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PPE > H&N > Flashcards

H&N Flashcards

1
Q

location of right common carotid

A

behind right SC joint

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2
Q

common carotids bifurcate at

A

c4

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3
Q

carotid massage purpose

A

can alleviate supraventricular tachycardia

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4
Q

where and what is carotid body. innervation

A

CN IX innervation. O2. outside at carotid bifurcation

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5
Q

where ICC enter skull

A

carotid canal

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6
Q

branches of external carotid

A

SALFOPMS

superior thyroid, ascending pharyngeal, lingual, facial, occipital, post auricular, maxillary, superior tempora

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7
Q

parotid vasculatur

A

artery - maxillary and superior temporal

vein - retromandibular vein

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8
Q

what foramen does vertebral arteries go through

A

c1-6

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9
Q

whats in carotid triangle and its borders

A

borders - digasrtic, SCM, omohyoid

inside - larynx, pharynx, thyroid, cervical plexus, vagus and hypoglossal

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10
Q

layers of scalp

A

skin, loose ct, aponeurosis, loose CT with vessels, periosteum

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11
Q

blood supply of scalp

A

occipital, superior temporal, posterior auricular from ECA, supratrochlear and supraorbital from ICA. all anastamose

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12
Q

dura and skull blood supply

A

MMA

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13
Q

cavernous sinus location and contents

A

above pterygoid plexus

contains ICA and abducens. In lateral wall CN3, 4, 5a, 5b

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14
Q

position of IJV and EJV in neck

A

IJV goes under SCM. EJV goes on top

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15
Q

where does thoracic duct and right lymphatic duct enter veins

A

thoracic duct - left IJV and left subclavian junction

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16
Q

innervations of extraocular muscles

A

LR6SO4R3

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17
Q

innervation of LPS and constrictor pupillae of eye

A

LPS - somatic

constrictor - PS ciliary ganglion from edinger westphal nucleus

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18
Q

CN3 palsy

A

down and out, dilated pupils, ptosis

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19
Q

CN4 palsy

A

diplopia on looking down and in

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20
Q

CN 6 damage how?

A

increaes ICP

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21
Q

motor innervation of CN V c

A

temporalis, masseter, medial pterygoids, digastric - mastication muscles

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22
Q

innervation of CNVb

A

upper lip, mucosa of nasal cavity, paranasal sinuses, palate

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23
Q

innervation of CNVc sensory

A

temples, cheek, chin, inner cheek, anterior 2/3rds of tongue

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24
Q

CN 7 innervation

A

taste anterior 2/3 (chorda tympani), facial expression, stapedius
PS of lacrimal, submandibular and sublingual glands

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25
Q

course of facial nerve

A

travels through IAM to facial canal to stylomastoid foramen

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26
Q

what is sensorineural hearing loss

A

damage to inner ear or nerve

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27
Q

what is conductive hearing loss

A

problem with conducting sound waves to cochlea

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28
Q

what is calorix reflex and used for

A

cold or warm water into EAM causes nystagmus if not brain dead

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29
Q

innervation of CN IX

A

stylopharyngeus, parotid (PS), carotid body, carotid sinus, pharynx, middle ear, posterior 1/3 tongue taste

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30
Q

CN IX test

A

gag reflex

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31
Q

CN X sensation

A

external ear, EAM, eardrum, palatopharyngeus, salpingopharyngeus, pharyngeal constrictors, laryngeal muscles, palatoglossus, PS of heart and abdomen

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32
Q

CN X motor

A

intrinsic larynx and pharynx (cricothyroid, salpingopharyngeus, levator veli palatini, palatoglossus, palatopharyngeus), bronchi and GI smooth muscle

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33
Q

acessory innervation

A

SCM and trapezius

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34
Q

hypoglossal innervation

A

genioglossus, hypoglossus, styloglossus, intrinsic muscles of tongue

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35
Q

what side does tongue and uvula deviate to

A

tongue towards uvula away

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36
Q

What are the 3 extra classes of special cranial nerves? What do they do?

A

Special visceral efferents – muscles derived from pharyngeal arches (CNV, VII, IX, X)
Special somatic afferents – equilibration, hearing, and sight
Special visceral afferents – taste

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37
Q

give PS ganglia and nuclei and what they innervate

A

COPS - 3977
Ciliary ganglion - edinger westphal nucleus - sphincter pupillae, ciliary muscle
Otic ganglion - inf salivatory nucleus - parotid
pterygopalatine - sup salivatory nucleus - lacrimal, nasal, nasopharynx, palate
submandibular - sup salivatory - submandibular and sublingual

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38
Q

what is horners

A

damage to symp trunk. Miosis, ptosis (superior tarsal innervation), enophthalmos, anhydrosis

