superciliary Arches Injury

A

sharp bony ridge above eye - Black eye

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5
Q

Malar Flush

A

redness covering the zygomatic process that occurs with fever (TB and lupus)

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6
Q

Le Fort I Fracture

A

horizontal fractures of maxilla superior to maxillary aveolar process

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7
Q

Le Fort II Fracture

A

entire central part of face separate from cranium

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8
Q

Le Fort III Fracture

A

horizontal fx that passes through the superior orbital fissure; causes maxillae and zygomatic bones to separate from the rest of the cranium

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9
Q

Injury and Lacerations of the Scalp

A
  • With deep lacerations, the 3 outer layers my be lifted off
  • Scalp will bleed profusely → hard to shut down scalp blood vessels in CT layer
  • Tx: Hard compression and Ice
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10
Q

Infections to Scalp

A
  • Superficial veins od the scalp have direct, valveless connections via the emissary veins → venous dural sinuses
  • In between these direct connections is the diploic venous system between the outer and inner cortical layers of skull bone
  • infections that arise in the scalp may progress intercranially via the venous system and involve the coverings/meninges of the brain → meningitis
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11
Q

Sebaceous Cyst

A

-ducts of sebaceous glands associated with hair follicles in the scalp may become obstructed → retention of sections → formation of sebaceous cysts

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12
Q

Epidural hemorrhages/hematomas

A
  • From trauma to head in the temporal region
  • involves rupture of the middle meningeal artery → forms a hematoma between the dura and the bone of the skull (extradural/epidural hematoma)
  • when bone is fractured it pushes away from dura → blood pools
  • x-ray looks “lens shaped” due to bone pushing away
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13
Q

Subdural hemorrhage/hemoatoma

A
  • rupture of the cerebral vein → forms a hematoma between the dura and arachnoid (subdural space)
  • fyi- cerebral veins pierce through dura into the dural sinuses/super sagittal sinus
  • tearing occurs here the vein crosses the subarachnoid spaces and enters the dural sinus
  • slow leakage
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14
Q

Subarachnoid hemorrhage

A

-rupture of the cerebral artery → forms a hematoma between the subarachnoid membrane and the pia

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15
Q

Resorption of the alveolar bone

A
  • extraction of teeth causes the alveolar bone to resorb in the affected regions
  • socket begins to fill with bone
  • mental foramina may disappear → exposes mental nerves → may produce pain
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16
Q

Fractures of calvaria (skull cap)

A
  • usually distributes, thus minimizes the effects of a blow to the head
  • depressed fx- bone fragment is depressed inward, compressing the brain
  • linear fx- occur at pt of impact, but fx lines radiate away from it in 2 or more directions
  • comminuted fx- bone is broken into several pieces
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17
Q

Age changes in the face

A
  • mandible is the most dynamic bone- changes size, shape, and number of teeth as age
  • newborn- mandible is 2 halves united in the middle by a cartilaginous joint (mandibular symphysis); union occurs at end of 2nd year
  • body of mandible elongates
  • growth of paranasal sinuses → alter shape of face and add resonance to voice
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18
Q

Craniosynostosis and Cranial Malformations

A

-primary craniosynostosis- premature closing of the cranial structures
-cause of craniosynostosis is unknown- exaggerated forces on the dura mater disrupt normal cranial sutural development
-Scaphenocephaly- premature closure of the sagittal suture → long, narrow wedge shaped cranium
Plagiocephaly- premature closure of the coronal suture (across) on one side → cranium is twisted and asymmetrical
Oxycephaly- premature closure of coronal suture → high tower like cranium

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19
Q

Cephalhematoma

A
  • bleedings between the baby’s pericranium and calvaria (skull cap) over the parietal bone after a difficult birth
  • blood is trapper causing a cephalhematoma
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20
Q

Fracture of pterion

A
  • lies over the anterior branches of the middle meningeal vessels (lateral wall of calvaria)
  • life threatening!
  • hard blow to side of head may fx → rupture branch of middle meningeal artery crossing the pterion → causes hematoma is the cerebral cortex → death
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21
Q

Tentorial Herniation

A
  • tentorial notch- opening in the tentorium cerebeli for the brainstem
  • space occupying lesions (tumors) produce increased intracranial pressures → may force temporal lobe of brain to herniate through the temporal notch
  • temporal lobe may be lacerated by the tough tentorium cerebelli
  • oculomotor nerve may be stretched
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22
Q

