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Y2 OSPE > HEAD, NECK & SPINE > Flashcards

HEAD, NECK & SPINE Flashcards

1
Q

what bones join at the pterion and what structure lies beneath it?

A

frontal, sphenoid, parietal and temporal bones

middle meningeal artery

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2
Q

contents of ciribriform plate

A

CN 1 olfactory nerve

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3
Q

contents of optic canal

A

CN 2 optic nerve + opthalmic artery

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4
Q

contents of superior orbital fissure

A

CN 3 occulomotor, CN 4 Trochlear, CN 5 opthalmic branch of trigeminal, CN 6 Abducens + superior opthalmic vein

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5
Q

contents of foramen rotundum

A

CN 5 maxillary branch of trigeminal

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6
Q

contents of foramen ovale

A

CN 5 mandibular branch of trigeminal

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7
Q

contents of foramen spinosum

A

middle meningeal artery

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8
Q

contents of carotid canal

A

internal carotid artery

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9
Q

contents of internal acoustic meatus

A

CN 7 facial (entry into cranium), CN 8 vestibulocochlear, labyrinthine artery

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10
Q

contents of jugular foramen

A

CN 9 glossopharyngeal, CN 10 vagus, CN 11 accessory, sigmoid sinus (into internal jugular vein)

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11
Q

contents of hypoglossal canal

A

CN 12 hypoglossal nerve

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12
Q

contents of foramen magnum

A

spinal fibers of CN 11 + inferior portion of medulla + vertebral arteries + spinal arteries

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13
Q

contents of stylomastoid foramen

A

CN 7 facial (exit from cranium)

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14
Q

surface landmark C7

A

long prominant spinous process at root of neck

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15
Q

surface landmark T3

A

at level of scapular spine

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16
Q

surface landmark T7

A

at level of inferior angle of the scapula

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17
Q

surface landmark L2

A

2 above L4 so palpate iliac crest and move up (where renal arteries branch from aorta and the cauda equina begins)

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18
Q

surface landmark L4

A

at superior aspects of iliac crests

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19
Q

demonstrate movements of atlanto-occipital joint

A

atlas (C1) + occipital condyles - movement is flexion and extention of the head (nodding yes)

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20
Q

demonstrate movements of atlanto-axial joint

A

axis dens (C2) + anterior arch of atlas (C1) - movement = lateral rotation of head (shaking head no)

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21
Q

describe the range of flexion and extension in the different regions of the vertebral column

A

Cervical - large range
Upper thorax - none (ribs and articular processes)
Lower thorax - limited
Lumbo-sacral - large range

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22
Q

describe the range of lateral flexion in the different regions of the vertebral column

A

Cervical - large range
Upper thorax - limited
Lower thorax - large range
Lumbo-sacral - limited

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23
Q

describe the range of rotation in the different regions of the vertebral column

A

Cervical - large range
Upper thorax - limited
Lower thorax - large range
Lumbo-sacral - none (vertical articulations)

