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Anatomy > Head and Neck Development + Imaging w/ Headaches! > Flashcards

Head and Neck Development + Imaging w/ Headaches! Flashcards

1
Q

Where are the 3 major growth areas of the head?

A

The skull base
Face
Cranial vault (calvarium)

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2
Q

What process enlarges the bones during development?

A

Endochondral ossification

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3
Q

Where are the fontanelles of the head located?

A

Anterior
Anterolateral/sphenoidal (each side)
Posterolateral/mastoid (each side)
Posterior

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4
Q

What are the flat paired bones of the skull formed from and by?

A

Formed from somatic mesoderm by intramembranous ossification.

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5
Q

What is unique about the TMJ/temporomandibular joint?

A

It is the only true synovial joint of the head. It has a fibrocartilage disc.

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6
Q

How many arches does a fetus have and what are the numbers?

A

1,2,3,4,6
Humans lack a 5th pharyngeal arch.

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7
Q

Name the CN that goes to each pharyngeal arch.

A

1 - V3
2 - VII
3 - IX
4 - X
6 - recurrent of X

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8
Q

Based on what you know regarding the arches, what muscles do they innervate?

A

1 is V3, so muscles of mastication.
2 is VII, so muscles of facial expression.
3 and 4 are IX and X, so muscles of the pharynx and palate.
6 is recurrent of X, so most of the phonation (laryngeal) muscles.

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9
Q

Describe the difference between a pharyngeal pouch and cleft.

A

A cleft is lateral, while pouches are medial.

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10
Q

What do the first pharyngeal pouches become?

A

Auditory tubes

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11
Q

What do the second pharyngeal pouches become?

A

Palatine tonsils

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12
Q

What do the third pharyngeal pouches become?

A

Inferior parathyroid and thymus.

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13
Q

What do the fourth pharyngeal pouches become?

A

Superior parathyroid and ultimobranchial body

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14
Q

What does the first pharyngeal cleft become?

A

External auditory meatus

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15
Q

What is unique about the third pharyngeal pouch?

A

During development, it sinks below the fourth pouch, which is why it contains the inferior parathyroid gland and the thymus.

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16
Q

What is malformation of the external ears commonly indicative of?

A

1st and 2nd arch development issues.

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17
Q

What is the significance of the cervical sinus in development and what do defects with it cause?

A

The cervical sinus needs to destroy itself during development. If not, it can form branchial cysts/fistulae.

You can have an external or internal branchial fistula/sinus, which appears as a hole in the neck or drains into the palatine tonsil.

Branchial cysts are self-isolated and fluid-filled. They do not open to skin or the pharynx.

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18
Q

Describe the path the thyroid gland descends down during development.

A

It leave the foramen cecum, going under the tongue and anteriorly, going under the hyoid anteriorly and descending in front of all the cartilages.

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19
Q

What is the abnormality we learned regarding thyroid development?

A

Thyroglossal duct cysts, where the thyroid tissue gets stuck as the gland moves down. Looks like a giant adam’s apple that is superior to where it should be.

20
Q

At what week in development does a fetus look like a muppet?

A

3.5 weeks

21
Q

At what week in development does a fetus look like an alien lizard?

A

5 weeks

22
Q

Describe the underlying developmental issue in unilateral cleft lip and the two kinds.

A

Unilateral failure of the medial nasal prominence to fuse with the maxillary prominence.

Incomplete appears with an intact nose and a lip deformity unilaterally.
Complete appears with the unilateral lip fused to the nose.

23
Q

What is the key developmental difference in unilateral cleft lip and oblique facial clefts?

A

Oblique facial clefts involve both the lateral and medial nasal prominences failing to fuse with the maxillary prominence, not just the medial.

24
Q

Describe the underlying developmental issue in bilateral cleft lip and the two kinds.

A

Bilateral cleft lip is the same as unilateral but with both medial nasal prominences failing to fuse to the maxillary prominences. It has both incomplete and complete.

25
Q

What part of the lip is responsible for the incisors?

A

Philtrum, which is the maxillary prominence fused.

26
Q

What is the key difference between cleft lip and cleft palate?

A

Cleft lip involves failure of medial nasal prominence fusion.
Cleft palate involves failure of palatine shelf fusion.

27
Q

What is holosprosencephaly and the two kinds?

A

Failure of cerebral hemispheres and lateral ventricles to separate. You can have semilobar or alobar.

28
Q

What is a regular feature seen in extreme holosprosencephaly?

A

Proboscis in the forehead.

29
Q

What kind of imaging would I use to check a TMJ?

A

CT and/or MRI.

30
Q

What are the 4 types of headaches?

A

Sinus, cluster, tension, and migraine.

31
Q

Define a sinus headache

A

A headache relating to the location and innveration of a paranasal sinus. Pain is usually found behind the browbone or cheekbones.

32
Q

Define a cluster headache

A

A headache with recurring, intense, UNILATERAL pain around the eye and cheek, lasting ~30 mins.

33
Q

Define a tension headache

A

A headache from muscle tension and fatigue, which causes BILATERAL scalp pain. Typically described as a band squeezing the head.

34
Q

Define a migraine

A

A variable, UNILATERAL headache with/without sensory changes. Typically associated with pain, nausea, and visual changes.

35
Q

What are the biggest red flags that would support CT head imaging?

A

Worst/first headache ever
Severe headaches with rapid onset
Post LP

36
Q

What hematomas can cause headaches and what imaging would I use for each?

A

Epidural hematoma: would typically be associated with trauma, use CT or MRI.
Subdural hematoma: can use CT or MRI, semilunar shape.
Subarachnoid hemorrhage: use MRI preferably, since blood and CSF cannot be differentiated well on a CT. requires more slices and planes to diagnose since blood is going anywhere CSF can.

37
Q

What can cause sensorineural hearing loss + vertigo and how would I image for it?

A

CNVIII dysfunctin most likely due to an acoustic neuroma or schwannoma. Can also affect CNVII since they both exit at the same area. (Stylomastoid foramen)
MRI recommended.

38
Q

What are acute neurological signs usually caused by?

A

Vascular issues

39
Q

What are progressive neurological signs usually caused by?

A

Tumors

40
Q

What are the common causes of dysfunction of multiple CNs?

A

Growths, Ischemias, or MS.

41
Q

What is dysfunction of CNVI often caused by?

A

Aneurysm of the internal carotid in the cavernous sinus or increased ICP.

42
Q

What is dysfunction of CNIII often caused by?

A

space-filling lesion that pushes it against the opposite tentorial notch. Generally leads to increased ICP.

43
Q

What is the main concern in neck masses for imaging?

A

If it is thyroid or non-thyroid.

44
Q

How do I image a thyroid mass?

A

Biopsy, bloodwork, and sometimes ultrasound for the biopsy.

45
Q

How do I image a non-thyroid mass?

A

CT scan, with and without contrast from the aortic arch to skull base.

Anatomy (19 decks)

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