Clinical Correlates FINAL Flashcards
uncinate fits
seizures originating in the uncus, a region of the temporal lobe, are preceded by hallucinations of unpleasant odors and sometimes taste (warning)
what is anosmia?
caused by?
loss of olfaction
- contralateral nostril can compensate for unilateral anosmia, so it can go unnoticed by patient
- causes: head trauma, viral infections, intracranial lesions, nasal passage obstruction, Kallmann syndrome, overgrowth of muscus over cilia
Kallmann syndrome
genetic disorder
*marked by delayed puberty and a lack of smell; connected to ANOSMIA
CSF rhinorrhea
how is this tested????
fracture of cribiform plate due to trauma can rupture the cranial meninges, causing a CSF leak through the nose bc it shears dura
- if left untreated, may lead to secondary bacterial infection such as MENINGITIS
- **HALO TEST= drop of blood on papaer and if a shadow around outside occurs then there has been damage to cribiform plate
bitemporal hemianopia
damage at the optic chiasm, as the result of a tumor or aneurysm, may present as loss of vision in lateral fields (bitemporal hemianopia)
- typically caused by problem with pituitary gland like a tumor causing compression on optic chiasm
- ***First symptom is visual loss
orbital blowout
- occurs medially and inferiorly involving the MX bone
- contents may prolapse and become entrapped in the MX sinus
- diplopia, globe ptosis, exophthamlos (protrusion of the eyeball)
pink eye
inflammation of the conjunctiva
dry eye syndrome or cysts
Give examples
dysfunction of the sebum
Ex: Chalazia or Stye!!!!
- chalazion is chronic inflammation in oild producing gland
- stye is from bacteria in gland at base of eyelid
CN 3 lesion
oculomotor nerve palsy
- ‘down and Out’ syndrome
- dilated, down and out pupil; ptosis
- dilated caused by para response which is dominate at rest
- dilate is sym
CN 4 lesion
trochlear palsy
- pupil drift is opposite normal function so it goes UP and IN
- diplopia
CN 6 lesion
abducens nerve palsy *pupil drift is medial *cannot fully abduct affected eye ***may turn head to compensate clinical signi is STAGNUS
lazy eye
typically a weakness of a specifica muscle (or possible problem with nerve)
what is Ludwig’s Angina?
commonly caused by?
do what ASAP?
- severe cellulitis from bacterial infection in the floor of oral cavity
- 2nd to sublingual or submandibular infections (molar abscess)
- may spread to neck and block airway— intubate ASAP
- more common in kids
- can spread contralaterally bc there is no midline boundary
retropharyngeal abcesses
- common in <5 yrs old due to increased prevalence of middle ear infections and nasopharyngeal infections
- **affects both true and false retropharygeal space; pocket develops and blocks airways and causes probs swallowing
tontillitis
inflammation of tonsils
- commonly taken out if have chronic infections like strep throat or a lot of ear infections
- commonly taken out of children, bc adults are pron to more complications due to more vasculature
horner’s syndrome definition?
results from interruption of cervical sympathetic trunk and is manifested by the absense of sympathetically stimulated functions on the ipsilateral side of the head
horner’s syndrome symptoms?
-constriction of pupil (miosis)
-drooping of superior eyelid (ptosis)
-‘sunken in’ eye (enophthalmos)
redness and increased temp of skin (vasodilation)
-absence of sweating (anhydrosis)
etiologies of horner’s syndrome include?
cluster migraines, trauma, cerebral vascular accident, cavernous sinus lesion, infections, aortic dissection, carotid dissection, and pancoast tumor
CN 7 lesion
Bells Palsy or CN 7 palsy
- -Presentation- dry eye/mouth, facial muscles paralysis, decreased taste, sensititve to sound
- -mastobrious presentation for most distal part that can be affected
CN 9 lesion
CN 9 palsy- rare, isolated, hard to detect
- May have altered gag reflex possible and glossopharyngeal neuralgia is possible
- 40-60 year old FEMAKES
- painin ipsilateeral ear
- bradycardia (slow heart) association
*paralysis of stylopharyngeus, unilateral denervation of posterior 1/3 tongue and unilateral decrease in parotid secretion WILL LIKELY GO UNNOTICED
CN 10 lesion/palsy
hoarseness of breath is classic!
*L palsy= L side droops
possible:
- dysphagia
- deviation of uvula to contralateral side
- ageusia =ALTERED TASTE
- altered gag reflex
- GI dysfunction
CN 8 lesion
vestibulocerebellar lesions
midline cerebellar disease
results in:
- nystagmus (can’t focus eyes)
- truncal ataxia (can’t maintain trunk posture)
- ataxic gait (fall a lot to lesion side)
cavernous sinus thrombosis
spread of clot from an infection (septic thrombi) into cavernous sinus typically from MX teeth, MX sinus, hair follicle
**usually staph aurius
results:
- periorbital edema (swelling)
- ophthalmoplegia (paralysis of muscles bc 3,4 and 6 squished)
- facial analgesia (ONLY V1 andV2)****
- initially unilateral symptoms, usually presents bilaterally
presbycusis
natural hearing loss due to age
-afftects higher pitches first
-affects men and women, men more
(CN 8)
idiopathic
sudden sensorineural hearing loss (ISSHL)
- due to viruses
- can come back
- TRANSIENT- comes and goes
carotid endarterectomy
devel of plaque causes narrowing of passageway for blood so you remove it
- 5-7% of these procedures have unilateral lesions to branches of CN 10
- CN 10 most frequent bc internal jugular vein and carotid and CN 10 are together in common sheath
- RESULTS= hoarse voice, dysphagia, stroke
CN 11 lesion
1) torticollis- abnormal contraction of SCM due to issue with muscle or CN 11
- -If R is contracted the chin poins L, so R is side with issue
2) typically only affects trapezius
- check by shrugging shoulders, the side that can’t shrug is affected
CN 12 paralysis
- unilateral lesion to the hypoglossal nerve results in paralysis of the ipsilateral tongue
- when tongue is protruded the apex deviates to the AFFECTED side (bc heathy side dominates)