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39
Q

what are symp ganglioa of head and neck

A

sup mid and inf cervical ganglions

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40
Q

where is philtrum and palpebral fissure

A

philtrum between nose and mouth

palpebral fissure between eyelids

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41
Q

what is TMJ made of

A

mandibular fossa and articular tubercle and condyle of mandible

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42
Q

ligaments of TMJ

A

stylomandibular, lateral ligament, sphenomandibular ligament

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43
Q

muscles in mandible elevation and depression

A

elevation - temporalis, masseter, medial pterygoid

depression - digastric, mylohyoid, geniohyoid, lateral pterygoid

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44
Q

muscles in mandible protraction and retraction

A

protraction - masseters, lateral and medial pterygoid

retraction - temporalis, digastric

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45
Q

what prevents posterior displacement of mandible

A

posterior glenoid tubercle

46
Q

what is clinical significance of infratemporal fossa

A

used for mandibular nerve block (dental)

47
Q

bones of orbit

A

frontal, zygomatic, mandibular, lacrimal, ethmoid, sphenoid

48
Q

fissures into orbit

A

SOF, IOF, optic foramen

49
Q

what goes into SOF

A

large french tarts sit nakedly in anticipation of sweets
lacrimal, frontal, trochlear, superior oculomotor, nasociliary, inferior oculomotor, abducens, superior opthalmic vein, sympathetic

50
Q

what goes into IOF

A

infraorbital artery vein nerve

51
Q

what is orbital and blowout fracture. results??

A

orbital - fracture of bones on outer rim
blowout - partial herniation through inf or medial walls

both lead to increased ICP and exophthalmos

52
Q

actions of eye muscles

A

sup rectus - elevates, adducts, intorts
inf rectus - depresses, adducts, extorts
sup oblique - depresses, intorts, abducts
inf oblique - elevates, extorts, abducts

53
Q

arteries of eye and venous

A

artery - central artery, infraorbital, short and long ciliary
vein - superiro and inferior opthalmic, central vein

54
Q

what is infraorbital a branch of

A

maxillary

55
Q

why can infection of facial vein bad

A

connected to cavernous sinus, no valves in facial vein. Infection of face can lead to brain

56
Q

what is tarsal, ciliary and lacrimal gland

A

ciliary and tarsal - seceretes meibum (oil) prevents evaportation of eyes tear film
lacrimal - aqueous layer of tear film

57
Q

what muscles open and close eyelid

A

open - LPS and superior tarsal

clsoe - orbicularis oculi

58
Q

what is bells palsy and symptoms

A

facial nerve palsy. self limited. paralysis of forehead and therefore no wrinkles

59
Q

how differentiate between stroke and bells palsy

A

stroke is forehead sparing

60
Q

auricle anatomy

A

see book

concha, helix, antihelix, EAM, lobule, tragus, antitragus

61
Q

how cauliflower ear

A

haematoma between cartilage and perichondrium leads to necrosis

62
Q

TM anatomy

A

umbo, handle of lmalleus, pars flacida and pars tensa

63
Q

mid ear muscles and innervations

A

stapedius (facial), tensor tympani (mandibular nerve)

64
Q

what is acute otitis media and otitis media with effusion. how differenite

A

AOM - inflammation of mid ear due to inabiliy to equalise, bulging TM
OME - negative pressure leads to effusion and sucking in of TM
both present wth conductive hearing loss but AOM has pain

65
Q

how treat otitis media

A

grommets - small tubes placed in TM to allow equalisation

66
Q

complications of AOM

A

mastoiditis leading to intracranial infecition. Damage to facial nerve.
Cholesteatoma - accumulation of dead squamous cells resulting in erosion of mid ear and bone via lytic enzymes

67
Q

saccule and utricle function

A

saccule - head movements in vertical plane

utricle - head movements in horizontal plane

68
Q

where endolymph and perilymph

A

perilymph in bony labyrinth

endolymph in membranous labyrinth

69
Q

explain structure of cochlea

A

If cochlea is a hotdog. Scala vestibule is superior bun. Scala tympani is inferior bun. Hotdog is tectorial membrane surounded by scala media.
Oval to round window

70
Q

what makes up septum of bone

A

vomer inferior, ethmoid superior, and septal cartilage

71
Q

what is superior, middle, inferior concha made of

A

superior and middle - ethmoid

inferior concha own bone

72
Q

name the nasal drainage

A 
SENSE
semilunar hiatus (frontal, maxilary, ant ethmoid), ethmoidal bulla, nasolacrimal duct, sphenoid sinus, eustachian tube
73
Q

arteris of nasal cavity

A

post and mid - sphenopalatine
inferior - greater palatine
sup and anterior - ethmoidal

74
Q

nasal veins

A

facial vein, pterygoid plexus, cavernous sinus

75
Q

commonest site of anterior epistaxis

A

keisselbachs plexus

76
Q

innervation of nasal cavity

A

CN1,
septum and lateral wall - ophthalmic and maxillary
post and inferior - nasopalatine nerve
anterior and superior - anterior ethmoidal

77
Q

what tests should you run in chronic epistaxis and how treat

A

test - bleeding abnormalitis

treat - lean forward and pinch cartilage. Can cauterise blood vessels, use nasal tampons

78
Q

sensation of meninges

A

Vb

79
Q

motor nerves from facial nerve

A

To Zanzibar By Motor Car Please

temporal, zygomatic, buccal, mandibular, cervical, posterior auricular

80
Q

what is torticolis

A

asymmetrical head/neck position poss due to shortened SCM

81
Q

what is pagets disease of bone

A

misshapen bones. localised.

