Head and Neck Flashcards
congential toricollis-age of onset, presentation, mc causes (2), treatment (2)
2-4 weeks, child prefers to hold head tilted to one side (tilted towards and rotated away from SCM damaged), mc result of malposition of head in utero or birth trauma (sternocleidomastoid muscle injury and fibrosis). treat with conservative therapy and stretching exercises.
recurrent laryngeal nerve- travels with which artery, injured how, results of injury (3)
close approximation to inferior thyroid artery, injured in surgical procedures and can results in laryngeal muscle paralysis,hoarse voice, and dyspnea
ansa cervicalis
loop of cervical plexus that receives contributions from C1, C2, C3. courses deep to the sternocleidomastoid muscle and loops around internal jugular vein. innervated sternohyoid, sternothryoid and omohyoid muscles
course of spinal accessory nerve
exits jugular foramen and courses on top of levator scapulae muscle to innervate the sternocleidomastoid
cleft lip vs cleft palate
frequently occur together, form during 6th week
- failure of maxillary promieneces to fuse with medial nasal prominence (becomes intermaxillary segment)
- PALATINE SHELVES of maxillary promienences fail to fuse with each other or the primary palate (aka intermaxillary segment)
name 3 genes of polyprotein precursors in HIV? what protein do they become
gag, pol, and env
env product is glycosylated gp160 and cleaved in ER and golgi to become gp120 (attach to CD4+ to cell) and gp41 (fusion and entry)
gag- makes p24 a capsid protein
pol-makes reverse transcriptase, aspartate protease, and integrase
how do you use tracheal PO2, alveolar PCO2 and alveolar PCO2 to determine diffusion vs perfusion limited
diffusion-only O2 would be effected b/c CO2 diffuses at a rate 20 times that O2
perfusion-both O2 and CO2 would be abnormal
also with perfusion alvelolar PO2 and tracheal PO2 are close in number
when is O2 diffusion limited? normal tracheal pO2 and alveolar levels?
tracheal PO2 is 150mmh and alveolar PO2 is 104
normally O2 is perfusion limited
diffusion limited occurs during exercise, emphysema, and pulmonary fibrosis
name 3 genetic causes of Downs syndrome
95% caused by trisomy 21
-other less common causes are unbalanced Robertsonian translocations (46 chromosomes with an extra arm of 21 attach to another chromosome) or mosaicism (pts with two cell lines-one normal and other with trisomy 21)
pterion-def, art that course deep to this structure, enters where?, branches from, at risk when, bleed can cause?
site where frontal, parietal, temporal, and sphenoid bones meet in skull.
- middle meningeal art
- enters through foramen spinosum
- branches from maxillary
- skull fractures here can cause laceration and epidural hematoma
oseltamivir-def, action (2) treatment,
neuraminidase inhibitor used to treat and prevent influenza A and B
-impairs release of newly formed virions and impairs viral penetration of mucous secretions in respiratory epithelium
Down syndrome characteristics-CNS, head and neck, extremity, cardiac, GI-increased risk of what two diseases as a child and which 1 disease as an adult?
mental retardation, facial dysmorphism, single palmar crease, endocardial cushin defects, duodenal atresia
-increased risk of AML-M7, ALL as a child and increased Alzheimer as an adult
test results in conductive hearing loss (external sounds to innner ear) vs senorineural loss (inner ear, cochleas, or auditory nerve problem)
- bone>air conduction: abnormal Rhinne (in affected ear) and Weber localizes to affected ear (b/c out ear problems masks outside noise and inner ear can hear sound louder)
- air>bone: normal Rhinne and Weber localizes to unaffected ear (b/c inner ear is fine)
reasons for conductive vs sensorineural loss
- Ceruem impactions, cholesteatoma, otoscelrosis, external or middle ear tumors, tympanic membrane rupture, severe otitis media
- Meniere’s disease, acoustic neuroma, presbycusis, ototoxic drugs (aminoglycosides)
calcification of internal carotid artery can lead to what visual field defect
aneurysm or atherosclerotic calcification of the internal carotid art can laterally impinge on the optic chiasm causing nasal hemianopia by damaging uncrossed optic nerve fibers from temporal portion of ipsilateral retina
calcification of internal carotid artery can lead to what visual field defect
aneurysm or atherosclerotic calcification of the internal carotid art can laterally impinge on the optic chiasm causing nasal hemianopia by damaging uncrossed optic nerve fibers from temporal portion of ipsilateral retina
occlusion leads to which visual defect
- posterior cerebral art
- anterior choroidal art
- middle cerebral art
- retinal art or central retinal vein
- homonymous hemianopia with macular sparing (macula is spared due to collateral blood from the middle cerebral art)
- optic tract (homonymous hemianopia )
- optic radiations (homonymous hemianopia)
- optic nerve
major adaptive immune mechanism that prevents reinfection with influenza virus
anti-hemagglutin IgG antibodies in circulation and mucosal anti-hemagglutinin IgA antibodes in nasopharynx
Edwards vs Patau’s Syndrome
both have rocker bottom feet
- Edwards (47,XX +18) has overlapping fingers and clenched hands, low set ears
- Patau’s (trisomy 13 )cleft lip and palate, polydactyly and omphalocele
mucormycosis is caused by which bacteria? presentation? pt pop? histo?
- rhizopus, mucor, or absidia species
- paranasal sinus involvement
- diabetic immunosuppressed pt
- fungi form in broad nonseptate hyphae that branch at right angles
Turner’s presentation (extremeties, cardiac, renal)
-45,XO; lymphedema of varied intensities (hands, feet, hydrops fetalis), coarctation of aorta, horseshoe kidney
47,XXX presentation
usually clinically silent, slightly decreased IQ scores
