CNs for Neuro Exam 1

Question 1

Cervical Pain

Answer 1

Causes

• inflamed lymph nodes: may indicate a malignant tumor in the head; however, primary cancer may be in the thorax or abdomen, lung cancer may metastasize through the neck to the cranium
• muscle strain
• protruding IV disks
• bony abnormalities: cervical osteoarthritis
• trauma

Aggravating factors: movement of the head and neck, and it may be exaggerated during coughing or sneezing

Question 2

Injuries of Cervical Vertebral Column

Answer 2

fractures and dislocation could injure the spinal cord, vertebral arteries (above C7), and the sympathetic plexuses running through the transverse foramen

Question 3

Fracture of Hyoid Bone

Answer 3

• can also fracture the styloid process of the temporal bone
• cause: manual strangulation of the throat, depresses the hyoid bone onto the thyroid cartilage
• inability to elevate and anteriorly move hyoid under tongue can be difficult to separate the respiratory tract from the alimentary resulting in aspiration pneumonia

Question 4

Paralysis of Platysma

Answer 4

• cause: damage to the cervical branch of CN VII (Facial N.)
• skin falls away from neck in slack folds
• extra care is taken during surgical dissections of the neck not to damage the cervical branch of CN VII
• in wound care of the neck, the skin is sutured with edges of platysma so the skin is not pulled in multiple directions leaving a disfigured scar

Question 5

Spread of Infection in neck

Answer 5

• investing layer protects against the spread of abscesses from infection in the neck
• if between investing layer and muscular part of pretracheal layer –> won’t spread past the superior edge of the manubrium
• if between investing layer and visceral part of pretracheal layer –> spread to thorax and pericardium of the heart
• posterior to prevertebral –> cause swelling posterior to SCM or enter retropharyngeal space –> buldge in pharynx and difficulty swallowing or speaking

Question 6

Deep Cervical Fascia purpose

Answer 6

1: provide containment of muscles and viscera in compartments w/ varying degrees of rigidity
2: to provide the slipperiness that allows structures to slide over each other
3: to serve as a conduit for the passage of neurovascular structures