Clincal Applications

Question 1

What is the emergency ariaway procedure

Answer 1

The cricothyroid ligament is pierced with a 1mm needle when a patient cannot breathe. An example of when this might happen is in an anaphylactic shock

Question 2

What is goitre and how does this happen

Answer 2

This is an enlarged thyroid gland, ofte caused by grave diease or iodine defieciencey.

Question 3

Patient presents with a distended EJC and you can hear a bruit, what condition might you think of.

Answer 3

Conjestive heart failure

Question 4

Lymph node englargement can be felt during an extra-oral examination. What are the typical presentations of an infection and a malignancy

Answer 4

Inflamed and tender = infection

Inflamed and hard = malignancy

Question 5

What artery is most commonly affected in Hortons diease

Answer 5

The superficial temporal artery, it is inflammation of the artery which can lead to decreased 02 supply leading to blindness and stroke

Question 6

Why will the scalp heal quickly following laceration

Answer 6

Because it is a highly vascularised so it will bleed profusely but it will heal quickly

Question 7

What is a berry aneurysm

Answer 7

This is an outpouching of a cerebral artery which may rupture and this has a high mortality rate

Question 8

An occlusion to which cerebral artery would cause affects to both Broca’s and wernickes area

Answer 8

The middle cerebral artery

Question 9

How may a cavernous sinus thrombosis happen

Answer 9

Bacteria from a third molar abscess may pass through the ptergygoid venous plexus through the spee holiday emissary veins to the cavernous sinus.

The Bacteria may then multiply due to the slow blood flow causing a thrombosis.

Question 10

What are the symptoms of a cavernous sinus thrombosis

Answer 10

Fever and swollen eye

Swollen eye because the blood id not being drained from the ophthalmic veins

Question 11

How might an ear infection cause facial nerve palsy

Answer 11

Because an ear infection could cause the mastoid air cells to become infected, as the facial nerve runs by the mastoid process it could be infected by this

Question 12

Why may be there prolonged anaesthesia when an IDB is delivered into the parotid gland

Answer 12

This is because of the dense fibrous capsule surrounding the parotid gland meaning that the anaesthetic is unable to escape leaving prolonged affects

Question 13

What two nerves will be affected when there is a stroke in the internal capsule - what will the affects be

Answer 13

The facial and hypoglossal nerve

Facial paralysis below the eyebrows on contralateral side and tongue deviation to contralateral side

Question 14

What is the name of bony protections which can block Arteries, nerves and veins and cause pain when turning head to the side

Answer 14

Osteophyctes

Question 15

Damage to cerivcal sympathetic trunk causing what condition and what are the presenting symptoms

Answer 15

Horners syndrome

Miosis( pupil constriction), Ptosis( drooping of eyelid) and anhydorsis( lack of sweating)

Question 16

If there is swelling of the parotid gland which Cranial nerve would this apply pressure to

Answer 16

Glossopharnygeal

Question 17

In trigeminal neuralgia where is the compression of the nerve happening and what medication can be used to treat it

Answer 17

It is no known cause but there is compression of the nerve at the foramen ovale

Carbamazepine can be prescribed

Question 18

Why is salivary caniculi more. Common in the submandibular duct.

What nerve may be at risk during their removal and what radiograph would you want to take first

Answer 18

This is because of the uphill flow of saliva in the duct

Lingual nerve

Manidublar true occlusal

Question 19

What artery sits just behind the pharyngeal recess that may be at risk in a biopsy if there is a pharyngeal recess tumour

Answer 19

Internal carotid artery

Question 20

What is a grommet used to treat

Answer 20

Glue ear/serious otitis media

Insertion into the tympanic membrane allowing air into the middle ear

Question 21

Wha happens in serious otitis media

Answer 21

There will be a blockage of the auditory tube usually by overgrowth of the tubal tonsils.

This may be caused by recurrent infection, if this occurs air cannot get into the middle ear so. The air is no longer refreshed. This leads to a proliferation of the goblet cell and a large amount of mucous is secreted.- glue ear

Question 22

What is chronic otitis media

Answer 22

Infection of the middle a ear leading to a tympanic membrane perforation and pus will leak. Into the external auditory meatu

Question 23

If a child has inserted a small toy into their nose and it has become lodged in their inferior meatus what might the presenting symptoms be

Answer 23

Pus build up and bad breathe

Question 24

Which cranial nerve may be responsible for reffered pain from toothache to the ear

Answer 24

Trigeminal

Question 25

What is responsible for a runny nose when you are crying or when it’s cold

Answer 25

The nasolacrimal duct - this drains tears from the lacrimal sac to just under the inferior nasal concha

Question 26

What is the name of the two areas where fish bones may get stuck

Answer 26

Pirform fossa and valleccula