Clinical Correlation Flashcards by Lashunda Fletcher

The subclavian vein puncture is not without complications because a misplacement of a needle can puncture what structure?

Apical pleura— producing a pneumothorax

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What are important complications if the internal jugular vein needle is displaced?

carotid artery

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What is the clinical significance of jugular pulse?

Can assess the venous presuress and waveform–reflection of the functioning of the right side of the heart.

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What is the usual symptom on thyroglossal duct cyst?

a midline mass—hyoid bone and entire duct must be surgically removed

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What structures can be ligated or damaged during a thyroidectomy?

Recurrent laryngeal and parathyroid glands

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Euthyroid is

normal thyroxine levels

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Most common disorder of the thyroid gland is

Multinodular goiter —thyroid hypertrophy and colloid cyst formation

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What hormone is overstimulated and causes atrophy of thyroid gland?

Thyroxine

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Myxedema is

under secretion of thyroxine

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Ectopic parathyroid glands

parathyroid glands fail to descend from pharyngeal pouches–high in neck or thorax

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What causes recurrent laryngeal palsy?

Disruption of the recurrent laryngeal nerves anywhere along its path or disruption of the vagus nerve before it splits—can cause hoarseness in patients

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Aortopulmonary window

cancer is between the pulmonary artery and aorta– can affect left recurrent laryngeal nerve

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Cancer in the apex of the right lung can affect what structure?

Right recurrent laryngeal

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What is the clinical significance of the cricothyroid ligament/membrane?

Gives access to the lower airway when the upper airway is blocked

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The external ear (external acoustic meatus) is investigated by what device?

Ostoscope

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The middle ear and inner is examined by what device(s)?

CT or MRI

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What is otitis externa?

Also known as swimmer’s ear and is a painful infection in the external acoustic meatus

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What is surfer’s ear?

most common in ppl who surf—- “bony lump” in the external acoustic meatus, reduces hearing of infected ear

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What is otitis media?

common infection of the middle ear which can lead to perforation in tympanic membrane.

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What is mastoiditis?

A secondary infection that spreads from the mucosa lining of the inner ear to the mastoid cells.]

Infection of the bone can spread to middle cranial fossa

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Labyrinth hydrops (edema) or excessive fluid in the endolymphatic sac is associated with what infection of the ear?

Meniere’s

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Meniere’s causes what symptoms?

Vertigo, roaring noises, or hearing loss, balance loss due to excess fluid pressure

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What is acoustic nueroma?

That is when there is a tumor on CN 8—vestibular shawnnoma

unilateral hearing

can compress brain

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Injury to lingual nerve where it meets the chorda tympani will cause a loss of sensation where?

anterior two-thirds of tongue, oral mucosa, gingivae, the lower lip, and the chin

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If there is a lesion distal to site where lingual is joined by chorda tympani then what sensation will be lost?

secretion from salivary glands below oral fissure and taste from anterior two thirds of the tongue

What can cause extradural hematoma?

Blows to the head which damages the meningeal arteries thus causing blood to leak---under arterial pressure---slowly detaches dura mater from its bone

Why can backflow of anaesthetics occur into tissues or the cranial cavity of the veins of head and neck?

there are no valves in the veins---particularly the pterygoid plexus

How can infections can spread into the cranial cavity from structures drained by the pterygoid plexus?

Through emissary veins which pass through the foramen ovale and through the cartilage that feels the foramen lacerum--medial to the pterygoid process at the base of the skull

Bell's palsy

intracranial lesion of facial nerve

Extracranial lesion of the facial nerve causes what symptoms`

paralysis of facial muscles | happens distal to stylomastoid foramen

Frey's disease

due to injury of auriculotemporal nerve of parotid gland---face swelling in the presence (or thinking of) food after a parotidectomy

What tumor of the right lung can cause Horner's syndrome?

Pancoast tumor because it involves sympathetic ganglion

What nerve is compressed during someone's course of having mumps?

The auriculotemporal nerve

Metalic taste in mouth and and dizziness is due to a possible leak of what fluid through the dura mater?

