Clinical Applications of Anatomy Flashcards
What is the indications for cricothyrotomy ?
Emergency airway e.g. anaphylaxis.
What is a cricothyrotomy ?
Cricothyroid ligament pierced with fine 1mm needle when occluded airway.
What is a goitre ? And what conditions is it commonly associated with ?
Enlarged thyroid gland. Commonly seen with Grave’s disease and iodine deficiency.
What is another symptom of Grave’s disease ?
Exopthalmos of the eye, also known as ocular proptosis.
What is congestive cardiac failure ?
EJV distension.
What is temporal arteritis (also known as Horton’s disease) ?
Inflammation of artery (most commonly superficial temporal), leading to reduced oxygenated supply.
What are the symptoms of Horton’s disease (temporal arteritis) ?
Blindness and stroke.
What is Paget’s disease ?
Disease of bone causing thickening and disorganisation of skull.
What are the clinical implications of Paget’s disease ?
Blindness and deafness.
Tumour of the bone marrow cells - what is the name of this malignancy ?
Multiple myeloma.
Where is the most common site and vessel for extra-dural haemorrhage ?
Pterion and middle meningeal artery.
What two main cranial nerves are affected by a stroke in the internal capsule ?
Facial (CNVII) and hypoglossal (CNXII).
Why are the facial and hypoglossal cranial nerve affected most by a stroke ?
Both cross over and do not innervate the same side (apart from facial nerve to forehead). Results in contralateral facial and hypoglossal symptoms.
What is Horner’s syndrome ?
Damage of cervical sympathetic trunk leading to damage of sympathetic functions of the face.
What are the symptoms of Horner’s syndrome ?
Loss of sweating on one side of face, constricted pupil and drooping of eyelid.
What nerve can be affected by swelling of the parotid gland ?
Glossopharyngeal (CNIX), due to pressure on nerve supplying the gland.
What is the name of the condition where a patient suffers severe pain in their face for no known cause ?
Trigeminal neuralgia.
What are the treatment options of trigeminal neuralgia ?
Carbamazepine, alcohol injection to foramen oval through mouth to cause necrosis and removal of part of the nerve.
What is anatomically significant about mandibular third molar extractions ?
Proximity to lingual nerve behind third molar.
When is a tonsillectomy indicated ?
Recurrent tonsillar infections in one year.
What is chronic otitis media ?
Infection of middle ear leading to tympanic membrane perforation. Pus can leak into external auditory meatus.
What are the symptoms if a posterior cerebral artery is affected by a stroke ?
- Contralateral homogenous hemianopia with macular sparing (visual field loss).
- Visual agnosia (recognition of objects) more commonly if left affected.
- Memory impairment (due to medial aspect of temporal lobe affected).
What are the symptoms if a middle cerebral artery is affected by a stroke ?
- Contralateral hemiparesis and sensory impairment, face and arm (as pre and post-central gyri supplied, pre and post motor cortex).
- Contralateral homogenous hemianopia (visual field loss).
- Aphasia (more commonly if left affected, hypoglossal no colateral).
- Anosognosia - impaired ability to understand illness (more commonly if right affected).
What are the symptoms if a anterior cerebral artery is affected by stroke ?
- Contralateral hemiparesis and hemisensory loss, leg and foot (paracentral lobule of cortex).
- Inability to identify objects.
- Apathy.
- Personality changes.
Where does bleeding occur in an extradural cranial haemorrhage ?
Between periosteum and dura.
What blood vessel is most commonly affected in extradural cranial haemorrhage ?
Middle meningeal.
How quickly to symptoms appear in extradural cranial haemorrhage ?
Within 24 hours.
What is the most common cause of extradural cranial haemorrhage ?
Trauma.
What are the symptoms of extradural cranial haemorrhage ?
Loss of consciousness.
Confusion.
Dilated pupil of contralateral eye.
Headache.
Nausea.
Where does bleeding occur in a subarachnoid cranial haemorrhage ?
Between pia and subarachnoid i.e. subarachnoid space.
What blood vessels are most commonly affected by subarachnoid cranial haemorrhage ?
Cerebral arteries.
How quickly do symptoms arise in subarachnoid cranial haemorrhage ?
Within minutes.
What is the most common cause of subarachnoid cranial haemorrhage ?
Berry aneurysm - out pouching of cerebral artery causing weakness to wall and ultimately rupture.
What are the common symptoms of subarachnoid cranial haemorrhage ?
Severe headache.
Stroke like symptoms - weakness, facial palsy, slurred speech.
Photophobia.
Nausea.
Double vision.
What blood vessel is most commonly affected in subdural cranial haemorrhage ?
Bridging cerebral veins and rupture in weakened dura.
Where does a subdural cranial haemorrhage occur ?
Between meningeal dura and subarachnoid layer.
How quickly do symptoms arise in subdural cranial haemorrhage ?
Very slowly.
Who is most affected by subdural cranial haemorrhage ?
Elderly - small trauma or weakening blood vessels due to age.
What are the most common symptoms of subdural cranial haemorrhage ?
Personality change.
Headache.
Confusion.
