Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

ESA4 > Disorders of the Head and Neck > Flashcards

Disorders of the Head and Neck Flashcards

1
Q

What does a CN III Nerve Palsy do?

Causes?

A

“Down and Out” Eyeball, Ptosis, Blown Pupil

Increase of intracranial pressure -> Compresses
Aneurysm
Cavernous Sinus Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does a CN IV Palsy do?

Causes?

A

Can’t look “Down and In”, Double Vision, Head Tilt

Congenital Palsy
Diabetic Neuropathy
Thrombophelbitis of Cavernous Sinus
Increase in intracranial pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does a CN VI Palsy do?

Causes

A

Can’t look laterally, medially rotated eye and diplopia

Any increase in downwards pressure
ICA Atherosclerosis in CS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the Common Problems with the Orbit?

A 
Cranial Nerve Palsy
Fractures
Mass Lesions
Cellulitis
Thyroid Eye Disease
Glaucoma
Retinal Detachment and Abrasion
Cataracts
Papilloedema
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the 2 Types of Orbital Fractures?

A

Rim - Fracture of a bone on the rim, happens at the suture join of the Maxilla, Zygomatic and Frontal bones

“Blowout” Fracture - Most common in Maxillary as it’s weak. Herniates into the Maxillary Sinus. Can be Medial or through the Floor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What does an Orbital Fracture Cause?

A

Increase intraorbital pressure
Exophthalmos
Haemorrhage into Sinuses (Blowout)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are some symptoms of Orbital Fractures?

A 
Lid Swelling
Pain
Diplopia
Reduced Vision or Eye Movements
Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the 2 Types of “Blowout” Fracture?

A

1) Medial - Ethmoid, Rarely Isolated, Horizontal Diplopia and Surgical Emphysema
2) Floor- Maxilla, Weak, Goes into the Sinus. Causes Vertical Diplopia

Can also get Lateral -> Zygomatic Arch

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Thyroid Eye Disease?

Signs and Symptoms?

A

Organ-Specific Autoimmune disease

Symptoms: Redness, Irritation of Eye and Diplopia

Signs: Proptosis, Lid Retraction and Lag, Restrictive Myopathy, Optic Neuropathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Orbital Cellulitis?

A

Inflammation of the Eyelids
Pain, Fever
Restricted Movement, Vision and Colour, RAPD
Sticky Discharge, Proptosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What causes Orbital Mass Lesions?

A

Inflammation
Cysts
Vascular
Metastatic Mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is an Orbital Mass Lesion?

A

Any swelling in and around the orbit

Can present with pain, inflammation and diplopia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is a Cataract?

Causes?

A

Lens becoming Opaque, develops slowly and with old age
Lens is flatter and harder so it can’t focus

Age, Diabetes, Smoking, Steroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is Open-Angle Glaucoma?

A

Increase in intraoccular pressure due to an increase in aqueous humour
Due to a blockage in the trabecular network
Increases the angle between the corneo and cris (pushes into vitreous humour)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What can Open-Angle Glaucoma cause?

A

Optic Nerve damage
Compression of Retinal Arteries
Lose Peripheral Vision

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is Papilloedema?

A

Swelling of the Optic Disc due to increased intracranial pressure
High Pressure -> No venous return = fluid retention = swollen disc
Compression -> Visual Impairment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is Retinal Detachment?

A

Trauma to the eye causes the neural and pigmented layers to seperate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is Corneal Abrasion?

A

Dirt/Particles cause Lacerations

If the sensory supply (V3) is damaged, the Patient may not notice the abrasion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is Conjunctivitis?

A

Inflammation of the Conjunctiva (thin film on sclera)
Infection and Allergy
Contagious, “Red-Eye”, Dischange

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is a Meibomian Cyst?

A

Infection of Tarsal Glands
Non-painful swelling
Not Serious

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is a Sty?

A

Infection of the Ciliary Glands
Normally caused by Staphyloccus
Can be Severe, Antibiotics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What happens in Central Vessel Occlusion?
Artery
Vein

A

Artery- Retina is pale, Macula dark

  • Occurs in Old, usually due to embolus
  • Instant and Total Blindness

Vein - Slow, Painless loss of Sight

  • Caused by Thrombophlebitis, dehydration
  • See “Stormy Sunsets” of Engorged Veins
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Describe Otitis Media

A

Infection of the Middle Ear, could be from the Eustachian Tube
Forces the Tympanic Membrane to retract so cannot see outline of Malleus any more

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Describe Otitis Media with Effusion

A

Draws Transudate into the Middle Ear
“Glue Ear”
Fix with Grommits
Problem with Eustachian tube = Negative Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What is BPPV?