82
Q

where jugulo-omohyoid and jugulodigastric found. what do they drain

A

corner of IJV and omohyoid or digastric
jugulo-omohyoid - tongue, oral cavity, trachea, oesophagus, thyroid
jugulo-digastric - tonsils and tongue

83
Q

anatomy of eye

A

see book

vitreous humor, iris, lens, ciliary body

84
Q

where do extraocular muscles attach to

A

common tendinous ring

85
Q

what is name for dilated pupil and causes

A

mydriasis - physiological, glaucoma

86
Q

what is a stye and meibomian cyst

A

cyst - blocked tarsal gland

stye - blocked ciliary gland

87
Q

where carotid palpated at

A

c6

88
Q

what is superior and inferior portion of middle ear called and what sinuses contianed

A

epitympanic recess - mastoid antrum entrance

tympanic cavity - eustachian tube

89
Q

what is exocytosis of ear canal

A

bony growth in EAM

90
Q

what CNs can refer pain to ear

A

facial, trigeminal, glossopharyngeal, vagus

91
Q

innervation of TM?

A

auricular branch of vagus and glossopharyngeal

92
Q

where would you block anterior sensory 2/3 of tongue?

A

inferior alveolar nerve block

93
Q

causes of sensorineural hearing loss

A

menieres, gentamicin

94
Q

development of pituitary gland

A

downward outgrowth of forebrain known as infundibulum. Grows towards rathkes pouch (from roof of mouth). Rathkes becomes ant pit. Infundibulum becomes post pit and connecting stalk

95
Q

development of tongue

A

4 swellings - lateral swelling and tuberculum impar (1), cupola (2,3) and epiglottal swelling (4)
lateral overgrows TI, 3rd cupola overgrows 2nd. Apoptosis aside from lingual frenulum

96
Q

innervation of tongue, sensory + taste

A

ant 2/3 sens - mandibular
ant 2/3 taste - chorda tympani (facial)
posterior 1/3 taste and sense - glossopharyngeal

97
Q

thyroid development

A

descends from foramen cecum of tongue via thyroglossal duct

98
Q

what is 1st arch syndrome

A

failure of colonisation of 1st arch with neural crest cells. hyoplasia of mandible and facial bones

99
Q

what is charge syndrome

A

CH7 mutation, no multipotent neural crest cells
Coloboma, Heart defects, Atresia of back of nasal passage, Retardation of growth and development, Genital hypoplasia, Ear defects

100
Q

nasopharynx epithelia

A

ciliated pseudostratified. rest of pharynx squamous

101
Q

what are the tonsils and where

A

pharyngeal (back of nasal cavity), palatine (palate), tubule tonsils (next to ustachian tube), lingual tonsils (base of tongue)

102
Q

what is lymph drainage of palatine tonsils

A

jugulodigastric

103
Q

what is stridor and stertor

A

stridor - lower airway obstruction. inspiratory or expiratory
stertor - upper airway obstruction. inspiratory only

104
Q

what is rolling and sliding hernia

A

rolling - herniates away from oesophagus

sliding - herniates into oesophagus

105
Q

infection between investing and visceral pretracheal. and posterior to prevertebral fascia. where go

A

first one - anterior mediastinum

2nd - erode through prevertebral fascia and into retropharyngeal space to fibrous pericardium

106
Q

muscles of pharynx and innervations

A

stylopharyngeus - CNIX

salpingo and palatpharyngeus - CNX

107
Q

where food can get stuck in mouth

A

vallecula, palatine tonsils, base of tongue

108
Q

muscles of larynx function and innervation

A

all inferior laryngeal except cricothyroid
thyroarytenoid
posterior cricoarytenoid - abduct vocal folds
lateral cricoarytenoid - adduct vocal folds
transverse and oblique arytenoids - adducts arytenoid cartilage

109
Q

suprahyoid muscles and innervation

A

stylohyoid (mandibular), digastric (ant = mandibular, post = facial), mylohyoid (mandibular), geniohyoid (C1)

110
Q

infrahyoid muscles and innervation

A

sternohyoid, omohyoid, sternothyroid, thyrohoid

all C1-3

111
Q

tongue musscles and innervation

A

genioglossus, palatoglossus (X), styloglossus, hypoglossus

all but P = XII

PPE (18 decks)

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