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Head And Neck > Clinical > Flashcards

Clinical Flashcards

0
Q

what is papiledema?

A

this is where there is a blurring of optic discs due to increased intracranial pressure

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1
Q

what is dysarthria?

A

difficulty speaking

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2
Q

what is rhinorroea?

A

this is where there is a leakage of CSF from the nose

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3
Q

what is anosmia?

A

loss of smell

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4
Q

what is the most fractured bone of the face?

A

the nasal

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5
Q

what is the second most common fracture of the face?

A

the mandible

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6
Q

what does ptosis result from?

A

CN III injury

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7
Q

which nerves decussate?

A

optic although not truely

trochlear is only true as it does it where it starts

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8
Q

what is lymphadenopathy?

A

enlargement of lymph nodes due to infection or malignancy

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9
Q

what do the lymph nodes feel like on palpation if enlarged due to infection?

A

tender
smooth
soft

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10
Q

on palpation, what do lymph nodes feel like if malignant?

A

hard
non tender
craggy
painless

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11
Q

what symptoms accompany EBV?

A 
swollen node 
sore throat
fatigue 
fever 
painful node
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12
Q

what are the majority of head and neck cancers?

A

squamous cell

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13
Q

what is head and neck cancer associated with?

A

hpv
alcohol
smoking

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14
Q

what symptoms present with head and neck cancer?

A

sore throat
dysphagia
hoarseness
lymphadenopathy

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15
Q

how do you diagnose head and neck cancer?

A

fine needle aspiration

biopsy

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16
Q

what is an extradural haematoma?

A

seperation of periosteum layer of dura matter from cranium and a torn blood vessel bleeds into this space

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17
Q

which vessel is an extradural haematoma most commonly associated with?

A

middle menangial artery

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18
Q

if there was a subdural haemotoma in a small baby, by which route would you aspirate and why?

A

between the partietal bones and frontal because they dont fuse until later on, insert a needle into the connective tissue separating them

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19
Q

why are cervical vertebrae prone to prolapse during whiplash injuries?

A

no horizontal alignment of vertebrae

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20
Q

why might a fracture of the lower mandible result in numbness of the lower lip?

A

may involve inferior alveolar nerve as it exits mental foramen

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21
Q

how does Paget’s disease affect the skull?

A

exaggerated reabsorption and replacement
thickening, swelling and increased vascularity
severe pain
jaw enlarged and teeth fuse with bone

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22
Q

what nerve may be damaged during a forceps delivery?

A

facial as it exits the stylomastoid foramen

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23
Q

how might a patient present with a damaged scm?

A

cannot flex or laterally flex
rotated neck
spasms

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24
Q

how can scm be damaged in childbirth?

A

may be stretched in delivery and tear

tight, fibrous tissue forms

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25
Q

what might a patient present with with an aneurysm of arch of aorta?

A 
vomitting and nausea
clammy
high hr
blood clots 
thoracic pain
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26
Q

if you were to feel for the pulse in the carotid triangle, what complication may arise?

A

syncope

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27
Q

why might an infection deep in the pterygoid region endanger the eye?

A

connected to cavernous sinus which is connected to eye via superior and inferior orbital veins
can increase icp

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28
Q

why does tongue become numb in inferior alveolar nerve block?

A

lingual is near and derives from the mandibular nerve as well

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29
Q

how can the tmj dislocate on yawning?

A

if there is excessive contraction of lat pterygoids while the other muscles are relaxed

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30
Q

What is bruxism?

A

Grinding of teeth when asleep

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31
Q

What is knacking?

A

Loud sounds when the jaw displaces (cracking)

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32
Q

What is mal occlusion syndrome?

A

Muscular pain

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33
Q

What is temperomandibular pain dysfunction?

A

Muscular pain not attributable to particular structure but tight and painful jaw

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34
Q

Why can metastasis occur in the infratemporal fossa?

A

Because it is a potential space

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35
Q

What can dislocation of TMJ be caused by?

A

Fractured mandible
Blow to open jaw
Yawning or a large bite

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36
Q

what are the common bacteria causing an ear infection?

A

strep pneumonia
viruses
moraxella catarrhalis
haemophillus influenza

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37
Q

how can osteosclerosis lead to impaired hearing?

A

osteosclerosis of stapes to oval window, resulting in dampened movement

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38
Q

what can Eustachian tube dysfunction result in?

A

negative pressure in middle ear and TM being drawn in, reducing function

39
Q

what type of infection is otitis externa usually?

A

bacterial

40
Q

what colour does the tympanic membrane turn in disease?

A

red or yellow

41
Q

what would bulging of the tympanic membrane suggest?

A

fluid in the middle ear or pus

42
Q

what would a retracted tympanic membrane indicate?

A

negative pressure in the middle ear

43
Q

what is meniere syndrome?

A 
blockage of cochlear aqueduct ->
recurrent tinnitis 
hearing loss
vertigo 
pressure in ear
44
Q

what is otalgia?

A

ear pain due to infection or inflammation around ear

teeth, pharynx or cervical spine pain is usually referred to the ear

45
Q

what is pruritus?

A

itching

46
Q

name some congenital ear deformities..

A

pre auricular pit
pre auricular skin tag
pinna malformation
antihelix deformity

47
Q

what are the two types of hearing loss?

A

conductive - due to blockage

sensorineural - defect in the pathway from cochlear to brain

48
Q

what is ottorhea

A

discharge from the ear
indicates acute or chronic infection
blood or csf related to bone fractures

49
Q

what causes motion sickness?

A

otoliths are embedded along hair cells - when hair cells bend, they stimulate the vestibular nerve and provides and indication of head in space
respond to quick tilting and motion sickness is a discordance between vestibular and visual stimulation

50
Q

explain the formation of cauliflower ears

A

a haemotoma develops between the cartilage and skin and if the haematoma is not drained then it can cause scarring. it also compromises blood supply to the cartilage. so it occurs if the haemotoma is untreated

51
Q

what is acute otitis externa?

