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Anatomy (Block 3) > Clinical Correlates > Flashcards

Clinical Correlates Flashcards

1
Q

Plagiocephaly

A

Premature fusion of 1 side of either the coronal suture or lambdoidal sutures (sometimes both)

  • stimulated by environmental/positioning remodeling
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2
Q

Craniosynostosis

A

Deformities that result from premature closure of a cranial sutures, usually genetic based but can be environmental

  • asymptomatic but can be symptomatic if severe
  • growth of brain occurs to the opposite side of the premature closure
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3
Q

Positional plagiocephaly (oblique head/ flat head syndrome)

A

Common condition of cranial malformation generally due to repetitive positioning during baby.

  • usually results in a oblique slant to the sagittal axis with one side protruding or “bossing” and the other side flattening
    (Contralateral and ipsilateral bossing and flattening)
  • treated via Dynamic Orthotic Cranioplasty (DOC) bands which force the skull back into normal shape
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4
Q

Scaphocephaly

A

Premature fusion of the sagittal suture (40-60%)

  • causes compensated growth along the lambdoidal and coronal sutures
  • most common type of craniosynostosis*
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5
Q

Brachycephaly

A

Premature fusion of the coronal suture (20-30%)

  • causes compensated growth laterally along sagittal sutures
  • second most common type of craniosynostosis*
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6
Q

Plagiocephaly

A

Premature fusion of 1 side of the crania, either the coronal or lambdoidal sutures (4%)

  • causes compensational growth along the opposite side
  • 2nd rarest craniosynostosis*
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7
Q

Trigonocephaly

A

Premature fusion of the metopic suture (10%)

  • causes compensational growth laterally and posteriorly (flat head)

Type of craniosynostosis

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8
Q

Clover leaf craniosynostosis

A

premature fusion of the coronal, lambdoidal, sagittal sutures

  • causes compensational growth in the shape of a clover leaf
  • most rare form of craniosynostosis*
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9
Q

Microcephaly

A

Premature fusion of all sutures and fontanelles during early cranial development.

  • causes decreased brain and cranium growth and severe mental/cognitive dysfunctions
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10
Q

Hydrocephaly

A

Congenital inability to absorb cerebral spinal fluid resulting in overproduction of it in the cranium
- usually caused by nonformation of a shunt from the CSF -> venous system

Increases intracranial pressure and causes hypertrophic growth of the calvaria (skull) bones along the sutures (Big head)

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11
Q

Le fort fractures

A

Fractures of the maxilla. Three types

1) horizontal fractures that pass superiorly to the maxillary alveolar process (roots of teeth)
- may or may not cross into the nasal septum and pterygoid plates

2) fractures that pass posterolateral from the maxillary sinuses through the infraorbital foramina and lacrimal foramina to the bridge of the nose
- this results in the entire central face to be separated from cranium

3) horizontal fracture that passes through superior orbital fosses and the ethmoid bone to the greater wings of the sphenoid and zygomatic sutures
- can result in maxilla and zygomatic bones along with the central face to separate from cranium

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12
Q

Cephalohematoma

A

Bleeding that occurs between a babies pericarnium layer of the scalp and calvaria bones and results from excessive trauma during birth.

  • this blood becomes trapped and forms a hematoma that is usually benign
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13
Q

Bell palsy

A

Injury or inflammation via viral infections to the facial nerve (CN7) or its branches on one side causes a perminant passive or sad face appearance on that side/area.
- caused by loss of loss of Tone in the obicularis oculi

Symptoms:

  • sad/ passive appearance
  • very dry cornea (susceptible to ulceration/scaring if untreated)
  • can prevent mastication and slurred speech
  • cannot whistle and present with drainage from lacrimal and salary glands (drooling)
  • can have skin irritations
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14
Q

Trigeminal Neuralgia (Tic douloureux)

A

Sensory dysfunction in CN 5 with idiopathic causes

  • all 3 branches of CN5 are susceptible, however the following is the order of most common to least common
    1) V2
    2) V3
    3) V1

Symptoms:

  • most common in elderly patients
  • paroxysm (sudden sharp pain) in the facial region can induce twitching
  • depression
  • difficulties eating, brushing teeth, shaving, etc.
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15
Q

Herpes zoster infection of the trigeminal (CN5) ganglion

A

Eruption of herpes vesicles along the sensory path way of the affect branch(s)

  • most common branch affect is V1 (ophthalmic)
  • can produce coronal ulceration and scarring of the cornea
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16
Q

