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BDS3 Head & Neck Anatomy > Clinical Relevance > Flashcards

Clinical Relevance Flashcards

1
Q

what is the significance of the carotid sinus

A

baroreceptors in wall, supplied by glossopharyngeal nerve detect blood gas levels

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2
Q

what does the vagus nerve supply

A

motor - pharynx, larynx, palate, GIT and chest organs
sensory - tongue, external auditory meatus and EAM

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3
Q

what is the sentinel node and if infected what does this mean

A

first node of that area to be biopsied and if it is infected then infection is not localised

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4
Q

3 types of haemorrhage and cause

A
  1. extra dural - middle meningeal artery
  2. sub dural - cerebral veins
  3. sub arachnoid - cerebral artery (berry aneurysm)
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5
Q

what is a cavernous sinus thrombosis and how does it come about

A

bacterial infection in the face spreads to cavernous sinus via sphenoid emissary vein through pterygoid venous plexus. triggers blood clotting mechanism which can put pressure on CN VI. symptoms are swelling of eye as blood cannot drain from eye via ophthalmic veins and temperature

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6
Q

sudden sharp facial pain caused by

A

trigeminal neuralgia which has no known cause other than it may be caused by compression of nerve around foramen ovale. treatment is carbamazepine, necrosis of nerve with alcohol or peripheral neurectomy

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7
Q

in a blow to the parietal lobe what area might be damaged and what could this result in?

A

Broca’s area damaged so can’t form words in speech
Wernicke’s area damaged so can’t understand spoken language

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8
Q

explain damage to CN XII in stroke

A

pyramidal decussation in lower medulla, the nerve from one side of the brain crosses over to the other. motor fibres are damaged so no innervation to the opposite side of the body and tongue is paralysed

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9
Q

explain relevance of pineal gland

A

controls melatonin secretion for modulating sleep patterns and also circadian rhythms i.e. body clock

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10
Q

what is vertebral basilar ischaemia

A

osteophytes press on vertebral artery temporarily blocking blood supply resulting in dizziness (osteoarthritis)

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11
Q

if pupils do not constrict, what nerve has been damaged

A

CN III constrictor papillae

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12
Q

patient has exaggerated reflexes, what might this suggest? What relevance has a Babinski effect?

A

stroke - positive response to Babinski reflex (plantar reflex)

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13
Q

damage to sympathetic cervical trunk, what are they symptoms and what is this called?

A

Horner’s syndrome - ptosis, loss of sweating and constricted pupils as dilator pupillae damaged; loss of sympathetic innervation

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14
Q

function of muscles of mastication

A

temporalis - elevate and retrude
masseter - elevate and retrude
medial pterygoid - elevate and protrude
lateral pterygoid - protrude and depress

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15
Q

what is glue ear

A

inflammation of middle auditory tube from infection of nasopharynx, hypertrophy of tubular tonsils due to repeated throat infections. lymphoid tissue and increased mucous into auditory tube. treated by grommet to allow ‘new air’

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16
Q

main problem associated with doing a biopsy of pharyngeal recess

A

very deep and close to internal carotid artery

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17
Q

clinical name for nosebleed, what artery causes this and how do you treat your patient?

A

epistaxis - sphenopalatine artery - treat patient by sitting upwards to reduce venous pressure

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18
Q

blockage of auditory tube

A

otitis media - use grommet to let new air in

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19
Q

what are the 3 common causes of deafness

A
  1. calcification of annular ligament or stapes
  2. wax from cerumenous glands
  3. glue ear
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20
Q

explain referred pain in a heart attack

A

sensory fibres use sympathetic fibres to get up the neck and then into the spinal cord thus causing referred pain

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21
Q

what nerve is likely to be affected if ptx experiences numbness in pinna / auricle of ear

A

greater auricular nerve (derived from cervical plexus receiving innervation from C2 & C3)

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22
Q

what areas are supplied by greater auricular nerve

A

lower ear, ear lobe, skin over parotid gland and mastoid process

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23
Q

following surgery on the side of the neck area, ptx experiences drooping eyelid and no sweating on that side. what is likely to have been damaged?

A

sympathetic trunk

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24
Q

name another sign other than drooping eyelid and no sweating that is indicative of sympathetic trunk damage

A

constriction pupil on same side

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25
Q

where does submandibular duct enter the mouth

A

sublingual near frenulum

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26
Q

if surgery to sublingual area, what nerve is at risk?

