Clinical Features Exam 1 Flashcards
Most frequently injured nerve with blows to the face
Infraorbital nerve/ maxillary division/ trigeminal N
Bell’s palsy
Facial nerve paralysis
Impingement of CNVII
Trigeminal Neuralgia
Sudden attacks of severe pain occurring in area of sensory distribution of trigeminal N
MC - maxillary division
LC- ophthalmic division
Torticollis
Pathological contraction of SCM
Head tilted toward affected side and face tilted away from affected side
Types of Torticollis
Congenital- fibrous tissue tumor
Muscular- birth injury
Spasmodic - abnormal tonicity in adults
Prominent external jugular vein
In CHF and obstruction of SVC
Exceptions: opera singers and bagpipe players
Clinical significance of fascia layers
May be channel for infection
Potential for lung collapse with neck injury
Cervical pleura and apex of lung pass through superior thoracic aperature immediately posterior to SCM
Broken 1st rib can cause atelectasis (lung collapse)
Endemic goiter
Dietary deficiency of iodine
Hormone inactive
Symptoms of hypothyroidism
Exothalmic goiter
Autoimmune
Hormone active
Hyperthyroidism or Graves’ disease
Factors contributing to difficult thyroid surgery
Vascularity
Presence of parathyroid glands
Presence of recurrent laryngeal nerve
Unilateral damage to recurrent laryngeal nerve
Respiratory distress and partial aphonia
Bilateral damage to recurrent laryngeal nerve
Complete aphonia and possible suffocation
Causes of damage to recurrent laryngeal nerve
Trauma during thyroid surgery
Goiter or thyroid tumor
Lung tumor
Left sided aortic aneurysms
Deviated septum
Nasal septum not on median plane
Causes of deviated septum
Congenital
Birth injury
Postnatal trauma
Epistaxis
Nosebleed
Forms of epistaxis
Mild- rupture of small branches in or near vestibule, due to minor trauma or low humidity
Severe- spurting of arterial blood due to rupture of sphenopalatine artery at major anastomoses from major trauma
Paranasal sinuses
Sinusitis
Nasopharynx
Acute pharyngitis
Lacrimal apparatus and conjunctiva
Conjunctivitis via nasolacrimal duct
Middle ear
Otitis media via pharyngotympanic tube
Anterior cranial fossa
Meningitis/ brain abscess via cribriform plate
Mastoid air cells
Mastoiditis
Damage to vagus nerve
Uvula deviates to unaffected side
Ankyloglossia
Tongue tied
Ankyloglossia due to
Frenulum of tongue short S-I and long A-P, extending near apex
Clinical importance of genioglossus
Pulls tongue forward and prevents tongue from falling backwards and blocking airway
Important during general anesthesia and seizure disorders
Tooth ache vs trigeminal neuralgia
Tooth ache= 1 tooth and static
Trigeminal neuralgia= multiple teeth and dynamic
Clinical important pharyngeal tonsils
May cause difficulty breathing if enlarged
2 MC removed
Clinical significance of retropharyngeal space
Hemorrhage from cervical trauma or abscess from pharyngeal infection may cause posterior wall of pharynx to balloon forward, leading to suffocation
*look on radiology
Dysphagia
Difficulty swallowing
Anosmia
Loss of olfaction
Tympanic N / CN IX
Otitis media
Pharyngeal br / CN IX
Acute pharyngitis
Tonsillar br / CN IX
Tonsillitis
Auricular br / CN X
Otitis externa / swimmers ear