Buccal nerve block

A

When preforming any cheek surgeries/operations, the buccal nerve must be blocked

  • site of anesthesia is into the retromolar fossa which is a triangular depression posterior to the 3rd molar tooth and between the anterior border of the ramus and temporal crest
  • open mouth wide and place your tongue behind your last molar, this is the area*
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17
Q

Infraorbital nerve block

A

When treating wounds of the teeth, upper lip or cheek, anesthesia into the infra orbital nerve must be obtained

  • site of anesthesia is in the superior aspect of the oral vestibule, to determine where specifically on this aspect, pressure is applied around it and where ever pain occurs is the site
  • inside the mouth, most superior part to the 1st molar (usually but can vary) and on the anterior gum line*
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18
Q

Scalp infections

A

The loose connective tissue layer of the scalp, “often referred to as the danger zone of the scalp”, is very susceptible to infection since pus and blood spread easily to this site.

  • infections here can also pass into emissary veins which take the infection into the cranium
  • ecchymoses in the eyelids with no reported trauma is a cardinal sing of a scalp infection that has spread*
  • a scalp infection cannot pass into the neck due to occipital bellies and also beyond the zygomatic bones due to the epic racial aponeruosis
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19
Q

Difference between superficial and deep scalp lacerations

A

Superficial: has not penetrated the cranial aponeurosis
- do not gape and do not require sutures

Deep: has penetrated the cranial aponeurosis
- do gape (very wide in the coronal region if the laceration is here) and require sutures to heal

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20
Q

Malar flush

A

Rash that breaks out along the zygomatic bone outline

  • indicative of certain diseases, must commonly associated with lupus and TB infections
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21
Q

Fractures of mandible

A

Usually results in two fractures, not just one.

- only exception is a fracture of the coronoid process of the mandible, however this is extremely rare

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22
Q

Resorption of alveolar bone

A

Extraction of teeth causes alveolar bone to resort in the regions
- causes bone loss in the alveolar bone, but filling of the tooth cavity with bone

can result in exposure of the mental foramina which can result in mental nerve impingement

23
Q

Fractures of the calvaria

A

Usually result in comminuted depressed fractures

Most common type is a linear fracture which occurs at the site of impact and spreads out ward

  • rare type is contrecoup (counterblow) fractures where a depressed fracture occurs directly opposite of the site of force*
24
Q

Meningitis

A

Infections of the leptomeninges usually caused by bacteria, virus or fungal infections
- bacterial is the most serious

Symptoms:

  • headache
  • fever and chills
  • stiff neck
  • vomiting
  • cardinal sign of meningitis is cloudy CSF with increased number of proteins*

Viral meningitis = normal glucose w/ lymphocytes in CSF

TB meningitis = decreased glucose w/ lymphocytes in CSF

Bacterial meningitis = decreased glucose w/ polymorphonuclear leukocytes in CSF

25
Q

Meningiomas

A

Tumors that arise from meninges
- idiopathic causes but seem to be relegated to chromosome 22

Surgical removal or radiation kills the tumors

26
Q

Vertebral-basilar circulation

A

Includes the vertebral arteries, the basilar artery, and the basilar artery branches

This circulation supplies medulla, pons, mesencephalon and cerebellum

27
Q

Vertigo/ Meniere disease

A

Bursting of the membranous labyrinth caused by excess endolymph production or blockage of the endolymphatic duct

Marked by tinnitus, hearing loss and vertigo

  • ballooning of the cochlear duct, saccule and utricle*
28
Q

Tinnitus

A

Ringing of the ear via prolonged exposure to Loud noises

29
Q

Ottis media

A

Infection of the middle ear usually secondary to upper respiratory infections

Earache and a bulging red tympanic membrane indicates this

Can produce impaired hearing via scarring if left untreated

30
Q

Ottis externa

A

Infection/inflammation of the external acoustic meatus
-usually develops from water in the ear or bacterial infections

Marked by redness of the outer ear and pulling on the auricle/Tragus causes pain

31
Q

Mastoidits

A

Infections of the mastoid air cells that results in a middle ear infection and inflammation of the mastoid process

Infection can spread into middle cranial fossa and cause Osteomyelitis if untreated

32
Q

Motion sickness

A

Discordance between the vestibular and visual stimuli

Caused by otoliths not functioning properly for linear/ angular acceleration

33
Q

Subarachnoid hemorrhage

A

Usually caused by rupture of one or more of saccular aneurysms

Mixes with CSF as well and is caused primarily by head trauma
- presents with yellow CSF = indicative of RBCs

34
Q

Septic thrombosis of cavernous sinus

A

Infections from orbit, paranasal sinuses or face cause thrombi into the cavernous sinus

Can affect abducens, oculomotor, trochlear, ophthalmic and maxillary nerves

35
Q

Strokes (cerebrovascular accidents)

A

Disruption of normal blood flow of brain resulting in death of brain cells.

