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Kofi: Pure Clinical Sem 3 > H&N: Eye and Throat. Weird > Flashcards

H&N: Eye and Throat. Weird Flashcards

1
Q

What structures are present in the apex of the orbital cavity?

A
  • Superior orbital fissure
  • Inferior orbital fissure
  • Optic canal
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2
Q

What protect the eye ball from injury?

A

Tough orbital rim

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3
Q

What are the important anatomical reactions of the orbit?

A
  • Paranasal air sinuses
  • Nasal air cavity
  • Anterior cranial fossae
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4
Q

What are the implications of the anatomical relation of the orbit?

A
  • Orbital trauma

- Spread of infection

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5
Q

What are the weakest parts of the orbital cavity?

A
  • Medial wall

- Floor of the orbit

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6
Q

What are symptoms of an orbital blow out fracture?

A
  • History of trauma to the eye
  • Painful periorbital swelling
  • Double vision
  • Impaired vision
  • Anasthesia over affected cheek on affected side
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7
Q

How does an orbital blow-out fracture occur?

A

-Sudden increase in intra-orbital pressure fractures floor of the orbit

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8
Q

What are the effects of an orbital blow out fracture?

A
  • Orbital contents and blood can prolapse into maxillary sinus
  • Structures can be trapped at the fracture site such as extra orbital muscle near floor or orbit
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9
Q

What separates the eyelid fat and orbicularis oculi muscle?

A

Orbital septum

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10
Q

What is the function of the orbital septum?

A

Acts as a barrier against infection spreading from the pre-septal space to post-septal

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11
Q

What is peri-orbital cellulitis?

A
  • Cellulitis of orbital structures.
  • Can be pre-septal or post-septal
  • Increasing degrees of severity
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12
Q

What are the precursors to periorbital cellulitis?

A
  • Bites
  • Periorbital trauma
  • Sinuses (fronto-ethmoidal)
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13
Q

What are the complication of periorbital cellulitis?

A
  • Abscess formation
  • Spread of infection intracranially
  • Cavernous sinus thrombosis
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14
Q

Which veins can infection of the orbit spread through?

A
  • Opthalmic veins (most likely)
  • Pterygoid venous plexus
  • Facial vein
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15
Q

What is a meibomian cyst?

A
  • Blockage of a meibomian gland.

- Prevention of evaporation of tear film and spillage is affected

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16
Q

What is a stye?

A

-Infection of the eyelash follicles

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17
Q

Is the cornea covered by the conjunctivae?

A

No. The conjunctivae extends to the limbus which is the edge of the cornea and reflected on the inner surface of upper and lower eyelid.

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18
Q

What is conjunctivitis?

A

When the conjunctiva become inflamed, blood vessels dilate and eye appears red.

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19
Q

What is a subconjuctival haemorrhage?

A

-Haemorrhage from blood vessels in conjunctiva that is readily visible

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20
Q

Where does the blind spot lie on the opthalmascope?

A

Medially on optic disc. Where the optic nerve is transmitted

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21
Q

What is glaucoma?

A

-Drainage of aqueous humour from anterior chamber can be blocked. Can lead to irreversible damage and death of the optic nerve

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22
Q

What is an open angle glaucoma?

A
  • Deterioration of trabecular meshwork
  • Aqueous humour cannot drain to the canal of Schlemm
  • Present with visual field loss and cupping of the optic disc

-Chronic (age)

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23
Q

What is a closed angle glaucoma?

A
  • Narrowing of iridocorneal angle
  • Rapid rise in the intra-ocular pressure
  • Presents with sudden onset of painful red eye, blurred vision, fixed or sluggish semi dilated oval shaped pupil, nausea, vomiting
  • Acute
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24
Q

What is the effect of the glaucoma?

A
  • Rise in intra-ocular pressure and damage to optic nerve
  • Optic disc cupping occurs
  • Sight threatening
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25
Q

What is the accommodation reflex?

