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Head & Neck > clinical LOs > Flashcards

clinical LOs Flashcards

1
Q

what sxs are associated with infection in the retopharyngeal space

A

dysphagia, dysphonia

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2
Q

under what circumstances does a hyoid fx usually occur

A

strangulation

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3
Q

what are the sxs of hyoid fx

A

dysphagia, difficulty maintaining separation btwn GI and respiratory tracts

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4
Q

under what circumstances does fx of laryngeal cartilage occur

A

anterior blow to the neck

usually in sports or MVA

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5
Q

what are the sxs of congenital torticullus

A

face looking away from affected side

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6
Q

what complication can arise from congenital torticullus

A

development of a hematoma which can impinge CN XI

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7
Q

what are the sxs of laryngeal cartilage fx

A

submucosal hemorrhage and edema
respirtatory obstruction
hoarseness/temporarily ability to speak

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8
Q

what is spasmodic torticullis

A

abnormal tonicity of cervical ms

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9
Q

what CN is affected in a stroke/intracranial hematoma

what are the associated sxs

A

CN VII

facial paralysis on contralateral side

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10
Q

lesions in what area are associated w/ olfactory hallucinations

A

temporal lobe of the cerebral hemisphere

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11
Q

how will the optic disc appear on ophthalmic exam in pts with optic neuritis

A

pale and unusually small

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12
Q

increasing intracranial pressure from an extradural hematoma often compressed what nerve against what structure

A

CN III compression against petrous part of temporal bone

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13
Q

why would CN VI be affected by an atherosclerotic internal carotid

A

they closely related in the cavernous sinus

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14
Q

which CN is most frequently paralyzed

A

CN VII

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15
Q

what structures are affected in conductive deafness

A

external and middle ear

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16
Q

what structures are affected in sensorineural deafness

A

cochlea, pathway from the cochlea to the brain

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17
Q

what is an acoustic neuroma

A

a slow-growing, benign tumor of the internal acoustic meatus

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18
Q

what structure is damaged in Horner’s syndrome?

A

cervical sympathetic trunk

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19
Q

what are the sxs of Horner’s syndrome

A

ptosis
miosis
anhydrosis
vasodilation

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20
Q

structures affected in le fort I

A

maxillae above alveolar process (roots of teeth)
bony nasal septum
possibly pterygoid plates

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21
Q

structures affected in le fort II

A

bridge of the nose
maxillary sinuses
hard palate & alveolar processed are separated from cranium

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22
Q

structures affected in le fort III

A

superior orbital fissues
ethmoid and nasal bones
greater wings of sphenoid
frontozygomatic sutures

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23
Q

what is the difference btwn craniotomy and craniectomy

A

in a craniotomy, the bone flap is replaced following surgery

in a craniectomy, a plastic or metal plate is put in its place

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24
Q

where will aberrant thyroid glandular tissue be found

A

along the embryonic thyroglossal duct

25
Q

in what circumstances would a thyroglossal duct cyst need to be removed

A

if it is causing dysphagia or issues w/ hyoid bone

26
Q

what structure may be absent in a pt with a pyramidal gland lobe of the thyroid gland

A

isthmus of the thyroid gland

27
Q

from what three structures might a thyroid ima a. arise

A

aorta
brachiocephalic trunk
common carotid

28
Q

why are children at increased risk of ear infection

A

pharyngotympanic tube lies flat until adulthood, allowing fluid to accumulate

29
Q

what is a cricothyrotomy and when is it performed

A

needle passed through cricothyroid membrane to permit air to enter
emergency, when intubation is not possible

30
Q

what are the steps of tracheostomy

A

incision at 2nd or 3rd tracheal ring => separation of infrahyoid ms => removal/retraction of isthmus of thyroid => insert tube into trachea to establish airway

31
Q

what causes the voice to change at puberty

A

increase testosterone => increase in size of laryngeal cartilages

32
Q

what causes the voice to change with aging

A

calcification of the thyroid gland

33
Q

what is a brachial fistula a remnant of

A

2nd pharyngeal pouch & groove

34
Q

what is a brachial sinus a remnant of

A

cervical sinus

35
Q

what structures are removed in a tonsilectomy

A

palatine tonsils, pharyngeal tonsils usually removed also

36
Q

what is a complication of adenoiditis?

A

pharyngeal tonsils can obstruct nasal passageways => hearing impairment and otitis media

37
Q

where do tonsil stones form

A

crypts of palatine tonsils

38
Q

what is vertebra-basilar insufficiency

A

decreased posterior circulation due to occlusion of vertebral a

39
Q

sxs of vertebra-basilar insufficiency

A 
syncope, vertigo, dizziness
slurred speech
diplopia/vision loss
loss of coordination
n/v
40
Q

what is subclavian steal syndrome

A

proximal stenosis or occlusion of subclavian => reversal of blood flow through vertebral a. to supply UE => decreased blood flow to the brain

41
Q

sxs of subclavian steal syndrome

A

syncope, neurologic defecits

can be associated w cervical rib

42
Q

why do scalp wounds bleed profusely

A

arteries of the peripheral scalp have abundant anastomoses

arteries are held open by dense CT

43
Q

through which layer of the scalp does infection spread

A

loose CT layer

can enter cranial cavity via emissary vs

44
Q

what nerve is usually affected in herpes zoster

A

CN V1 => painful corneal ulceration

45
Q

what causes an auricular hematoma

A

localized collection of blood btwn the perichondrium and auricular cartilage => distortion of the auricle

46
Q

what complication can arise from otitis media?

A

perforation of tympanic membrane => middle ear deafness

47
Q

what is myringotomy

A

incision to release pus from middle ear abscess

48
Q

where should the incision be made in myringotomy and why

A

incision made posterio-inferiorly to avoid injury to chorda tympani, ossicles and blood vessels

49
Q

what is meniere syndrome

A

recurrent attacks of tinnitus, hearing loss, vertigo due to excess endolymph production or blockage of endolymphatic duct

50
Q

what causes anterior mandible dislocation

A

excessive contraction of lateral pterygoids w yawning or chewing

51
Q

why are posterior mandible dislocations rare

A

postglenoid tubercle and intrinsic lateral ligament stabilize TMJ posteriorly

52
Q

what structures do you need to watch for during surgery of the TMJ

A

facial n

auriculotemporal ns

53
Q

what nerve should be blocked to anesthetize the upper mouth

A

infra-orbital n

54
Q

where should you pass the needle to perform an infra-orbital nerve block

A

btwn oral mucosa and gums at superior oral vestibule => into infraorbital foramen

55
Q

what is the source of bleeding in most cases of epitaxis?

A

anterior 1/2 of the nose

56
Q

what is the venous drainage of the nasal cavity

A

sphenopalatine v
facial v
ophthlamic v

57
Q

what as. come together in the kiesselbach area

A 
branches of maxillary a:
greater palatine a
anterior and posterior ethmoidal a
sphenopalatine a
branches of facial a:
superior labial a
lateral nasal branches
58
Q

what CN is most susceptible to impingment by a thrombus & why

A

abducent (CN VI) b/c it is free-floating in venous blood of the cavernous sinus

Head & Neck (7 decks)

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