A

inflammation of the external acoustic meatus
often develops in swimmers who dont dry their ears
itching and pain

52
Q

what is otitis media

A

an infection within the middle ear and causes a bulging tympanic membrane
can cause blockage of the Eustachian tube
can lead to impaired hearing and scar ossicles
common due to strep pneumonia

53
Q

what is glue ear?

A

absorption of water and oxygen
adherence of tympanic membrane to ossicles
bacteria thrive anaerobically so you use gromets to relieve the pressure and let air in
can spread to the brain

54
Q

what is horners syndrome?

A

partial ptosis
fixed pupil
constricted pupil
may have: anihydrosis, flushing on affected side
due to a sympathetic supply being damaged

55
Q

what is anihydrosis

A

failure to sweat on one side

56
Q

what is harlequin syndrome?

A

patchy coloured face, hemifacial sweating, hemifacial flushing
doesnt neccessarily involve the eye

57
Q

what does partial ptosis result from?

A

loss of innervation of smooth muscle of eyelid

58
Q

what does paralysis of levator palpebrae superioris result in?

A

drooping of the eyelid - almost shut

59
Q

why might the eye be partially open if the levator palpebrae superioris is damaged?

A

smooth muscle of eyelid may still be working

60
Q

what does a paralysis of the orbicularis oculi result in?

A

failure to close the eye therefore cannot blink, fluid builds up, stagnation, infection of eye

61
Q

how is blinking initiated?

A 
touching cornea
irritation to cornea
foreign body to cornea
sight of something coming toward eye
drying of cornea
62
Q

how might a lesion to the abducens nerve present?

A

paralysis of the lateral rectus muscle

inability to abduct the eye

63
Q

how is abducens nerve palsy caused?

A

fracture of orbit or cavernous sinus

64
Q

how does trochlear nerve palsy present?

A

paralysis of superior oblique muscle

unable to look down when eye is adducted

65
Q

how is trochlear nerve palsy caused?

A

orbital fractures

stretching around the brainstem

66
Q

how is occulomotor nerve palsy caused?

A

loss of innervation to all eye muscles bar the SO and LR
ptosis
down and out
dilated and non reactive pupil

67
Q

how is an occulomotor nerve palsy caused?

A

involving cavernous sinus

aneurysm

68
Q

what can an increased icp lead to?

A

blindness

papiloedema

69
Q

what can a bloodshot eye result from?

A

infection
trauma
allergy
icp increased

70
Q

name 3 causes of exopthalmos

A

Graves’ disease
haematoma
aneurysm

71
Q

what is miosis?

A

constriction of pupil due to PS spinchter activation or loss of sympathetic

72
Q

what is hyphema?

A

haemorrage within the anterior chamber of the eyeball

due to trauma

73
Q

what is coloboma?

A

a loss of a section of the iris
congenital
injury
surgery

74
Q

what is presbyopia?

A

this is where the lens becomes harder and flattened with age leading to a decreased focus of lens

75
Q

what is cateracts?

A

cloudiness, harder lens, less focused

areas of opaquness

76
Q

how might a blow to the eye affect the retina?

A

may cause it to detach

complain of flashes of specks across the eye

77
Q

what is mydriasis?

A

dilation of pupil
due to underactivity of PSNS or over SNS
can be due to increased ICP

78
Q

what is gluacoma?

A

when there is an increase in pressure between the anterior and posterior chambers of the eye, because it is not being balanced as blood is not being removed and delivered at the same rate

79
Q

what muscles are paralysed during a stroke

A

facial muscles apart from the orbicularis oris and occipitofrontalis because there is bilateral innervation

80
Q

what muscles are paralysed during Bell’s palsy?

A

all muscles of facial expression

81
Q

what are the causes of facial nerve palsy?

A

idiopathic
iatrogenic
traumatic
non traumatic

82
Q

what are the non traumatic causes of facial nerve palsy?

A

inflammation
infection e.g. viral or parotitis
compression

83
Q

what are the traumatic causes if facial nerve palsy?

A

fractures
gunshots
stabbing
forceps delivery

84
Q

if facial nerve palsy is due to idiopathic causes, what is it called?

A

Bell’s palsy

85
Q

if the chorda tympani were damaged, what would present?

A

reduced salivation and loss of taste on illipsilateral 2/3 tongue

86
Q

if the nerve to stapedius was damaged, what would be affected?

A

hyperacusius

87
Q

if the greater petrosal nerve was damaged, how would it present?

A

ipsilateral reduced lacrimal fliud production

88
Q

what pathology in what bodily part can affect the facial nerve most commonly?

A

middle ear pathology e.g. tumour or infection

parotid gland pathology

89
Q

if there was an extracranial lesion of the facial nerve, what would be affected?

A

motor innervation affected

90
Q

why is there forehead sparing in a stroke?

A

because there is bilateral innervation of the orbicularis occuli and occipitofrontalis

91
Q

if there was an occulomotor palsy, proximal to ciliary ganglion, how would this present?

A

down and out
ptosis
dilation of pupil
loss of accomodation

92
Q

if there was a complete occulomotor palsy distal to the ciliary ganglion, how would this present?

A

down and out
ptosis
pupils equal
PUPIL SPARING

93
Q

if the ciliary portion of CN III was damaged but anatomical spared, how would this present?

A

loss of accomodation
dilated pupil unilateral
normal occulomotion

94
Q

how is CN III commonly damaged?

A

DM
hypertension
tumour

95
Q

how does herpes zoster present?

A

rash on ONE dermatome

Head And Neck (10 decks)

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