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OSPE > Head, Neck and Spine > Flashcards

Head, Neck and Spine Flashcards

1
Q

What is the pterion? (4)

A

Area where the frontal, parietal, temporal and sphenoid bones join together just behind the temple

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2
Q

What bones are found on the cranium? (6)

A

Frontal, Parietal, Temporal, Occipital, Ethmoid, Sphenoid

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3
Q

What are the facial bones? (8)

A

Maxilla, zygoma, mandible, lacrimal, palatine bone, conchae, vomer and nasal bone

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4
Q

What travels through the optic canal (2)

A

Optic nerve (CNII) and the opthalmic artery

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5
Q

What travels through the superior orbital fissure (5)

A

Oculomotor, trochlear, ophthalmic branch of the trigeminal, abducens (CNIII, IIII, Va, VI), ophthalmic vein

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6
Q

What travels through the foramen rotundum

A

Maxillary branch of the trigeminal (CNVb)

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7
Q

What travels through the foramen ovale

A

Mandibular branch of the trigeminal CNVc

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8
Q

What travels through the foramen spinosum (2)

A

Middle meningeal artery and middle meningeal vein

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9
Q

What travels through the carotid canal?

A

the internal carotid artery

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10
Q

What travels through the internal acoustic meatus (2)

A

Facial and vestibulocochlear (CNVII, VIII)

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11
Q

What travels through the jugular foramen (4)

A

Glossopharyngeal, vagus, accessory (CNIX, X, XI) and the internal jugular vein

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12
Q

What travels through the hypoglossal canal

A

Hypoglossal (CNXII)

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13
Q

What travels through the foramen magnum (7)

A

Spinal roots of accessory nerves, (CNXI) meningeal lympathics, spinal cord, spinal meninges, sympathetic plexus of vertebral arteries, vertebral arteries, vertebral artery spinal branches

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14
Q

What travels through the stylomastoid foramen

A

Facial nerve (CNVII)

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15
Q

What travels through the stylomastoid foramen

A

Facial nerve (CNVII)

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16
Q

What comprises the yes joint?

A

Atlanto-occipital joint

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17
Q

The no joint?

A

Atlanto-axial joint

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18
Q

Where does this travel through: CN 1 (Olfactory nerve)

A

Cribriform plate

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19
Q

Where does this travel through: CN 2 (Optic nerve)

A

Optic canal

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20
Q

Where does this travel through: ophthalmic artery

A

Optic canal

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21
Q

Where does this travel through: CN 3 (oculomotor)

A

Superior orbital fissure

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22
Q

Where does this travel through: CN 4 (trochlear)

A

Superior orbital fissure

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23
Q

Where does this travel through: N 5a (ophthalmic branch of trigeminal)

A

Superior orbital fissure

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24
Q

Where does this travel through: CN 6 (abducens)

A

Superior orbital fissure

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25
Q

Where does this travel through: ophthalmic vein

A

Superior orbital fissure

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26
Q

Where does this travel through: CN 5b (maxillary branch of trigeminal)

A

Foramen rotundum

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27
Q

Where does this travel through: CN 5c (mandibular branch of trigeminal)

A

Foramen ovale

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28
Q

Where does this travel through: middle meningeal artery

A

Foramen spinosum

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29
Q

Where does this travel through: middle meningeal vein

A

Foramen spinosum

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30
Q

Where does this travel through: internal carotid artery

A

Carotid canal

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31
Q

Where does this travel through: facial nerve (CNVII)

A

Internal acoustic meatus and exits through the stylomastoid foramen

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32
Q

Where does this travel through: vestibulocochlear (CNVIII

A

Internal acoustic meatus

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33
Q

Where does this travel through: CN 9 (glossopharyngeal)

A

Jugular foramen

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34
Q

Where does this travel through: CN 10 (vagus)

A

Jugular foramen

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35
Q

Where does this travel through: CN 11 (accessory)

A

Jugular foramen

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36
Q

Where does this travel through: internal jugular vein

A

Jugular foramen

37
Q

Where does this travel through: CN 12 (hypoglossal)

A

Hypoglossal canal

38
Q

Which vertebral level is: the cervical vertebra with a prominent spinous process

A

C7

39
Q

Which vertebral level is: level with the medial end of the scapular spine

A

T3

40
Q

Which vertebral level is: level with the inferior angle of the scapula

A

T7

41
Q

Which vertebral level is: level of the lowest part of the 12th rib

A

L2

42
Q

Which vertebral level is: level of the iliac crest

A

L4

43
Q

What is the surface landmark for: L4

A

level of the iliac crest

44
Q

What is the surface landmark for: T7

A

level with the inferior angle of the scapula

45
Q

What is the surface landmark for: T3

A

level with the medial end of the scapular spine

46
Q

What is the surface landmark for: L2

A

Level of the lowest part of the 12th rib

47
Q

Where can you inject an epidural

A

L3-4, or L4-5

48
Q

Difference between thoracic and lumbar vertebrae in terms of movement?

A

Thoracic allows rotation but limited extension, lumbar allows extension but limited rotation

49
Q

How many lines do I feel for lymph nodes?