Pituitary tumors

A

-cause the diaphragm sellae to bulge → produce disturbances in endocrine fxn

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23
Q

Thrombophlebitis of facial vein

A

-facial vein connects with cavernous sinus through the superior ophthalmic vein AND with the ptergoing venus plexus though deep facial veins
-due to many connections, an infection in the face may spread to the cavernous sinus and ptyergoid venous plexus
-facial vein has no valves → how blood can enter the cavernous sinus (go backward)
pieces of infected clot can extend into the intercranial venous system

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24
Q

Occlusion of cerebral veins and dural venous sinuses

A

Occlusion of cerebral veins and dural venous sinuses can result form clots, tumors, and venous inflammation

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25
Q

Metastasis of tumor cells to dural venous sinuses

A
  • basilar and occipital sinuses communicate thought the foramen magnum
  • because channels are valveless –compression of thorax, abdomen, pelvis etc during a heavy cough can causes venous blood from these regions → internal vertebral venous system → dural venous sinuses → spread to brain
26
Q

Dural region of Headaches

A
  • dura is sensitive to pain, especially where there are dural venous sinuses and meningeal arteries
  • pulling on arteries → pain
  • distension of the scalp or meningeal vesels → causes headaches
  • many headaches are dural in origin (ex: headache after removal of CSF) → thought to be from stimulation of sensory nerve ending in the dura
27
Q

Leptomeningitis

A
  • inflammation of the leptomeninges (arachnoid and pia) from pathogenic microorganisms
  • infection confined to the subarachnoid space
  • microorganism can enter though blood or spread from lungs, heart, etc
28
Q

Facial Lacerations and Incisions

A
  • face has no distinct deep fascia thus facial lacerations tend to gape wide apart
  • thus, skin must be carefully sutured so it doesnt scar
  • looseness allows blood to accumulate in CT → bruising
29
Q

Bell Palsy

A
  • paralysis of facial muscles usually on side due to an interruption of the CN VII (facial)
  • inability to close lips, eyes, or chew
  • paralysis is often associated with exposure to the cold
30
Q

Infraorbital Nerve block

A
  • used to treat wounds of the upper lip, check or maxillary incisor teeth
  • inject infraorbital nerve though the infra-orbital foramen by elevating lip and putting in there
  • because orbit is close to here, bad injection could lead to paralysis of extraocular muscles
31
Q

Mental and Incisive nerve blocks

A
  • when wanting to anesthetize one side of the skin and mucous membrane of the lower lip and skin of the chin
  • injection made into the mental foramen
32
Q

Buccal Nerve Block

A
  • to anesthetize the skin of the cheek

- injection into the mucosa covering the retromolar fossa

33
Q

Trigeminal Neuralgia

A
  • a sensory disorder of the sensory root of CN V that occurs in old people
  • experience sudden attacks of facial pain- often when touching the face
  • V2 (maxillary) is most frequently involved
  • occurs because demyelination of the axons in the sensory root has occurred
  • surgery is often the best option
34
Q

Lesions of trigeminal nerve

A

-can cause widespread anesthesia involving the: 1)corresponding anterior half of the scalp 2) face, except for area around the angle of the mandible, cornea, and conjunctiva 3) mucous membranes of the nose, mouth

35
Q

Herpes zoster infection of trigeminal ganglion

A

-most often involves the ophthalmic division, but any can be involved

36
Q

Testing sensory function of CN V

A
  • tested by asking person to close eyes and respond when they are touched
  • repeated on forehead (V1), cheek (V2), and lower jaw (V3)
  • should feel the same on both sides
37
Q

Infection of the parotid gland

A

-mumps is an inflammatory enlargement of the parotid gland where the facial covering of the gland tightens → painful

38
Q

Abscess in the parotid gland

A
  • bacterial infection localized in the parotid → abscess

- infection could be from poor dental hygiene and infection could spread from ducts

39
Q

Parotidecotomy

A
  • most salivary gland tumors occur in the parotid glands
  • most are benign
  • tx: surgical excision of the parotid gland (parotidectomy)
  • CN VII and its branches are in danger during surgery
  • contour of face is changed once removed
40
Q

Mandibular nerve block

A

-anesthetizes the inferior alveolar nerve, lingunial, auriculotemporal, and buccal branches of CN V3

41
Q

Inferior alveolar nerve block

A
  • anesthetizes the inferior alveolar nerve (branch of CN V3)
  • injection around the mandibular foramen
  • all mandibular teeth are numb
42
Q