A
  • Light rays from near-objects are more divergent and require greater refraction to being them into focus on retina
  • Autonomic constriction of the pupil
  • Eyes converge
  • Lens becomes more biconcave due to contraction of the ciliary muscle
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26
Q

Which extra-ocular muscles are not supplied by the oculomotor nerve?

A
  • Lateral rectus by the abducens nerve

- Superior oblique by Trochlear

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27
Q

How do we isolate the action of superior oblique?

A
  • Move the eyeball to a medial position

- Move the eyeball down

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28
Q

How do we isolate inferior rectus?

A
  • Move the eyeball into the lateral position

- Move the eyeball down

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29
Q

How do we isolate the action of inferior oblique?

A
  • Move the eyeball into the medial position

- Move the eyeball up

30
Q

How do we isolate the action of superior rectus?

A
  • Move the eyeball into the lateral portion

- Move the eyeball up

31
Q

What is sialolithiasis?

A
  • Salivary stones.
  • Most are located in the submandibular glands
  • Leads to dehydration and reduced salivary low
32
Q

What are the symptoms of sialolithiasis?

A
  • Pain in gland
  • Swelling
  • Infection
33
Q

What is used to investigate salivary stones?

A

Sialogram

34
Q

What are the symptoms of tonsillitis?

A
  • Fever
  • Sore throat
  • Pain/difficulty swallowing
  • Cervical lymph nodes
  • Bad breath
35
Q

How do peritonislar abscesses form?

A
  • Can follow on from tonsillitis

- Can arise on its own

36
Q

What are the symptoms of peritonsillar abscess?

A
  • Severe throat pain
  • Fever
  • Bad breath
  • Drooling
  • Difficulty opening mouth
37
Q

What is found in the oropharynx?

A

Palatine tonsils between Palatoglossus and Palatopharyngeal

38
Q

What is found in the laryngopharynx?

A

Piriform fossa

39
Q

What is Killian’s dehiscence?

A

Weakness found between the thyropharyngeal and cricopharyngeal muscle. These 2 are parts the inferior constrictor muscle

40
Q

What is a pharyngeal pouch?

A

A posteriomedial (false) diverticulum. Could be due to

  • Failure of the upper oesophageal sphincter to relax
  • Abnormal timing of swallowing
  • Essentially there is higher pressure in laryngo pharynx
  • Weakness between muscle belly of the inferior constrictor muscle produces out pouching of pharyngeal mucosa
41
Q

What are the symptoms of pharyngeal pouches?

A
  • Dysphagia
  • Bad breath
  • Regurgitation of food
  • Occasional choking on fluids
  • General difficulty swallowing
42
Q

What are the symptoms of pharyngeal pouches related to?

A

Food material collecting in pouch or disruption of swallow

43
Q

What are some causes of dysphagia?

A

Stroke
Progressive neurological disease
COPD
Dementia

44
Q

What are signs and symptoms of dysphagia?

A
  • Coughing and choking
  • Sialorrhoea
  • Recurrent pneumonia
  • Change in voice/speecj
  • Nasal regurgitation
45
Q

What are the 3 layers of the eye?

A
  • Sclera (fibrous and tough)
  • Chorioid (Vascular and muscular)
  • Retina (rods and connes)
46
Q

What connects the choroid and iris?

A

-Ciliary body which is vascular and muscular

47
Q

What is uveitis?

A
  • Inflammation of the choroid layer
  • Presents with a red and painful eye which is worse when focusing or attempting to look at bright lights
  • Autoimmune associated (AS, IBS)
48
Q

What is the purpose of pigment layer and where does it lie?

A
  • Between the choroid and retina
  • Cells contain melanin
  • Plays a role in helping absorb scattered light that has passed into the eye.
  • Reduces reflection and allow us to focus images appropriately on the retina
49
Q

How is vision affected in people with albinism?

