Clinical relevance Qs Flashcards

1
Q

what procedure is it when you need emergency airway

A

cricothyrotomy/ tracheostomy

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2
Q

what causes congestive heart failure

A

distension of jugular vein

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3
Q

what is the clinical significance of a scalp laceration

A

it will bleed profusely BUT heal quickly due to the rich vascular supply

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4
Q

what is temporal arteritis and some symptoms, treatment

A
  • Inflammation of BV in head – inadequate o2supply
  • Fever, headache, double vision (diploplia) can cause blindness & stroke- Corticosteroids
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5
Q

how do you remove a foreign object from a nostril

A

Nasal septum opens nostrils & forceps are used to remove it – in inferior nasal meatus

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6
Q

What is Horner’s syndrome and the 3 clinical symptoms

A

damage to the cervical sympathetic trunk
1. no sweating
2. constricted pupils
3. droopy eye

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7
Q

what is Trigeminal neuralgia, symptoms and treatment

A

= 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.

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8
Q

what is Vertibrobasilar ischemia

A

Compression of basilar artery when turn head in certain position – dizziness

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9
Q

what can cause Diploplia

A

Blowout Fracture
Damage to C3,4 & 6
Tumours in orbital roof
Temporal arteritis
MS
Sinusitis

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10
Q

what can cause an Oro-antral communication

A

Upper extractions can open floor of maxillary sinus
Epithelium becomes continuous – fistula

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11
Q

what is Sinusitis

A

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

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12
Q

Trismus (dental) cause?

A

Reduced opening of jaw - Can be caused by LA in medial pterygoid

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13
Q

Pituitary Tumour symptoms

A

Gigantism (GH) & loss of peripheral vision (tumour presses on optic chiasm)

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14
Q

What is Parkinsons disease, symptoms and treatment

A

Death of dopamine generating cells in substantia nigra (black substance round peduncle)
Tremor & lack of expression.
Dopamine replacement

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15
Q

Significance of Cavernous Sinus Thrombosis

A
  • 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

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16
Q

what is Chronic otitis media

A

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

17
Q

How do you test CN I

A

Test with smells of mild odours

18
Q

How do you test CN II

A

Confrontation method – sit 1m away, cover one eye & move object into visual field

19
Q

How do you test CN III,IV, VI

A

Get patient to follow objects horizontally, vertically, diagonally.
Double vision, squint

20
Q

How do you test CN III

A

Controls constriction of pupils – Shine torch in eye

21
Q

How do you test CN V

A

Test touch sensation to face.
Get patient to clench - palpate masseter & temporalis

22
Q

How do you test CN VII

A

Raise eyebrows, smile, close eyes tightly.
Puff cheeks – can they seal orbicularis oris

23
Q

How do you test CN VIII

A

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)

24
Q

How do you test CN IX, X

A

Say aaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaaah

25
Q

How do you test CN XI

A

Push against chin & get them to turn head to test SCM.
Push against shoulders – trapezius

26
Q

How do you test CN XII

A

Lick corners of mouth.
Stick out tongue & see if it deviates to a side

27
Q

What is Facial Nerve Palsy (all aspects)

A

Causes sudden weakness in the muscles on one side of the face. - UMN axons descend ipsilaterally

Difficulty eating & speaking, unable to close eyes, drooping eyelid, lip etc

(Temporalis, masseter & extra ocular muscles still work)