A

lingual nerve

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27
Q

upon laceration of the lip, there may be profuse bleeding; why?

A

rupture of facial artery (inferior labial branch), where the left and right branches anastomose

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28
Q

what muscle of mastication is responsible for most protraction movements

A

lateral pterygoid

29
Q

tendon of which muscle inserts into the coronoid process of mandible

A

temporalis

30
Q

if a patient was to have a stroke / cerebrovascular accident affecting the RHS, name 2 main muscle groups affected

A

LHS of lower face and LHS of the tongue

31
Q

what nerve innervates motor supply of the tongue

A

hypoglossal

32
Q

which muscle is responsible for protrusion of the tongue

A

genioglossus

33
Q

what is the name for a long standing ear ache

A

chronic otitis media

34
Q

what nerve is at risk of damage during an operation to the middle ear

A

facial nerve

35
Q

what nerve causes the shoulders to roll

A

accessory nerve

36
Q

what muscle causes the shoulders to roll

A

trapezius

37
Q

what nerve innervates the carotid sinus

A

glossopharyngeal nerve

38
Q

in which area of the pharynx is it likely that a patient may get a fish bone stuck

A

pyriform fossa or vallecula

39
Q

ptx is admitted to A&E with bruising on the side of the head, which type of haemorrhage may have occurred

A

extra dural haemorrhage

40
Q

which blood vessel has been damaged in an extra dural haemorrhage

A

middle meningeal artery

41
Q

which cranial nerve supplies the larynx

A

vagus CN X

42
Q

which type of epithelium is found covering the larynx

A

stratified squamous epithelium

43
Q

when making full dentures, where should they be extended in relation to the mylohyoid line

A

should finish above the line

44
Q

where do the lymph nodes from the maxillary sinus drain

A

submandibular nodes

45
Q

extraction of a maxillary molar (possibly close to a sinus) may cause which problem

A

oroantral communication

46
Q

lymph node drainage of maxillary sinus

A

submandibular gland nodes

47
Q

lymph node drainage of oropharynx

A

cervical nodes

48
Q

muscle near submandibular gland

A

genioglossus

49
Q

muscle deep to zygomatic arch

A

temporalis

50
Q

damage to temporal branch of CN VII results in

A

inability to close eyelid thus cornea dries out

51
Q

if there is a loss of sensory supply to mucosa of larynx what nerve has been damaged

A

recurrent laryngeal nerve

52
Q

describe the epithelium of the larynx

A

pseudostratified columnar epithelium covers the majority of the larynx except from true vocal folds which is covered in stratified squamous epithelium

53
Q

describe oroantral communication

A

this can occur when roots positioned too close tot he maxillary sinus are extracted causing an opening between the maxillary sinus floor and oral cavity. when this occurs, fluid and food can come out of the nose when swallowing

54
Q

motor supply from vagus nerve

A

larynx, pharynx, palate, thorax, GIT

55
Q

sensory supply from vagus nerve

A

tongue and external auditory meatus

56
Q

where is the pineal gland located

A

behind the 3rd ventricle under the corpus callosum bathed in CSF

57
Q

osteosclerosis

A

calcification of annular ligament

58
Q

chronic otitis media

A

can cause tympanic membrane perforation due to infection in the medial ear that can lead to pus flowing into the external auditory meatus

59
Q

explain referred pain in heart attack

A

pain is felt in the neck due to sympathetic fibres of cervical sympathetic trunk travelling up from the heart. it can also be due to the homunculus model

60
Q

what can happen EJV in heart disease / hypertension caused by smoking

A

can become distended so EJV fills up, bulges and pulsates

61
Q

what is diplopia

A

double vision

62
Q

what causes diplopia

A

blow out fracture, sinusitis, MS, temporal arteritis which damages CN III / IV / VI

63
Q

Hodgkin lymphoma

A

malignancy of lymphatic system with multiple lymph nodes affected. reed-sternberg cells found

64
Q

non-Hodgkin lymphoma

A

lymphocytes become abnormal

65
Q

what is trismus and what causes it

A

it is reduced opening of the jaw and this can be caused by LA into the medial pterygoid muscle

66
Q

occult tumour

A

tumour located in the pharyngeal recess

67
Q

to tell difference between facial palsy and stroke

A

ptx will be unable to move eyebrows in facial palsy

68
Q

what can cause facial palsy

A

injection of LA into parotid gland which will anaesthetise muscles of facial expression

BDS3 Head & Neck Anatomy (25 decks)

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