A

4, submental to pre-auricular, the down anterior chain, then posterior chain, then occipital

50
Q

What is at: C3

A

The body of the hyoid bone

51
Q

What is at: C4

A

Upper border of thyroid cartilage

52
Q

What is at: C6

A

The cricoid cartilage

53
Q

Which vertebral level is: the body of the hyoid bone

A

C3

54
Q

Which vertebral level is: the upper body of the thyroid cartilage

A

C4

55
Q

Which vertebral level is: the cricoid cartilage

A

C6

56
Q

What are the borders of the anterior triangle of the neck

A

Inferior border of the mandible, the SCM, and the midline of the neck

57
Q

What are the borders of the posterior triangle of the neck

A

SCM, anterior border of the trapezius and the clavicle

58
Q

What are the contents of the anterior triangle of the neck (6+4)

A

Platysma, mylohyoid, digastric, infrahyoid strap muscles (omohyoid, sternohyoid, thyrohyoid, sternothyroid), carotid artery and internal jugular vein

59
Q

What are the contents of the posterior triangle of the neck (7)

A

External jugular, subclavian artery and vein, trunks of brachial plexus, phrenic nerve, vagus nerve, spinal accessory nerve

60
Q

Describe the insertion point for a central line into the internal jugular vein

A

Turn head left, insertion is between medial and lateral head of the SCM. Palpate carotid artery and aim lateral to it. Aim towards ipsilateral nipple.

61
Q

Describe the position of the internal jugular vein

A

Line from the earlobe to the SC joint, lateral and parallel to the common carotid

62
Q

Describe the position of the external jugular vein

A

Line from the earlobe to the mid-clavicle

63
Q

Test the accessory nerve

A

Contract the sternocleidomastoid by turning neck or the upper fibres of the trapezius by shrugging the shoulders

64
Q

How many of which teeth in an adult male

A

32 total, 8 incisors, 4 canines, 8 premolars, 8 molars, 4 wisdom teeth

65
Q

What are the bones of the nasal cavity (7+2)

A

Nasal bone, superior, middle and inferior nasal conchae, vomer, maxilla, palatine bone, cribiform plate, sphenoid bone

66
Q

What is the thyroid isthmus

A

Middle bit of the thyroid gland

67
Q

What are the paranasal sinuses

A

Frontal sinus, ethmoid sinus/air cells, maxillary sinus, sphenoid sinus

68
Q

Where is the mastoid air cells

A

In the mastoid process behind the external ear

69
Q

What is a tracheostomy

A

Tracheostomy is the formation of an opening into the trachea, usually between the 2nd and 3rd tracheal cartilage ring

70
Q

What is a cricothyroidectomy

A

Incision made through the cricothyroid membrane (between thyroid and cricoid cartilage)

71
Q

Identify the features of the external auditory meatus and eardrum (4 and 8)

A 
External auditory meatus (foreign body, wax, skin, shape)
tympanic membrane (pars tensa, pars flaccida, handle of malleus, short process of malleus, umbo, cone of light, anterior and posterior malleolar folds), behind TM (not always visible)
72
Q

What to do before examining the ear canal

A

Pull the ear up and back

73
Q

Which nerves control the eye movement? How to test

A

3, 4, and 6. Move finger in the H shape and then move close to face to test accommodation

74
Q

Test ipsilateral and consensual pupillary light reflex

A

Ipsilateral - Ask subject to look at distant target. Shine one eye with penlight, observe pupillary constriction in the same eye.
Consensual - Ask subject to look at distant target. Shine one eye with penlight, observe pupillary constriction in the fellow eye.
Swinging torch – RAPD – both pupils constrict when light swings to undamaged side, both pupils paradoxically dilate when light swings to damaged side.

75
Q

What direction do CN III, IV and VI move the eye

A

III - adduction (towards middle) and up
IV - adduct and down
VI - abduction

76
Q

Afferent pathway of the accommodation reflex? (7)

A

Afferent from the primary visual pathway: retina -> optic nerve (CN2) -> optic chiasm -> optic tract -> lateral geniculate body -> optic radiation -> visual cortex.

77
Q

Efferent pathway of the accommodation reflex?

A

visual cortex -> pretectal nuclei -> Edinger-Westphal nucleus -> CN3 -> sphincter pupillae.

78
Q

What muscle and nerve controls the pupil?

A

Sphincter pupillae, CNIII

79
Q

Afferent and efferent arms of the corneal reflex?

A

Afferent – nasociliary branch of ophthalmic branch of trigeminal (V1)
Efferent – temporal and zygomatic branches of facial nerve (VII)

80
Q

Test the sensory functions of the three divisions of the trigeminal

A

Trigeminal is the sensory nerve of the face
To the eyelids is the ophthalmic
Anterior temple, middle part of the face to the corners of the mouth is the maxillary
Middle part of the temple anterior to the ear and down to the chin is the mandibular branch, as is the lower teeth, gums, lips, inside of cheeks, floor of mouth and anterior 2/3rds of the tongue

81
Q

Test the motor function of the accessory nerve

A

Shrug shoulders to move trapezium and turn head to test SCM

82
Q

Test the motor function of the mandibular division of the trigeminal nerve

A

Palpate masseter (cheeks) and temporalis (temples) muscles

83
Q

Test motor function of the facial nerve

A

Ask patient to adopt various expressions and look for assymetry - smile, frown, close eyes tightly, lift eyes, show teeth, puff cheeks.

84
Q

What are the functions of the facial nerve

A

Supplies motor muscles of facial expression & via chorda tympani, parasympathetic to submandibular/sublingual salivary glands

85
Q

Test function of the glossopharyngeal nerve

A

Use 2 tongue depressors (1 to hold tongue down and other to touch back of mouth) and evoke a gag reflex.
It is the sensory nerve of the posterior 1/3rd of the tongue and oropharynx

86
Q

Test motor function of the vagus

A

Ask the subject to open their mouth and say “ahh” and observe the elevation of the uvula to see if there is any deviation from the midline (away from the lesioned side)

87
Q

Test the motor function of the hypoglossal nerve

A

Protract (stick out tongue) deviation goes towards lesioned side

88
Q

What is the motor function of the hypoglossus

A

The tongue

OSPE (7 decks)

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