Clinical Features Exam 1

Question 1

Most frequently injured nerve with blows to the face

Answer 1

Infraorbital nerve/ maxillary division/ trigeminal N

Question 2

Bell’s palsy

Answer 2

Facial nerve paralysis

Impingement of CNVII

Question 3

Trigeminal Neuralgia

Answer 3

Sudden attacks of severe pain occurring in area of sensory distribution of trigeminal N

MC - maxillary division
LC- ophthalmic division

Question 4

Torticollis

Answer 4

Pathological contraction of SCM

Head tilted toward affected side and face tilted away from affected side

Question 5

Types of Torticollis

Answer 5

Congenital- fibrous tissue tumor

Muscular- birth injury

Spasmodic - abnormal tonicity in adults

Question 6

Prominent external jugular vein

Answer 6

In CHF and obstruction of SVC

Exceptions: opera singers and bagpipe players

Question 7

Clinical significance of fascia layers

Answer 7

May be channel for infection

Question 8

Potential for lung collapse with neck injury

Answer 8

Cervical pleura and apex of lung pass through superior thoracic aperature immediately posterior to SCM

Broken 1st rib can cause atelectasis (lung collapse)

Question 9

Endemic goiter

Answer 9

Dietary deficiency of iodine

Hormone inactive

Symptoms of hypothyroidism

Question 10

Exothalmic goiter

Answer 10

Autoimmune

Hormone active

Hyperthyroidism or Graves’ disease

Question 11

Factors contributing to difficult thyroid surgery

Answer 11

Vascularity
Presence of parathyroid glands
Presence of recurrent laryngeal nerve

Question 12

Unilateral damage to recurrent laryngeal nerve

Answer 12

Respiratory distress and partial aphonia

Question 13

Bilateral damage to recurrent laryngeal nerve

Answer 13

Complete aphonia and possible suffocation

Question 14

Causes of damage to recurrent laryngeal nerve

Answer 14

Trauma during thyroid surgery

Goiter or thyroid tumor

Lung tumor

Left sided aortic aneurysms

Question 15

Deviated septum

Answer 15

Nasal septum not on median plane

Question 16

Causes of deviated septum

Answer 16

Congenital
Birth injury
Postnatal trauma

Question 17

Epistaxis

Answer 17

Nosebleed

Question 18

Forms of epistaxis

Answer 18

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

Question 19

Paranasal sinuses

Answer 19

Sinusitis

Question 20

Nasopharynx

Answer 20

Acute pharyngitis

Question 21

Lacrimal apparatus and conjunctiva

Answer 21

Conjunctivitis via nasolacrimal duct

Question 22

Middle ear

Answer 22

Otitis media via pharyngotympanic tube

Question 23

Anterior cranial fossa

Answer 23

Meningitis/ brain abscess via cribriform plate

Question 24

Mastoid air cells

Answer 24

Mastoiditis

Question 25

Damage to vagus nerve

Answer 25

Uvula deviates to unaffected side

Question 26

Ankyloglossia

Answer 26

Tongue tied

Question 27

Ankyloglossia due to

Answer 27

Frenulum of tongue short S-I and long A-P, extending near apex

Question 28

Clinical importance of genioglossus

Answer 28

Pulls tongue forward and prevents tongue from falling backwards and blocking airway Important during general anesthesia and seizure disorders

Question 29

Tooth ache vs trigeminal neuralgia

Answer 29

Tooth ache= 1 tooth and static Trigeminal neuralgia= multiple teeth and dynamic

Question 30

Clinical important pharyngeal tonsils

Answer 30

May cause difficulty breathing if enlarged 2 MC removed

Question 31

Clinical significance of retropharyngeal space

Answer 31

Hemorrhage from cervical trauma or abscess from pharyngeal infection may cause posterior wall of pharynx to balloon forward, leading to suffocation *look on radiology

Question 32

Dysphagia

Answer 32

Difficulty swallowing

Question 33

Anosmia

Answer 33

Loss of olfaction

Question 34

Tympanic N / CN IX

Answer 34

Otitis media

Question 35

Pharyngeal br / CN IX

Answer 35

Acute pharyngitis

Question 36

Tonsillar br / CN IX

Answer 36

Tonsillitis

Question 37

Auricular br / CN X

Answer 37

Otitis externa / swimmers ear