  • most common neurological disorders in US adults*

Cardinal symptom is sudden neurological symptoms out of nowhere

Two types ischemic (blockage) or hemorrhagic (bleeding)

36
Q

Cerebral herniations

A

Herniations of brain into one of three compartments

  • infratentorial
  • right and left supratentorial

Caused by lesions/tumors

Most common types are the following

  • subfalcine = inferior, free border of falx cerebri
  • tentorial = around border of tentorial notch
  • tonsillar = cerebellar tonsils through foramen magnum
37
Q

Epidural hemorrhage

A

Caused by lesion or vessel burst with blood pooling between the caval bones and the periosteal layer of the dura mater.

38
Q

Subdural hemorrhage

A

Blood pooling between the meningeal dura layer and the arachnoid layer

Usually a result from dural venous lesions/bursts

39
Q

Saccular/berry aneurysms

A

Most common form of cerebral aneurysms

  • most commonly occurs when circle of Willis needs to anastomosis
  • this causes a subarachnoid hemorrhage if it ruptures*
40
Q

Concussion

A

Head injury with temporary loss of brain function

  • can cause loss of consciousness but not always

Symptoms tend to resolve after one or two days but can persist for months as post-concussion syndrome
- only roughly 15% of cases escalade to this

41
Q

Cerebral contusion

A

Brushing of the brain by forceful contact between inner surface of skull and polar regions of cerebral hemispheres via head trauma

Edema levels often decide degree of symptoms

Develops scars after macrophages engulf and destroyed bruised brain tissue
- usually doesn’t require surgery though

42
Q

Non-communicating vs communicating hydrocephalus

A

Non-communicating = obstruction of CSF within ventricular system and leads to dilation of ventricles
- usually cerebral aqueduct or intraventricular foramen

Communicating = obstruction of CSF outside ventricular system
- usually by impaired reabsorption from the arachnoid granulations, or overproduction of CSF

43
Q

Leakage of CSF

A

Fractures of floor of the middle cranial fossa as well as tympanic membrane rupture can lead to CSF leakage from external acoustic meatus (CSF otorrhea)

Fractures of the anterior cranial fossa and cribiform plate May result in CSF leakage through nose (CSF rhinorrhea)

  • both causes major increase in meningitis chances*
44
Q

Guillian-Barre syndrome

A

Inflammation disease in CSF and CNS that causes demyelination of axons in peripheral nerves

CSF notes massive increase in proteins with normal glucose and some WBC

45
Q

Hyperthyroidism

A

Overactive thyroid that results in multiple symptoms surrounding increased metabolism

Almost never caused by too much TSH being released

is almost always found in Graves’ disease where you get enlarged bulging eyes

46
Q

Hypothyroidism

A

Underactive thyroid

Symptoms surround slow metabolism specifically weight gain and exhaustion

47
Q

Goiter

A

Massively enlarged thyroid caused by a lack of iodine in the diet

48
Q

Lingual/ectopic thyroid

A

Thyroid fails to descend during development and stays behind the tongue

49
Q

Branchial cysts

A

Embryological Grooves do not obliterate and remain, filling with fluid or draining fluid to external surface (leaking)

50
Q

Pharyngeal arch syndrome

A

Insufficient migration of neural crest cells into the arches during week 4 can cause cartilages to not degrade normally

Causes variety of congenital defects in the eyes, ears, mandible and palate

51
Q

Treacher-Collins syndrome

A

Underdevelopment of the zygomatic bones via 1st arch defects

Symptoms are

  • under developed jaw
  • underdevelopment of zygomatic bones
  • retracted tongue
  • poor teeth
  • external ear defects

Causes abnormalities to the external, Middle and inner ear

Hearing, seeing and breathing can all be affected

52
Q

Pierre robin sequence

A

Underdeveloped mandible, cleft palate and defects of the eye and ear via 1st arch defects

Symptoms

  • hypoplastic mandible
  • bilateral cleft palate
  • defects of the eyes and eats
53
Q

Cervical (branchial) cysts

A

Cervical sinus/2nd groove remnants remain and form cysts that grow overtime

Usually found in the neck inferior to the ankle of the mandible (gonion)

Not usually apparent under early adulthood

54
Q

Cervical (branchial) fistula

A

Abnormal canal that opens into the tonsillar sinus, through the neck and then ultimately into the carotid stealth

Caused by persistence of both the 2nd groove and 2nd pouch

Anatomy (Block 3) (10 decks)

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