A

Benign Positional Paradoxical Vertigo

There is Otolith which is displaced and keeps moving after the head has stopped so vertigo symptoms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is Mastoiditis?

A

Inflammation of the Mastoid Air Cells/Cavity
Due to increased back pressure
Swelling behind the ear, lose creases of pinna
Can spread to Middle Cranial Fossa and cause Meningitis
Death!

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Describe Perforation of the Tympanic Membrane

A

Central or Subtotal
Can be 2ndary to Infection (Pressure Necrosis)
Trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What are some congenital defects that you can get of the Pinna?

A

Pre-auricular Skin Tags
Pinna Malform (Microtia)
Antihelix Deformity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Describe Cholesteatoma

A

When there is Negative Middle Ear Pressure = Pockets/Recesses
Collection of Necrotic Epithelial Cells
Can erode Ossicles/Ear from lytic enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What is a Pinnal Haematoma

A

When blood accumulates between the cartilage and perichondrium of the bone
It strips the layers away from each other
Causes pressure necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is Cauliflower Ear

A

Due to Haematoma
Not Drained
Necrosis causes Cauliflower Shape

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

Describe Otitis Externa

A 
Cellulitis of External Ear
Inflamed, Red, Swollen
"Swimmers Ear"
Staph aureus or Pseudomonas a.
Candida albicans, Aspergillus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What can cause a retraction of the tympanic membrane? General and Specific Conditions

A

Otitis Media (+ Effusion)
Infections
Ruptured Membrane
Eustachian Tube Dysfunction

Generally: Weak Membrane or Negative Pressure

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What can cause damage to the Facial Nerve?

A

Any Middle Ear Disease

Compression of Facial Canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

How would you notice a problem with the Chorda tympani?

A

Loss of taste of 2/3 of the anterior tongue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What can cause a fracture of the Ossicles?

A

Trauma
Loud Noise (Blast Injuries)
Cholesteatoma

Causes sudden hearing loss

37
Q

What is Menier’s Disease?

A

Low Pitch Tinnitus
Vertigo
Hearing Loss

Endolymphatic Hydrops distend the ducts
High Pressure damages ear membranes

38
Q

What are the regions most succeptible to Epistaxis?

A

Kiesselbachs Plexus

Sphenopalatine (lots of blood lost)

39
Q

What can cause Anosmia?

A

Damage/Inflammation in Cribriform Plate
Tumour in the Olfactory Groove

Tumour in Frontal Lobe/Meninges/ACF can compress the bulb

Olfactory Nerve Damage
Infection
Neurodegenerative Disease

40
Q

What is a Septal Haematoma?

A

When there is a haematoma between the septal cartilage and pericondrium

41
Q

Why is the nose so succeptable to fracture?

A

As it sticks out from the face (it’s prominent)

Trauma often in Sport

42
Q

Sinusitis

A

inflammation of the mucosal lining of the sinuses, which is continuous with the vestibule of the nose

43
Q

How can infection of the Frontal Sinus spread to the Maxillary Sinus?

A

As they both open up at the hiatus semilunaris

Frontal is above Maxillary so fluid can go down it

44
Q

What is a Saddle deformity

A

When damage causes the septum (cartilage or bone) to collapse as structural support is lost

45
Q

What is Rhinitis?

A

Inflammation of the mucosal lining of the nasal cavity
Allergic
Viral
Bacterial

46
Q

What are Polyps?

A

Polypoidal masses from the Mucosa

Non-Tender and Moveable

47
Q

How can infection spread from the nasal cavity to the middle ear?

A

Via the Eustachian Tube

48
Q

How can infection spread from the nasal cavity to the Middle Cranial Fossa?

A

Via the Frontal Sinus (as the posterior wall is very thin)

49
Q

What is Treacher Collins Syndrome?

A

Rare, Autosomal Dominant Disorder
Failure of Neural Crest Cells to invade the 1st Arch
Results in Hypoplasia of Maxilla, Mandible and Zygomatic arches
Ear and Palate developmental defects

50
Q

What is DiGeorge Syndrome?

