Facial Nerve Paralysis and ET Flashcards
Loss of axoplasm flow (stuns a nerve)
Neurapraxia
Axon is separated from neuron cell body and degenerates to distal to the injury
Wallerian degeneration
Wallerian degeneration with preservation of endoneural sheaths
Axonotmesis
Wallerian degeneration and LOSS of endoneural tubules
Neurotmesis
Sunderlands 5 levels of neural injury
1st: neurapraxia (temporary), 2nd: Axonotmesis, 3rd: neurotmesis with loss of endoneurium, 4th:neurotmesis with loss of endoneurium and perineruim, 5th: Neurotmesis with loss of endo, peri, and epineurium
House Brackmann Classification
1:normal function, 2: mild disfunction (only slight weakness noticeable), 3: moderate dysfunction (complete closure of eye with effort, 4: Moderately severe dysfunction (incomplete closure of eye/no forehead motion) 5:Severe dysfunction (assymetry ar rest), 6: total paralysis
Infection associated with Bell’s palsy
Herpes simplex
When to do electrophysiologic tests for facial paralysis
Only when House Brackmann 6 classification
How to treat Bells Palsy
Prednisone at high dose for 7-10 days, acyclovir 7 days, must start within 3 days
Where is the maximal injury of Bell’s Palsy
Occurs in Meatal foramen, decompression direct at labyrinthine portion
Ramsay hunt syndrome
Facial paralysis, ear pain, vesicular eruption, pain preceded by paralysis by a few days, Herpes zoster oticus is cause
Most common compliation after the onset of facial paralysis
Eye injury!!
Classes of oropharyngeal (Mallampati)
1: complete visualization, 2:part of pillars covers, 3: no fauces, 4: no visualization
4 things to check for with ET tube placement
Bilateral lung sounds, fog in endotracheal tube, equal chest rise, measure expired CO2
Order of drugs
Pentothal before succinylcholine