A
  • Lack of melanin in pigmented layer

- Wear glasses to prevent the scattering of light

50
Q

What is the macula?

A
  • Concentration of cone cells
  • Cone cells have high visual acuity
  • Centre of the macula is the fovea and has a rich density of only cones
51
Q

What is retinal detachment?

A
  • Pigmented epithelial cell layer can detach from neurosensory cell layer in certain layer
  • Photoreceptors at the site of detachment are no longer able to function resulting in visual disturbance (lack of blood supply)
52
Q

What is the purpose of the rods?

A
  • Vision in low light
  • Doesn’t discern colours.
  • Abundant in the periphery
53
Q

Where is the anterior chamber?

A

-Space between cornea and Iris

Filled with aqueous humour

54
Q

Where is the posterior chamber?

A

-Space between the Iris and lens

Filled by aqueous humour and ciliary body and processes found in this chamber

55
Q

What are cataracts?

A

Degradation of proteins in the lens which can cause it to become clouded and less transparent. Occur gradually

56
Q

Which two muscles are found in the iris and what is their purpose?

A
  • Sphincter pupillae and dilator pupillae

- Acts to control the size of the pupil and are controlled by the autonomic nervous system

57
Q

What is presbyopia?

A

As we age

  • Lens becomes dense, less elastic and more difficult to change shape
  • Thus, the ability to accommodate and focus on near-objects becomes impaired as well get older
58
Q

What is the hole on the medial side of the lower eyelid and its purpose?

A
  • Puncta

- Collects tears

59
Q

What are the steps to take clinical examination of the eye?

A

IVA FROM

I - Inspection of the eye
VA - Visual acuity tested using Snellen Chart
(V)F - Tested using Confrontation
R - Test te reflex. Direct and consensual reflex and accommodation reflex.
O - Use of an ophthalmoscope to visualise back of the eye.
M - Test the eye movements

60
Q

What are the borders of the oral cavity?

A

Anterior: Oral fissure
Posterior: Oropharyngeal isthmus
Lateral and medial wall: Anterior and posterior pillars of faucet formed by the palatoglossus anteriorly and the palatopharyngeal posteriorly

61
Q

What are the innervations of the extrinsic muscles of the tongue?

A

Hypoglossal nerve

  • Genioglosus
  • Styloglossus
  • Hyoglossus

Vagus nerve
-Palatoglossus

62
Q

Where are the parts of the pharynx located?

A

Nasopharynx - C1
Oropharynx - C2-C3
Laryngopharynx - C3-C6

63
Q

What is located externally on the walls of the pharynx?

A
  • Superior constrictors
  • Middle constrictors
  • Inferior constrictors
64
Q

What innervates the constrictors of the pharynx and what is their action?

A

Vagus nerve

Relax and contrat to propel bolus into the oesophagus

65
Q

Which parts of the pharynx and soft palate are supplied by the vagus nerve?

A

-All the muscles of the pharynx except stylopharyngeus

66
Q

What is the sensory innervation of parts of the pharynx?

A

Nasopharynx - Maxillary Nerve
Oropharynx and Eustachian tube - Glossopharyngeal Nerve
Laryngopharynx - Vagus Nerve

67
Q

What happens to the pharyngeal tonsils in adulthood?

A

They atrophy after puberty

68
Q

What is a potential site for foreign bodies in the larygngopharynx?

A
  • Piriform fossa is a potential site

- Also a site for cancer

69
Q

What are the extrinsic longitudinal muscles muscles of the pharynx?

A
  • Stylopharygeus (glossopharyngeal)
  • Palatopharyngeus (vagus)
  • Salpingopharyngeus (vagus)
70
Q

What is the function of the extrinsic longitudinal muscles of the pharynx?

A
  • Elevation of the larynx

- Widen and shorten the pharynx

Kofi: Pure Clinical Sem 3 (44 decks)

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