CATCH 22?

A 
Failure of the development of the Pharyngeal Pouches 3 and 4
Cardiac Problems
Abnormal Facies
Thymic Aplasia
Cleft Palate
Hypocalcaemia
(Chromosome) 22 Deletion
51
Q

What is Bell’s Palsy?

A

Palsy of Facial Nerve,
From Swelling of the Nerve
Usually Unilateral
Paralysis of Facial Muscles of Expression
If Extra-cranial, only Motor is affected
If Intracranial, can also affect salivation, taste, hearing and tear production

52
Q

What is Harlequin Syndrome?

A

Asymmetric sweating and flushing of the chest, face and neck

Caused by damage to pre-ganglionic sympathetic neurons of the Ciliary Ganglion, at the level of the thoracic cord

53
Q

What is Trigeminal Neuralgia?

A

A Chronic Pain Disorder, where the Trigeminal Nerve is extremely sensitive, thought to be due to compression by enlarged nearby blood vessel

Normally affects V2 and V3

Gives episodes of extreme pain

54
Q

How can a Varicella Zoster infection affect the Head and Neck?

A

As it remains dormant in the dorsal root ganglia, and also most commonly affects the Trigeminal Nerve, especially CN V1
Produces a Rash, Conjunctivitis, Optic Nerve Palsy/Vision Loss, Pain and Inflammation

55
Q

How can Herpes affect the Head and Neck?

A

Can cause Bell’s Palsy

56
Q

What is Horner’s Syndrome?

A

Damage to the Sympathetic Trunk

Get decreased sweating (anhydrosis), miosis, ptosis and sunken eyeball on the same side as the lesion

57
Q

What does RAPD mean?

When does it appear?

A

Relative Afferent Pupillary Defect

When Pupil constricts less when a bright light is shone from unaffected eye to the affected eye

58
Q

Give some Inflammatory examples of Orbital Mass Lesions

Describe them briefly:

A

Wegener’s Granulomatosis - Vasculitis

Dacryoadenitis - Inflammation of the Lacrimal Glands

Pseudotumour- Idiopathic Condition, involving extra-ocular muscles
Rapid Onset, Unilateral, Painful Proptosis and Diplopia

59
Q

Give some Vascular examples of Orbital Mass Lesions

Describe them briefly:

A 
Capillary Haemangioma: 
Infants, most common orbital tumour of infancy
It is a Neoplasm
Subcutaneous Mass
Known as a "strawberry haemangioma"

Cavernous Haemangioma:
Most Common Vascular Lesion in Adults
Slow Flow Venous Malformations
Normally results in Proptosis, Can have Diplopia and Visual Field Defects

60
Q

What is Fetal Alcohol Syndrome?
Signs?
Incidence?

A

When the development of a foetus has been affected by maternal drinking during pregnancy
It affects brain development and neural crest cell migration
It occurs in 1/100 births

Flat Midface
Less prominent Philtrum and Thin Upper Lip
Small Nose and Nasal Bridge
Small Palpebral Fissure

61
Q

What are the types of Cleft Lip and Palate?

A

Unilateral Cleft Lip (can involve primary palate)
Bilateral Cleft Lip
Isolated Cleft Palate
Combined Cleft Lip and Palate

62
Q

What is a Branchial Cyst?

A

When the 2nd Pharyngeal Cleft fails to grow over the other Pharyngeal Arches

63
Q

What isn’t usually affected by Bell’s Palsy?

A

The Forehead Muscles

As it has Bilateral Innervation

64
Q

What are some causes of Bell’s Palsy?

Bilateral?

A

Intracranial:
Middle Ear Pathology

Extracranial:
Parotid Gland Pathology
Nerve Infection (Herpes Virus)
Forceps Delivery
Idiopathic

Parkinsons

65
Q

What is Epistaxis?

A

A Nose Bleed

66
Q

Where does Epistaxis occur?

A

90% in Kiesselbachs Plexus, where the arteries anastomose on the septum, also known as Little’s Area

10% Other areas, more problematic as they tend to be harder to reach areas
Sphenopalatine (Problems with Warfarin, High Pressure)

67
Q

What are some Risks for Epistaxis

A 
Trauma
Coagulation Defects
Vascular Abnormalities
NSAIDs - Ibuprofen, Asprin
Warfarin
Tumours
Granulomas
Mucosal Drying
EToH (Alcohol)
Infections
68
Q

How do you Manage Epistaxis?

