Head & Neck 2 Flashcards

1
Q

Which cervical vertebrae are atypical?

A

C1 C2 C7

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2
Q

What makes the atypical vertebrae atypical?

A

C1 - No body
C2 - Dens
C7 - large spinous process

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3
Q

Describe the main feature used to discern the cervical vertebrae from the others

A

Foramina in the transverse processes

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4
Q

What is of clinical relevance to the cervical spine regarding the articular surfaces of the vertebrae?

A

They are more horizontal than in other vertebrae making it easier for them to be dislocated possibly causing paralysis or death

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5
Q

What is the most common sites for cervical spine injuries?

A

Obviously C1, C2 and C7 because they are atypical but also C6
The most sever injuries occur C1-4

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6
Q

What can neck hyperflexion injuries lead to?

Hint: Usually lower cervical spine

A

Crush fractures
Rupture of the supraspinous ligament
Rupture of the lower disc (leading to nerve compression)

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7
Q

What can neck hyperextension injuries lead to?

Hint: Usually upper cervical spine

A

Vertebral fracture
Disc prolapse
Cervical spinous process fracture
Dens fracture

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8
Q

What is a hangman’s fracture?

A

Hyperextension injury (likely at a judicial hanging) disrupting the posterior arch of C2

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9
Q

What is a Jefferson’s fracture?

A

Caused by axial load injuries through the head - it’s a burst fracture of C1 (usually anterior AND posterior arch)

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10
Q

What is degenerative spine disease?

A

Osteoarthritic narrowing of the facet joints of the vertebral arches +/- age related swelling of discs causing compression of a spinal nerve with associated pain and weakness

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11
Q

What bones comprise the skull?

A

Cranium

Mandible

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12
Q

What is the cranial cavity?

A

The space within the cranium which holds the brain

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13
Q

Building on last session’s cards, what is the neurocranium comprised of?

A

Calvaria

Cranial floor

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14
Q

What is the diploe?

A

The spongy layer between the two compact layers of bone that make up the calvaria

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15
Q

What is so great about the tri-laminar arrangement of bone in the calvaria?

A

Increased protection without significant added weight

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16
Q

What is the pterion?

A

Thinnest part of the calvaria

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17
Q

What is the clinical relevance of the pterion?

A

It overlies the middle meningeal artery, fracture here could cause an extradural haematoma

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18
Q

What is an extradural haematoma?

A

When blood accumulates between the periosteal layers of the dura mater and bone putting pressure on the brain

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19
Q

How many bones make up the skull?

A

22

20
Q

How many bones are there in the neuro- and viscerocranium?

A

Neuro - 8

Viscero - 14

21
Q

Name the bones of the viscerocranium

Hint: 14

A

2x nasal, 2x lacrimal, 2x zygomatic, 2x maxilla, mandible, 2x inferior nasal concha, vomer, 2x palatine

22
Q

Name the bones of the neurocranium

Hint: 8

A

Frontal, occipital, 2x parietal, sphenoid, ethmoid, 2x temporal

23
Q

Which types of joints are found in the skull?

Hint: 2

A

Sutures

Synovial (TMJ)

24
Q

How many sutures are ther in the skull?

A

4; coronal, squamous, saggital, lambdoid

25
Q

Name the convergance points of the sutures and their associated sutures
Hint: 3

A

Bregma - between saggital and coronal
Pterion - between coronal and squamous
Lambda - between lambdoid and saggital

26
Q

Fontanelles: What and Why?

A

Membranous areas of unfused skull which aid in birthing and brain growth, they will close after 2 years and can be enlarged, sunken or bulging

27
Q

Which imaging modality is used for suspected skull fracture?

A

CT - not X ray, you want to look for brain damage as well

28
Q

What are the signs of basilar skull fractures?

Hint: 4

A

Leakage of CSF from nose (Rhinorroea)
Haemotympanum (blood in middle ear)
Mastoid (preauricular) brusing
Bilateral bleeding/brusing around the eyes

29
Q

List the features of degenerative spinal disease

Hint: 5

A
Osteophytes
Facet joint hypertrophy
Disc herniation 
Disc space narrowing
Sclerosis of end plates
30
Q

What are the pharyngeal arches?

A

A sequence of 5 mesenchymal proliferations on the lateral walls of the embryonic pharynx numbered 1-6 as 5 does not form in humans

31
Q

What is the structure of the pharyngeal arches?

A

Mesenchyme core (with some neural crest cells) surrounded by an ectodermal surface layer on one half and an endodermal layer on the internal surface.

32
Q

What is the significance of the pharyngeal clefts (grooves)?

A

All but the 1st disappear, the 1st becoming the external auditory meatus

33
Q

What is associated with each arch?

Hint: 3 structures

A

Nerve, artery and cartilage bar

34
Q

What are the pharyngeal pouches and what are their significance?

A

The internal equivalent of the clefts - glandular structures arise from them inc. parathyroids, thymus and tonsils

35
Q

What is Meckel’s Cartilage?

A

The cartilage bar of the 1st arch, it will become the mandible, malleus and incus bones

36
Q

Name the 3 vesicle stages that arise as the anterior end of the neural begins to form the brain

A

Prosencephalon - forebrain
Mesencephalon - midbrain
Rhombocephalon - hindbrain

37
Q

From what is the facial skeleton (viscerocranium) formed?

A

Frontonasal prominence and 1st pharyngeal arch

38
Q

Which arch do the muscles of mastication arise from?

A

Pharyngeal arch 1

39
Q

Which arch do the muscles of facial expression arise from?

A

Pharyngeal arch 2

40
Q

Which muscles arise from the 6th pharyngeal arch?

A

Intrinsic muscles of the larynx

41
Q

Which cranial nerves are associated with the pharyngeal arches?

A

V, VII, IX, X

42
Q

From which arch does the Trigeminal nerve (CN V) arise?

A

1st - sensory nerve of face and muscles of mastication

43
Q

From which arch does the facial nerve (CN VII) arise?

A

2 - muscles of facial expression and sensory to anterior 2/3/ tongue

44
Q

From which arch does the Glossopharyngeal nerve (CN IX) arise?

A

3 - SS to posterior 1/3 of tongue

45
Q

From which arch does the Vagus nerve (CN X) arise?

A

4 AND 6 - 4th = superior whil 6th = recurrent

46
Q

What name is given to the arteries of the arches?

Hint: only 3 remain

A

1st & 2nd disappear
3rd = internal carotid
4th = arch of aorta (L) & brachiocephalic (R)
6th = “pulmonary arch”