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24
Q

locate the hyoid bone

A

pincer finger 2 cm above laryngeal prominence and ask patient to swallow

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25
locate the cricoid cartilage
2.5 com inferior to laryngeal prominence
26
locate the thyroid
between cricoid cartilage and jugular notch
27
locate the lateral mass of atlas
between mastoid process and ramus of mandible
28
demonstrate the boundaries of the anterior triangle of the neck
midline of neck inferior border of mandible anterior border of SCM
29
demonstrate the boundaries fo the posterior triangle of the neck
posterior border of SCM anterior border of trapezius middle 3rd of clavicle
30
Contents of anterior triangle of the neck
``` hyoid bone common carotid artery internal jugular vein supra-hyoid muscles infrahyoid muscles ```
31
contents of posterior triangle of the neck
``` external jugular vein subclavian vein subclavian artery trunks of brachial plexus phrenic nerve vagus nerve spinal accessory nerve ```
32
surface landmark the internal jugular vein
runs lateral and parallel to common carotid (under SCM from earlobe to jugular notch)
33
surface landmark the external jugular vein
runs from angle of mandible to middle of clavicle
34
surface landmark insertion of central line
needle inserted into jugular vein at apex of triangle formed by clavicle, sternal head of SCM and clavicular head of SCM (right jugular preferred as it is wider in diameter and often more superficial)
35
Palpate the cervical lymph nodes
move fingers along in circular motions from behind the patient. submental nodes - under chin submandibular - under jaw pre-auricular - infront of ear anterior cervical chain - anterior border of SCM posterior cervical chain - posterior border of SCM post-auricular - behind ear occipital nodes
36
Innervation of the superior oblique muscle
CN 4 Trochlea
37
Innervation of the lateral rectus muscle
CN 6 Abducens
38
Extraocular muscles innervated by the oculomotor nerve (CN 3)
medial rectus inferior oblique superior rectus inferior rectus
39
function of the superior oblique muscle
depression, abduction and medial rotation of the eyeball
40
function of the inferior oblique muscle
elevation abduction and lateral rotation of the eyeball
41
function of the medial rectus muscle
adduction
42
function of the lateral rectus muscle
abduction
43
function of the superior rectus muscle
elevation, adduction, medial rotation of the eyeball
44
function of the inferior rectus
depression, adduction, lateral rotation of eyeball
45
Test the function of the extrinsic muscles of the eye
H-test exam 30-40cm away cover one eye repeat with other eye
46
test the ipsilateral and consensual pupillary light reflex
penlight check ipsilateral pupil and then contralateral pupil repeat for other eye
47
afferent pathway for pupillary constriction (accommodation reflex)
1. ganglionic cells in the eye 2. CN2 (optic) 3. Optic tracts 4. pretectal nucleus 5. Edinger-westphal nucleus
48
efferent pathway for pupillary constriction (accommodation reflex)
1. Edinger-westphal nucleus 2. parasymp fibers along CN 3 (occulomotor) 3. ciliary ganglion 4. parasymp fibers along ciliary nerves in CN 5 (opthalmic branch of trigeminal) 5. sphincter pupilae
49
afferent arms of the corneal reflex
touch sensation to CN 5 (opthalmic branch) --> spinal trigeminal nucleus in medulla --> facial motor nucleus
50
efferent arms of corneal reflex
from facial motor nucleus in brainstem --> along CN 7 (facial) --> orbicularis oculi (quickly shutting the eye)
51
test sensory function of the trigeminal nerve
ask patient to close their eyes touch test and ask patient to say yes when they feel it left and right forehead (opthalmic division) left and right cheek bone (maxillary division) left and right chin (mandibular division)
52
test the motor function of the mandibular division of the trigeminal nerve
palpate masseter muscle (anterior to temporomandibular joint) and temporalis muscle (over temples) on both sides while patient clenches their teeth
53
test the motor functions of the facial nerve
ask patient to perform a series of facial movements 1. raise eyebrows (temporal branch) - assess symmetry 2. squeeze eyes shut against resistance (Zygomatic branch) 3. smile/reveal teeth (Buccal branch) - symmetry 4. puff out cheeks against resistance (Mandibular branch) 5. purse lips - symmetry
54
motor branches of the facial nerve (CN 7)
``` Temporal Zygomatic Buccal Mandibular Cervical ```
55
test the glossopharyngeal nerve
test patients gag reflex with a wooden tongue depressor
56
test the motor function of the vagus nerve
ask the patient to open their mouth and say "ah" - observe elevation and any deviation of the uvula (would deviate away from side of lesion
57
test the motor function of the hypoglossal nerve
ask patient to stick their tongue out and look for deviation from the midline (will deviate towards side of lesion)
58
test the motor function of the accessory nerve
with dorsum of hand at patients cheek - ask them to turn their head while you resist the movement - palpate ipsilateral SCM ask patient to shrug shoulders against resistance (trapezius)
59
list teeth in a quadrant of a complete set of adult teeth
2 x incisors 1 x canine 2 x premolars 3 x molars 8 in a quadrant, 32 in complete adult set
60
features of the external auditory meatus and eardrum that can be seen through an otoscope
pars flacida pars tensa lateral process of malleolus cone of light
61
cricothyroidotomy
transverse incision made between thyroid cartilage and cricoid cartilage to allow access to the airway (used mainly in emergency due to ease of locating site of incision but has associated complications due to movement during swallowing)
62
tracheostomy
transverse incision made between 2nd and 3rd cartilage rings palpable below cricoid cartilage (used for temporary intubation or long-term airway access)
63
7 bones that make up the orbit of the skull
``` Frontal Sphenoid Lacrimal Ethmoid Maxilla Zygomatic Palatine ```
64
afferent and efferent arms of corneal reflex
Afferent: sensation to touch via CNV1 to spinal trigeminal nucleus in medulla Efferent: from facial motor nucleus to CNVII to orbicularis oculi which closes the eye
65
identify the 4 paranasal sinuses
``` maxillary sinus (under orbit) sphenoid sinus (under sella turcica) frontal sinus (above nose) ethmoid air cells ```

Y2 OSPE (8 decks)

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