CSF

Infection of leptomeninges and causes Kernig's sign is

meningitis

Blood within the subarachnoid space --intracerebral bleed is due to what? and can be treated by cannulation of what artery?

intracerebral aneurysms femoral artery

What type of fracture will show air within the orbit?

Medial wall fractures of the orbit

Blockage and inflammation of eyelash follicles or sebaceous sweet glands results in what?

Stye

What is a chalazion?

Blockage and inflammation of a tarsal gland and is on the inner surface of eye.

Drooping of upper eyelid affects what two muscles?

Superior tarsal muscle or legatos palpebrae superioris muscle

Drooping of lower eyelid and inability to close eyelid is due to loss of innervation of what nerve?

Facial nerve (CN VII)

What is Horner”s syndrome caused by?

A lesion that leads to the lost of sympathetic function in the head.

What are symptoms of Horner’s Syndrome?

* pupillary constriction due to paralysis of dilator papillae muscle * partial ptosis (drooping of upper eyelid) * absence of sweating to face and neck * vasodilatation

What is glaucoma?

Increase of intra-ocular pressure in relation to the aqueous humor.

What is cataracts?

The lens become opaque or cloudy.

What causes the formation of a cleft lip?

When the medial nasal prominence and maxillary prominence fail to fuse?

What causes cleft palate?

When the palatal shelves fail to fuse in the midline .

What structure can cause the spread of bacteria to the mastoid air cells.

The Eustachian tube (pharyngotympanic tube) because is mucosa lining is continue with that of mastoid antrum of the middle ear.

If a patient is asked to track a physician’s finger laterally and then upward, which of the following muscles is being tested?

Superior rectus

Which artery supplies the posterior part of frontal, parietal and medial portions of temporal lobe?

Middle cerebral artery

An infection of the infra-temporal fossa could reach the pterygopalatine fossa through which structure?

Pterygomaxillary fissure

What muscles does the infra-temporal fossa consists of?

Muscles of mastication and lateral and medial pterygoid muscles

What nerves pass through the infratemporal fossa?

Mandibular and it’s branches (auriculotemporal, Buccal, lingual and inferior alveolar nerves) Chorda tympani (branch of facial nerve) Otic ganglion (a parasympathetic collection of neuron cell bodies—for parotid gland)

What vasculature of the infra-temporal fossa can be the route of which infection?

Pterygoid venous plexus which drains the eye and is directly connected to cavernous sinus

What nerve passes through the pterygopaltine fossa?

The Maxillary branch and its branches (infraorbital, zygomatic, nasopalatine, superior alveolar, pharyngeal and greater and lesser palatine nerves). And pterygopalatine ganglion

The pterygopalatine ganglion consists of what type of fibers?

Postganglionic parasympathetic fibers that runs with maxillary nerve to supply mucosal and lacrimal glands

Where is the maxillary nerve most likely to be approached during an extensive dental surgery

Greater palatine fossa

The laryngeal muscle most responsible for stretching the vocal ligament is?

Cricrothyroid

To isolate the function of the superior and inferior rectus muscles, the patient is asked to track the physician’s finger

Laterally and up or down

After turning the eye inward toward the nose an inability to look downward most lifelike involves which of the following nerves?

Trochlear nerve

The outermost later of the optic nerve sheath is a continuation of the ______.

Meningeal dura

Which of the following structures serves as a venous conduit between the facial and and pterygoid plexus of veins to the cavernous sinus?

The emissary veins

The greater Petrosal nerve (branch of facial nerve) carries what type of fibers and continue as what nerve after it joins the deep petrosal nerve?

Carries preganglionic parasympathetic innervation (secretomotor for lacrimal gland) and continues as nerve to pterygoid canal

What kind of fibers does the pterygopalatine ganglion has ?

Postganglionic parasympathetic fibers

Deep petrosal nerve is a branch of what and carries what type of fibers?

Superior cervical plexus and postganglionic sympathetic fibers