The 5 steps and the last resorts

A

1) Compression and Hypocratic Position for 20 mins
2) Try Again
3) Cautery (Silver Nitrate or Electo)
4) Anterior Packing + Bolster (24-48 hours)
5) Posterior Packing

Surgical Ligation - Sphenopalatine, Maxillary or ECA
Radiological Embolism

69
Q

What tests do you do when investigating an Epistaxis?

A

Blood Test- Coagulation, Hb Count, INR (Clotting Time)
Blood Pressure
Heart Rate
Capillary Refill (Shock)

70
Q

What is 1st arch syndrome?

A

Failure of Neural Crest Cells to migrate into the 1st arch

Can cause facial anomolies

71
Q

What is CHARGE syndrome?

A

Mtuation of Chromosome 7
Affects NCC production

Coloboma
Heart Defects
Atresia of Choana
Retardation
Genital Hypoplasia
Ear Defects
72
Q

Describe Adenoid Hypertrophy

A

Hypertrophy of the Adenoid Tonsils
Can block the Eustachian tube- deafness and infections
Can obstruct the nasal cavity

73
Q

Describe Tonsillitis

A

Inflammation of the Palatine Tonsils
Most common viral and bacterial (Streptococcus)
Fever, Pain, Chills, Headaches

74
Q

What is a Pharyngeal Pouch?

A

A true diverticulum

Part of the pharynx herniates through Killian’s dehiscence

75
Q

What can happen in the Piriform Fossa?

A

Malignancy

Foreign Bodies

76
Q

What kind of cancers occur in the Larynx?

A

Most squamous cell carcinoma

Poorer Prognosis the further you go down

77
Q

What kind of cancers occur in the laryngopharynx?

A

Piriform Fossa

78
Q

Describe Ectopic Thyroid Tissue

A

Can occur anywhere on path of descent
Tongue is the most common site (lingual thyroid)
May be functional
Gives dyspnoea, dysphagia and dysphonia

79
Q

What is a thyroglossal cyst?

A

A remnant of the thryoglossal duct

80
Q

What is CSF Rhinorrhoea?

A

Damage to the cribriform plate, causes tearing of the meningeal layers, causing CSF to leak from the nose

81
Q

What can affect the Optic Nerve?

Think brain and nearby structures

A

Demyelination by CNS Dieases e.g. Multiple Sclerosis

Pituitary Tumours

82
Q

What can cause damage to CN III?

A

Compression

Increase in intracranial pressure, compresses against petrous part (affects ANS first)

Aneurysm of the Superior/Posterior Cerebral Artery

Cavernous Sinus Infection

83
Q

Why can the trochlear nerve be affected easily?

A

As it has a very long course can be damaged in head injuries
But is rarely affected on its own
General increase in intracranial pressure
Goes through the cavernous sinus

84
Q

What can go wrong with the Vestibulocochlear nerve?

A

Sensorineural Deafness - Cochlear disease of anywhere in its path to the brain
Vertigo
Acoustic Neuroma

85
Q

What is Acoustic Neuroma?

What does it cause?

A

A neurofibroma- a slow growing tumour of Schwann cells
Occurs to CNVIII in the IAM or the cerebellopontine angle so it also affects the facial nerve

Get hearing loss, tinnitus etc

86
Q

What can damage to CN X cause?

A 
Dysphagia - injure pharyngeal branches
Superior Laryngeal - Upper anaesthetic, weak voice
Recurrent Laryngeal: 
One-side- hard to speak, hoarse
Two-sided- lose voice, stridor
87
Q

What can damage the recurrent laryngeal nerve?

A

Aneurysm of the Arch of the Aorta
Neck Operations
Malignancy of Larynx, Thryoid
Apical Lung Tumour

88
Q

Why can bleeding from the scalp track into the orbit and cause a black eye?
Why not go into neck or laterally?

A

As the aponeurosis of the scalp of occipitofrontalis only connects into the skin and connective tissue and not the bone, as it does in other directions, anteriorly

Occipital –> Occipital bone and mastoid process (not into neck)

Epicranial Aponeurosis is continuous with temporal fascia (lateral)

Therefore bleeding in the loose connective tissue layer/under the aponeurosis can go into the nasal bridge and around the orbit

ESA4 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions