Clinical Applications of COMM - Treffer Flashcards
Ear
Frequency of this in infants is due to?
OM
Shorter eustacian tibe and more A/P
What bone(s) are most likely to cause constriction/blockage of eustacian tube? Where does the tube lie?
Sphenoid and temporal
It lies in the GROOVE BETWEEN THE PETROUS TEMPORAL BONE AND GREATER WING OF SPHENOID
Pain in the cranium may be due to?
Examples (2)
Distention, traction or dilation of intracranial or extracranial arteries.
Examples - MMA, superficial temporal arteries
Arteries within the dura
What nerve is associated with them?
Especially proximal parts of ACA and MCA and intracranial portion of ICA.
Trigeminal nerve
Cranial Veins within dural envelop
Superior and inferior sagittal sinus
Straight sinus
Transverse sinuses
Relationship between superior cervical ganglion (symp to head and face) with what vertebra?
Relationship of inferior ganglion of the vagus to what vertebrae?
C2
C1
Patient complains of frequent HA, stressful current job. Palapatory exam reveals hypertonic cervical muscles. You do suboccipital release.
What is the name of this HA and what nerves?
Subocciptial HEadache
Cervical Nerves - C1,2,3! (these innervate teh upper neck musculature)
Pateint has paralysis of right side of face, sudden onset, no trauma, Bells Palsy (ipsilateral dry eye and loss of taste to ant 2/3 of tongue). What nerves?
CN7
What bones does CN7 pass through?
Temporal!
Distribution of chorda tympani
What part goes to tongue/mouth?
What part goes to lacrimal gland?
Tongue - chorda tympany - lingual nerves and submandibular ganglion
Lacrimal gland -
Compression of CN& that results in Bell’s Palsy results in what symptoms?
change in taste to ant 2/3 of tongue (chorda tympani)
Unable to control affected side face muscles.
Drying of cornea - lack of lacrimation.
Correction of what for Bell’s Palsy?
marked external rotation of temporal with Sphenobasilar flexion an dSB rotation. Paralysis solved quickly.
What nerve conveys supratentorial sensory info?
What nerves convey infratentorial sensory info referred to vertex and post head and neck
What nerves refer pain to nasoprbital area, ear, throat?
Trigeminal nerve
Cervical nerves 1-3
CN7, 9, 10
Patient has lancinating pain in face. Pain is incapacitating and lasts seconds to 2 mintues. Stimulus is chewing. What is this called and what nerve?
Trigeminal Nerualgia.
V1 and V2
What does the trigeminal nerve transmit?
sensory impulses from forehead, orbit, anterror and middle fossae of the skull, and the upper surface of the tentorium
V1, V2, V3 pass through what spaces?
Standing Room Only
V1 - Superor orbital fissure (and CN3,4,6)
V2 - foramen Rotundum
V3 - foramen Ovale
FO and FR are in what bone?
Sphenoid
What bone has the trigeminal gangion? And what part of the bone?
Temporal
Meckel’s cave - superior surface of petrosal ridge of temporal bone.
What is tightly attached to the petrosal ridge of Meckel’s Cave?
If temporal bone is ER, what would this put pressure on?
Tentorium cerebri.
Pressure on structures deep to the tentories (dura mater) cerebri.
OM implicated by what bone turned in what direction?
Temporal Bone in IR
OM suture associated with drainage of what and what CN’s affected?
venous drainage, CN9, 10, 11q
Bell’s Palsy - what CN and what bone and what exit?
CN7, temporal bone dysfunction, exits stylomastoid foramen
