Head and Neck Flashcards
Primary curvatures
Thoracic and sacral
MC site of berry aneurysm
ACOM
Structures within the vertebral canal
Spinal cord, dorsal and ventral nerve roots, meninges
Where are the spinal nerves located?
Outside the vertebral canal - exit through the intervertebral Foramen
Vertebral dislocation without fracture
Cervical only - articular surfaces inclined horizontally
Vertebral dislocation with fracture
Thoracic and lumbar - articular surfaces inclined vertically
Fish mouth deformity of X-ray
Sickle cell anemia - central depression in vertebral body
Absent vertebral arch with no neurologic deficits
Spina bifida occulta
Scottie dog sign
Fracture of neck of the dog - fracture of pars interarticularis
View to see Scottie dog sign
Oblique view on X-ray
Usual site of spondylolisthesis
Degenerative: L5-L5
Congenital: L5-S1
Anterior subluxation
Bamboo spine on X-ray
Ankylosing spondylosis
Ankylosing spondylosis usually affects what region
Sacroiliac
Remnant of notochord
Nucleus pulposus
Usual herniation of nucleus pulposus
Posterolaterally
NP –> PL
MC level of disc herniation
L5-S1
Common s/s of disc herniation
If at L5-S1 usually pain at back and lateral leg radiating to sole of the foot (sciatica)
Plexus involved in posterior epistaxis
Woodruff’s plexus
Plexus involved in anterior epistaxis
Hesselbach’s plexus/ Little’s area
Kieselbach?
Treatment of choice for Juvenile nasopharyngeal angiofibroma
Angioembolization
Soap bubble on X-ray
Ameloblastoma
MC malignant tumor of parotid gland
Mucoepidermoid carcinoma
Trigeminal neuralgia - what ganglion?
Gasserian
Ganglion of CN 7
Geniculate ganglion
Sensory innervation: tip of nose
V1
Sensory innervation: side of nose
V2
Sensory innervation: lower lip
V3
Sensory innervation: upper lip
V2
Sensory innervation: temples
V3
Innervation: muscles of mastication
V3
Innervation: stylohyoid
CN 7
Innervation: platysma
CN 7
Innervation: anterior digastric
CN 5
Innervation: superior omohyoid
Ansa cervicalis
Sensory innervation: scalp near hair line anteriorly
V1
Sensory innervation: posterior scalp
C2
Sensory innervation: shoulder
C5
Sensory innervation: thumb
C6
Which cranial nerves exit from the pons
CN 5, 6, 7, 8
Glands innervated by CN 7
Submandibular
Sublingual
Lacrimal
Inn of parotid gland
CN 9
Ear muscle innervated by CN 7
Stapedius
Innervation of tensor tympani
V3
Innervation: muscles for facial expression
CN 7
Trumpeter’s muscle
Buccinator
For blowing
Nerves that exit cerebellar pontine angle
CN 5, 7, 8
Exit of CN 7
Stylomastoid foramen
Crocodile tears
Facial nerve
Proximal to geniculate ganglion
Corneal reflex afferent nerve - be specific
Nasociliary nerve of V1
Exits optic canal
Optic nerve
Ophthalmic artery
Exists sup orbital fissure
Ophthalmic vein
Ophthalmic nerve
CN 3,4,6
Fracture of pterion - what vessel is likely injured?
MMA
Anosmia, raccoon eye, rhinorhea - what part of cranium fractured
Anterior cranial fossa
Innervation: muscles of deglutition
CN 9
Innervation: Muscles for phonation
CN 10
PCA - branch of?
Basilar artery
Basilar artery - branch of ?
Vertebral artery
Precentral gyrus
Motor
Area 4
Post central gyrus
Sensory
Areas 1,2,3
Heschl’s gyrus
Primary auditory
Areas 41,42
Broca’s area
Inferior frontal
Area 44,45
“Bulol” - expressive aphasia
With inferiority complex
Wernicke
Superior temporal
Area 22,39
Primary visual cortex
Area 17
Blood supply of occipital lobe
PCA
Lateral brain blood supply
MCA
Medial brain blood supply
ACA
Loss of sensation in dura of middle cranial fossa
CN 5
Dura above tentorium
CN 5
Headache - forehead and face
Dura below tentorium
First 3 cranial nerves
Headache - back of head to neck
Scalp wound - gaping
Galea aponeurotica
Scalp wound infection
Loose areolar
Layers of scalp
SCALP Sweat and sebaceous glands Connective tissue Aponeurosis - dense regular CT Loose connective - EMISSARY veins here Pericranium/ periosteum
Dense regular connective tissues in the body
Tendons
Ligaments
Aponeurosis
Thinnest part of skull
Pterion
Junction of 4 major bones of the skull
Pterion
Type of hematoma with fracture to pterion
Epidural
MMA involved
External auditory meatus - epithelium
Lateral 1/3 - cartilaginous
Medial 2/3 - biby
Length of EAM
2.5 cm
TM layers
Outer - cutaneous
Intermediate - fibrous
Inner - mucous
Internal TM innervation
Tympanic branch of CN 10
Cone of light
Antero-inferior quadrant
Originating from the UMBO
Tympanic cavity - within what bone
Peteous
Hyperacusis - CN? Muscle?
Stapes it’s
CN 7
Innervation of tensor tympani
V3
Chorda tympani from what CN?
CN 7
Pain from TM in otitis media - what nerve?
CN 9
Present sinuses at birth
Maxillary
Ethmoid
Largest sinus
Maxillary
Also most commonly infected
Blow out fracture - what bones involved?
Floor or orbit
Roof of maxillary
Drains into middle meatus
Maxillary
Frontal
Anterior ethmoid
Middle ethmoid
Drains into superior meatus
Posterior ethmois
Where does the sphenoid sinus drain into?
Sphenoethmoidal recess
What lies above the sphenoid sinus
Pituitary gland
Injury to right optic nerve
Blind right eye
Think: optic neuritis
Optic chiasm
Bitemporal hemianopsia
Think: pituitary tumor
Right angle chiasm
Right nasal hemianopsia
Think: ICA aneurysm
Right optic tract
Left homonymous hemianopsia
Think: vascular problem
Paired cranial bones (2)
Parietal
Temporal
Unpaired: frontal, occipital, sphenoid, ethmoid
Unpaired facial bones (2)
Vomer
Manible
(Vonga si Mandy pero single)
Paired: zygomatic, maxilla, nasal bones, lacrimal bones, palatine bones, inferior conchae
Most common facial fracture
Nasal bone fracture
Origin of middle meningeal artery
Maxillary artery
What produces CSF
Choroid plexus
Rotates the eyeball so that the cornea looks upward and laterally
Inferior oblique muscle
Rotates eyeball so that cornea looks downward and laterally
Superior oblique muscle
Muscle that dilates the pupil
Dilator pupillae of iris
Sympathetic innervation
Constricts the pupil
Sphincter pupillae of iris
Parasympathetic via CN III
Muscle for accommodation
Ciliary muscle
Parasympathetic via CN III
Lens become more globular
Origin of lacrimal nerve
V1
Outer 1/3 of external auditory meatus
Elastic cartilage
Inner 2/3 of external auditory meatus
Bone
What divides the cochlear canal into the scala vestibuli above and scala tympani below
Basilar membrane
Muscles of mastication
Masseter
Temporalis
Lateral pterygoid
Medial pterygoid
Innervated by V3
Reduction of temporomandibular joint dislocation - what direction?
Press thumbs downward and push the jaw backward
Inability to depress eye when abducted
SO