Clinical relevance Qs Flashcards
what procedure is it when you need emergency airway
cricothyrotomy/ tracheostomy
what causes congestive heart failure
distension of jugular vein
what is the clinical significance of a scalp laceration
it will bleed profusely BUT heal quickly due to the rich vascular supply
what is temporal arteritis and some symptoms, treatment
- Inflammation of BV in head – inadequate o2supply
- Fever, headache, double vision (diploplia) can cause blindness & stroke- Corticosteroids
how do you remove a foreign object from a nostril
Nasal septum opens nostrils & forceps are used to remove it – in inferior nasal meatus
What is Horner’s syndrome and the 3 clinical symptoms
damage to the cervical sympathetic trunk
1. no sweating
2. constricted pupils
3. droopy eye
what is Trigeminal neuralgia, symptoms and treatment
= Vascular compression of CN5 ganglion
Commoner in older people. Usually occurs spontaneously, but is sometimes associated with facial trauma or dental procedures.
Severe pain in face, sudden onset
Carbamerzipine used to treat pain.
what is Vertibrobasilar ischemia
Compression of basilar artery when turn head in certain position – dizziness
what can cause Diploplia
Blowout Fracture
Damage to C3,4 & 6
Tumours in orbital roof
Temporal arteritis
MS
Sinusitis
what can cause an Oro-antral communication
Upper extractions can open floor of maxillary sinus
Epithelium becomes continuous – fistula
what is Sinusitis
Infection of mucous membrane
The ostia for drainage are located high on the medial wall and open into the semilunar hiatus of the lateral nasal cavity =hence maxillary sinus hard to drain
Trismus (dental) cause?
Reduced opening of jaw - Can be caused by LA in medial pterygoid
Pituitary Tumour symptoms
Gigantism (GH) & loss of peripheral vision (tumour presses on optic chiasm)
What is Parkinsons disease, symptoms and treatment
Death of dopamine generating cells in substantia nigra (black substance round peduncle)
Tremor & lack of expression.
Dopamine replacement
Significance of Cavernous Sinus Thrombosis
- Bacteria from infection in face e.g dental sepsis after extraction of maxillary 8 (abscess)
- This can spread to pterygoid plexus & can travel to cavernous sinus via sphenoidal emissary vein
- Slow flow (due to venous plexus) means bacteria can multiply faster leading to CST
- Pterygoid plexus can be pierced during injection causing haematoma
- “Danger triangle” area of face – venous connection between cavernous sinus & facial vein – leads to bacteria getting into venous blood at area of foramen ovale & cavernous sinus becomes inflamed
Raised temperature (toxins), a swollen eye (blood can’t drain), blood clotting mechanism
what is Chronic otitis media
Infection of middle ear, likely to cause tympanic membrane perforation
If there is pus from infection leaked to external acoustic meatus, it is chronic otitis media
Chronic infection difficult to treat
Middle ear is linked to nasocavity. Infection of respiratory tract & can spread to middle ear
How do you test CN I
Test with smells of mild odours
How do you test CN II
Confrontation method – sit 1m away, cover one eye & move object into visual field
How do you test CN III,IV, VI
Get patient to follow objects horizontally, vertically, diagonally.
Double vision, squint
How do you test CN III
Controls constriction of pupils – Shine torch in eye
How do you test CN V
Test touch sensation to face.
Get patient to clench - palpate masseter & temporalis
How do you test CN VII
Raise eyebrows, smile, close eyes tightly.
Puff cheeks – can they seal orbicularis oris
How do you test CN VIII
Hearing is first tested in each ear by whispering something while occluding the opposite ear
Vestibular function can be evaluated by testing for nystagmus (a rhythmical, repetitive and involuntary movement of the eyes)
How do you test CN IX, X
Say aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaah
