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MRCS Other > Doctors Acadamy - Head and Neck COPY > Flashcards

Doctors Acadamy - Head and Neck COPY Flashcards

1
Q

what is the blood supply to the scalp?

A
  • Supratrochlear Artery
  • Supra orbital Artery
  • Posterior audicular
  • Occipital
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2
Q

what sinus is at risk during a mastoidectomy ?

A

sigmoid sinus

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3
Q

What are the 4 parasympathetic ganglion?

A

Cillary ganglion
Pterygopalentine ganglion
Submandibular ganglion
otic ganglion

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4
Q

what is the typical form of eye involvement in a patient with giant cell arteritis

A

AION

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5
Q

what is the typical biopsy finding in giant cell arteritis

A

inflammatory infiltration of the arterial wall at the transition between tunica adventitia and tunica media

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6
Q

What is secreted by the anterior pituitary gland?

A
  • Prolactin
  • FSH
  • LH
  • ACTH
  • GH
  • TSH
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7
Q

What is secreted by the posterior pituitary gland?

A
  • Oxytocin
  • Vasopressin (ADH)
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8
Q

what structures travel within the cavernous sinus

A
  • Abducens Nerve
  • Carotid Plexus
  • internal carotid artery
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9
Q

Which structures travel within the lateral wall of the cavernous sinus

A
  • Oculomotor Nerve
  • Trochlear Nerve
  • othamlmic (V1) and Maxillary (v2) branches of trigeminal
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10
Q

What is the nerve supply for the sensation of the external ear?

A

Upper 1/3 = Auriculotemporal (v3)

Middle 1/3 = Lesser Occipital (Cervical plexus)

Lower 1/3 = Greater Auricular Nerve (Cervical Plexus)

External Ear Canal = auricular branch of vagus

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11
Q

What is the nerve supply to the middle ear (sensation)

A

CN 9 - Glossopharyngeal

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12
Q

what is the nerve supply to the inner ear

A

CN 8 - vestibulocochlear

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13
Q

what is the nerve supply to the nose

A

External nasal branch of the anterior ethmoidal nerve

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14
Q

What 4 strucutres lie in close proximity to the parotid gland

A
  • Facial Nerve
  • Auriculotemporal nerve
  • Superficial temporal artery
  • retromandibular vein
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15
Q

which 2 veins contribute to the formation of the external jugular vein

A
  • Posteiror auricular vein
  • poterior division of the retromandibular vien
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16
Q

What are the contents of the anterior traingle

A

Nerves:

  1. Vagus nerve
  2. Hypoglossal Nerve
  3. Ansa Cervicularis
  4. Nerve to Mylohyoid
  5. Small branch of spinal accessory nerve

Artery:

  1. external carotid
  2. facial artery
  3. common carotid artery

Vein;

  1. facial veins
  2. internal jugular vein
  3. anterior jugular vein
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17
Q

Where are psomomma bodies found?

A

The Thymus

They are also commonly seen in papillary thyroid cancer

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18
Q

What condition would you suspect in a patient with bilateral parotid gland swelling?

A
  1. Sjograns if there are associated Autoimmune conditions e.g. Rheumatoid Arthritis + dry eyes and mouth etc
  2. Sarcoidosis can cause bilateral parotid swelling
  3. Mikulicz - presentation is similar but no dry eyes/ or arthritis
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19
Q

In what condition do you see Asteroid Bodies

A

Sarcoidosis

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20
Q

Where are Hassels Corpuscles found

A

In the medulla of the thymus

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21
Q

What are the features of Folicuar Thyroid cancer? what is the managment? what is the spread? and how do you monitor for it?

A

Demographic / Features: Females, iron defficient areas. Single Nodule

Managemet: total thyroidectomy +/- radioiodine

Spread: Haematogenous Spread (To the lung most commonly)

Monitor: Thyroglobulin

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22
Q

What are the features of Papillary Thyroid cancer? what is the managment? what is the spread? and how do you monitor for it?

A

Most common thyroid cancer (75%)

Features: Females, previous irradiation to neck. Multinodular. Papillary Projections. Psommoma bodies and orphan ani nuclei

Managment: Total thryoidecomy + central lymph node clearance if nodes involved

Monitor: Thyroglobulin

Spread: Lymphatic

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23
Q

What are the features of Anaplastic Thyroid cancer and what is the managment?

A

Common in Elderly Females
Local invasion is common

Managment: palliative debulking and palliactive chemotherapy.

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24
Q

What are the features of Medullary Thyroid cancer? what is the managment? what is the spread? and how do you monitor for it?

A

Features: They are tumours of the parafolicular C cells. Associated with MEN 2a and 2b. Multinodular.

Treatment: Total thyroidectomy + bilateral neck disection

Spread: Lymph and haem spread

Monitor: Calcitonin

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25
Q

What is the blood supply to the thyroid?

A
  1. Inferior thyroid artery (from thyrocervical trunk)
  2. Superior thyroid artery (From external carotid)
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26
Q

What antibodies are seen in Hashimotos thyroiditis

A

Anti TPO & anti thyroglobulin both raised

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27
Q

What abnormality of the parathyroid glands are most often found in MEN2 ?

A

Hyperplasia

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28
Q

What is the contents of the posteior traingle

A

Nerves:

  1. Accesory nerve
  2. Phrenic Nerve
  3. Trunks of brachial plexus
  4. branches of the cervical plexus

Artery:

  1. subclavian artery

Vein:

  1. External Jugular
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29
Q

What is the blood supply of the parathyroid glands

A

Inferior Thryoid Artery (Thyrocervial Trunk) - gives majority of blood supply

Superior thyroid artery (External Carotid)

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30
Q

in what facial layer would a haematoma form post thyroidectomy

A

pretracheal layer of the deep cervical fascia

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31
Q

which muscle splits the superficial from the deep lobe of the submandibular gland

A

mylohyoid

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32
Q

between which two muscles do pharyngeal pouches commonly arise

A

between the thyropharyngeas and the cricopharyngeas

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33
Q

what structures are commonly sacrificed in a radical neck disection

A
  • sternocleidomastoid muscle (always)
  • internla jugular vein
  • accessory nerve
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34
Q

What are the branches of the external carotid

A

“Some Angry Ladies Figured Out PMS”

  • Superior thryoid artery
  • Asscending pharyngeal
  • Lingual
  • Facial
  • Occipital
  • Posterior auricular
  • Maxillary
  • Superficial Temporal

superficial temporal and maxillary arteries are your termainal branches

35
Q

What are the branches of the Opthalmic Brach (V1) of the trigeminal Nerve?

A
  1. Frontal Nerve
  2. Lacriminal Nerve
  3. Nasocillary Nerve
  4. Supraorbital
  5. supra and infra trochlear
  6. external nasal
36
Q

What are the branches of the Maxillary Branch (V2) of the trigeminal Nerve?

A
  1. Zygomatic Nerve
  2. Infra orbital Nerve
  3. Nasal nerves
  4. Greater and lesser palaentine
  5. Pterygopalentine Ganglion which gives off the Pharyngeal nerve
  6. Middle Meningeal nerve - accompanies middle meningeal artery and vein and supplies the dura
  7. Superior Alveolar Nerve - sensation to upper teeth
  8. Inferior Palprepal nerves - sensation eyelid and conjunctiva
  9. Superior labial - upper lip sensation
  10. zygomatofacial
  11. zygomatotemporal
37
Q

What are the branches of the Mandibular Branch (V3) of the trigeminal nerve?

A

Sensory:

B - Buccal

A - Auriculotemporal

I - Inferior Alveolar

L - Lingual

Motor:

  • Masseter
  • Medial and lateral pterygoid
  • temporalis
  • TEnsor TEmpani
  • Nerve to tensor veli pallitini
  • Nerve to mylohyoid
  • Nerve to ant belly of the diagastric
38
Q

Name the suprahyoid muscles and their nervous innervation

A

Suprahyoid Muscsles:

  • Mylohyoid
  • Stylohyoid
  • Geniohyoid
  • Ant and Post belly of the

Nervous Innervation

  • Mylohyoid - Nerve to Mylohyoid (Branch of V3)
  • Stylohyoid - Facial Nerve
  • Geniohyoid - Hypoglossal nerve
  • Diagstric:
    • Anterior belly - Nerve to Mylohyoid (branch of V3)
    • Post Belly - facial nerve
39
Q

What are the Infra hyoid (strap) muscles and what are their nervous innervation?

A

Infrahyoid Muscles:

  • Sternohyoid
  • Omohyoid
  • Thyrohyoid
  • Sternothyroid

Nerveous Innervation:

All supplied by Ansa Cervicularis appart from Thyrohyoid which is supplied by C1 fibres from Hypoglossal nerve

40
Q

A hoarse voice is caused by damage to which nerve?

A

Recurrant Laryngeal Nerve

41
Q

Airway obstruction can be caused by damage to what nerve

A

medial fibres of the recurrant laryngeal nerve

42
Q

Loss of ability to make high pitched sound is caused by damage to which nerve?

A

Superior laryngeal nerve (supplies cricothyroid muscle which stretches vocal cords)

43
Q

What antibodies are seen in Graves disease

A
  • Anibodies to TSH receptors on thyroid
  • TRAB antibodies
  • TSI antibodies
44
Q
A
45
Q

What antibodies do you get in de quervans thyroiditis

A

none - it is a post viral inflamation, no autoantibodies are produced

46
Q

if a patient presents with a hard woody swelling in the neck + hypothyroidism what is your top differential?

A

Riedles thyroditits

47
Q

what are the contents of the carotid sheath?

A
  • Common carotid artery
  • Internal carotid artery
  • Internal jugular vein
  • Vagus nerve
48
Q

Damage to which nerve is most likely to cause hyperacousia?

A

Facial Nerve

49
Q
A
50
Q

when is secondary haemorrhage most likely to occur following tonsillectomy

A

5-10 days

51
Q

What is the treatment for benign parotid gland tumours?

A

Superficial Paritodectomy

52
Q

If the question says there is a lesion at the cerebropontine angle what does this mean it likely is?

A

Acustic Neruoma

53
Q

Name the structures found within the parotid gland and list them superior to deep

A
  • Facial Nerve
  • Retromandibular vein
  • Superficial Temporal Artery
54
Q

Which of the structures listed below lies posterior to the carotid sheath at the level of the 6th cervical vertebra

A

cervical sympathetic chain

55
Q

From which vessels is the retromandibular vein formed?

A

The retromandibular vein is formed from the union of the maxillary and superficial temporal veins.

56
Q

What is the sensation of the tongue?

A

Posterior 1/3: Glossopharyngeal

Anterior 1/3:

  • General Sessation: lingual
  • Taste specific sensation: Chordae tympanae (branch of fascial)
57
Q
A
58
Q

Where are oxyphil cells found/

A

Parathyroid gland

59
Q

From what vessel does the middle menineal artery arise?

A

Maxillary artery

60
Q

Damage to which vessel most common causes extra dual haemorrhages

A

Middle meningeal artery (branch of the maxillary artery)

61
Q

What are the layers passed through when performing a lumbar puncture?

A
  • skin
  • subcutaneous tissue
  • supraspinous ligament
  • interspinous ligament
  • ligamentum flavum
  • epidural space
  • dura
  • arachnoid
  • subarachnoid space.
62
Q

The superior and redcurrant laryngeal nerves are branches of what nerve?

A

Vagus nerve

63
Q

Which nerve is most commonly damaged in a superficial parotidectomy?

A

Greater auricular nerve

64
Q

What nerve innervates the muscles of the tongue ?

A

Hypoglossal nerve

65
Q

The sphenopalentine artery is a branch of what artery?

A

Maxillary artery

66
Q

The middle meningeal artery is a branch of what artery?

A

The maxillary artery

67
Q

If a patient develops a “breathy” sounding voice post tonsillectomy, what is the cause?

A

Unilateral inferior laryngeal nerve palsy

68
Q

Which muscle(s) cause abduction and adduction of the vocal cords?

A

Abduction: posterior cricoarytenoid

Adduction: lateral cricoarytenoid, thyroarytenoid, interarytenoid, and cricothyroid

69
Q

Which nerve carries the nerves for lacrimation?

A

Greater petrosal nerve

70
Q

If the middle meningeal artery is lighted, what associated nerve may be damaged

A

The auriculotemporal nerve

71
Q

Where does the chorda tympani nerve lie in relation to the pars flaccida

A

The chorda tympani passes on the medial side of the pars flaccida

72
Q

What cell type is the tympanic membrane made up of?

A

Outer layer - stratified squamous epithelium

middle layer - fibours tissue

inner layer - mucus membrane which is consistent with the inner ear

73
Q

Using the thy 1-5 classification for FNA findings of thyroid cancer, what is the treatment for each stage?

A

Thy 1 and 2 = likely benign

Thy 3a (atypical cells present) = do a core biopsy

Thy f (follicular cells present) = hemithryoidectomy

Thy 4 and 5 (likely malignant) = total thyroidectomy

74
Q

In a tenitiam scan what does a hot and Cold nodule represent

A

Cold nodule - malignant

Hot nodule - benign

75
Q

What is the treatment of Graves’ disease

A
  1. Carbomazapine (unless in first trimester of pregnancy then you use propylthiouracil)
  2. Radioiodine
  3. Partial or total thyroidectomy - patient must be euthyroid first which can be achieved by using lugals iodine
76
Q

What is the most common type of brain tumour in children

A

Astrocytoma

77
Q

What is a common complication of mastoiditis

A

Dural venous thrombosis

78
Q

What level does the vertebral artery enter the transverse foramena

A

C6 (it then traverses the foramena of C6-C1)

79
Q

Which muscles of mastication elevate and depress the jaw

A

All muscles of mastication elevate the jaw apart front he lateral pterygoid which depresses the jaw

80
Q

In which bones are the 12 cranial fossa found

A

They are all found in the sphenoid bone apart from:

  • internal autistic meats + jugular foramen - Temporal bone
  • Hypoglossal foramen + foramen magnum - Occipital bone
81
Q

Which cranial nerves carry parasympathetic fibres

A

10, 9, 7, 3

82
Q

If a patient presents with thyroid swelling and CD20 what is the diagnosis

A

Lymphoma

83
Q

Which organism is associated with nasal cancer

A

EBV

MRCS Other (19 decks)

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