Head and Neck

Question 1

Branches of the facial nerve - superior to inferior

Answer 1

Temporal
Zygomatic
Buccal
Mandibular
Cervical 
(To Zanzibar By Motor Car)

Question 2

What are the facial branches of the trigeminal nerve?

Answer 2

V1 - opthalmic
V2 - maxillary
V3 - mandibular

Question 3

Causes of facial nerve palsy

Answer 3

• damage in forceps delivery
• parotidectomy surgery
• brain tumour, aneurysm, viral infection or stroke
• idiopathic i.e. Bell’s palsy

Question 4

Branches of the external carotid artery

Answer 4

Superior thyroid
Lingual
Facial
Occipital 
Ascending pharyngeal 
Posterior auricular 
Maxillary 
Superficial temporal

Question 5

What is a consequence of infection in the retropharyngeal space?

Answer 5

Mediastinitis

Question 6

Borders and contents of the carotid triangle

Answer 6

Lateral - SCM, inferior - omohyoid, superior - diagastric

Contents - IJV, carotid bifurcation, vagus and hypoglassal nerves

Question 7

What is significant about the facial veins? What area do they drain?

Answer 7

Connects to the cavernous sinus through the superior opthalmic vein, valveless here so blood can back track from the face to the cavernous sinuous. Infections and thrombophlebitis can back track into the inter-cranial system. Danger triangle of the face - medial angle of eyes to the lips.

Question 8

Why does the scalp bleed profusely?

Answer 8

Dense connective tissue is pulled apart by the aponeurosis of occipitofrontalis preventing healing by primary intention.

Question 9

Layers of the scalp

Answer 9

Skin
Connective tissue -dense 
Aponeurosis of occipitofrontalis
Loose connective tissue
Periosteum

Question 10

Causes of swollen lymph nodes and differentiating characteristics

Answer 10

Infection - tender, firm, mobile

Malignancy - non-tender, hard, ‘matted’, immobile

Question 11

What order do you palpate the lymph nodes in a resp exam?

Answer 11

Submental, submandibular, pre-auricular, Post-auricular, occipital, anterior chain, posterior chain, supraclavicular node

Question 12

Why are the cervical vertebrae more vulnerable to whiplash injuries?

Answer 12

Horizontal zygophyseal joints, weight of head above neck.

Question 13

What is lateral cleft lip?

Answer 13

failure of fusion of medial nasal prominence and maxillary prominence

Question 14

What is cleft lip and palate?

Answer 14

Failure of fusion of the medial nasal prominence, maxillary prominence and palatal shelves.

Question 15

Causes of recurrent laryngeal nerve pasly

Answer 15

Aortic arch aneurysms, thyroid cancers, laryngeal cancers, enlarged mediastinal lymph nodes (lung cancer)

Question 16

Symptoms and signs of recurrent laryngeal nerve palsy

Answer 16

weak cough, hoarse voice, dysphagia, aphonia, inspiratory stridor

Question 17

What is Horner’s syndrome

Answer 17

Caused by a lesion of the sympathetic trunk leading to unopposed parasympathetic innervation to the face. Contraction of the pupil, ptosis, sinking in of the eye (enophthalmos). Vasodilation and ahidrosis in the neck and face. Can be due to an apical lung tumour.

Question 18

Innervation of the extraoccular muscle

Answer 18

Abducens nerve (CN6) - Lateral rectus
Trochlear nerve (CN4) - superior oblique
Occulomotor nerve (CN3) - superior, medial and inferior rectus, inferior oblique 

LR6 SO4 R3

Question 19

What is meinbomian cyst?

Answer 19

Blocked tarsal gland, painless, no antibiotics required

Question 20

What is a stye?

Answer 20

Infected sebaceous (or ciliary) gland, painful. Usually caused by staph. aureus. treat with antibiotic eye drops.