TMJ dislocation

A
  • excessive opening/closing of mouth may cause head of mandible to dislocate anteriorly
  • mandible remains depressed and the pt cant close mouth
  • can also occur from a side blow
  • may also occur from a fracture of the mandible
  • posterior dislocation is UNCOMMON
  • during surgery be careful of auriculotemporal nerve (branch of CN V3)
43
Q

Arthritis of TMJ

A

TMJ can become inflamed from arthritis

-may result in dental occlusion (blockage) and joint clicking (crepitus)

44
Q

Nasal Fractures

A

Epistaxis, disruption of bones/cartilage resulting in nose displacement

45
Q

Deviation of Nasal Septum

A

contact with the lateral wall of nasal cavity obstructs breathing or exacerbates snoring

46
Q

Rhinitis

A

swollen and inflamed nasal mucosa during URIs and allergies

47
Q

Infection of Ethmoidal Cells

A

if nasal drainage is blocked, infections may break through fragile medial wall of orbit; may cause blindness

48
Q

Leptomeningitis

A

inflammation of arachnoid and pia from microorganisms

49
Q

Branchial Cyst (Cervical Lymphoepithelial Cyst)

A

Majority arise from remnants of the second branchial arch; most common between 20-40 years old; benign; appear in the upper/lateral aspect of neck on the sternocleidomastoid; well circumscribed 2-5 cm in diameter with fibrous walls containing lymphoid tissue

50
Q

Thyroglossal Duct Cyst

A

Remnants of the developmental tract may persist producing cysts 1-4 cm in diameter; connective tissue wall may have lymphoid aggregates or thyroid tissue

51
Q

Paraganglioma (Carotid Body Tumor)

A

Paraganglia are clusters of neuroendocrine cells associated with the sympathetic and parasympathetic nervous systems. Commonly associated with tumors of the adrenal medulla. Mutations are associated with succinate dehydrogenase or mitochondrial oxidative phosphorylation; more common in people living in high altitudes.
Typically develop in Paravertebral Paraganglia (organs of Zuckerkandl and bladder) - sympathic connections and Paraganglia related to great vessels called aorticopulmonary chain, including carotid bodies - parasympathetic connections; usually arise in 50s/60s; autosomal dominant transmission

52
Q

Agnosia

A

The inability to understand or recognize the significance of sensory stimuli, although the sensory pathways and the primary sensory cortex are intact. Therefore, the lesion is related to cortical association areas (somesthetic, visual, auditory).

53
Q

Tactile agnosia

A

the patient finds it impossible to correlate the surface texture, shape, size, and weight of an object and to compare the sensation with previous experience. Tactile agnosia occurs with lesions involving the parietal association cortex (left or right).

54
Q

Visual agnosia

A

the inability to recognize objects that cannot be attributed to a defect of visual acuity or to intellectual impairment; the patient fails to relate present to past visual experiences, with the result that the patient fails to recognize what is seen and appreciate its significance (what). Visual agnosia occurs with lesions involving the visual association cortex (left or right).

55
Q

Auditory agnosia

A

a condition in which a patient with unimpaired hearing fails to recognize or appreciate a meaning with a perceived sound. Auditory agnosia occurs with lesions involving the auditory association cortex .

56
Q

Anosognosia

A

a loss of disease awareness. Anosognoais occurs with lesions involving the parietal lobule (right).

57
Q

Prosopagnosia

A

(face blindness) - a cognitive disorder of face recognition where the ability to recognize faces is impaired, while other aspects of visual processing (e.g., object discrimination) and intellectual functioning (e.g., decision making) remain intact. Involves lesions affecting the underside of the occipital lobes.

58
Q

Apraxia

A

The inability to carry out a motor action in response to a verbal (written) request in the absence of paresis/paralysis, sensory abnormality, comprehension deficit, or disturbance of coordination (ataxia). Generally associated with the dominant cerebral hemisphere (left).

59
Q

Aphasia

A

A defect in language processing caused by brain lesions, not caused by mental deficits, disturbances in sense organs, or paralysis of muscles for speech; develop as a consequence of lesions in the dominant cerebral hemisphere; most cases are caused by stroke, head injury, cerebral tumors, or degenerative dementia such as Alzheimer’s disease.

60
Q

Expressive Aphasia

A

(Broca’s aphasia; non-fluent aphasia [motor aphasia]; verbal apraxia or dyspraxia) - problem in formulation of speech (“articulated speech”).

61
Q

Receptive Aphasia

A

(Wernicke’s aphasia or fluent aphasia [auditory aphasia]) - a form of auditory agnosia in which the patient fails to recognize or comprehend the meaning of known words - “word deafness“.

Neurological Medicine (8 decks)

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