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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
Q

locate the cricoid cartilage

A

2.5 com inferior to laryngeal prominence

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26
Q

locate the thyroid

A

between cricoid cartilage and jugular notch

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27
Q

locate the lateral mass of atlas

A

between mastoid process and ramus of mandible

28
Q

demonstrate the boundaries of the anterior triangle of the neck

A

midline of neck
inferior border of mandible
anterior border of SCM

29
Q

demonstrate the boundaries fo the posterior triangle of the neck

A

posterior border of SCM
anterior border of trapezius
middle 3rd of clavicle

30
Q

Contents of anterior triangle of the neck

A 
hyoid bone
common carotid artery
internal jugular vein
supra-hyoid muscles
infrahyoid muscles
31
Q

contents of posterior triangle of the neck

A 
external jugular vein
subclavian vein
subclavian artery 
trunks of brachial plexus
phrenic nerve
vagus nerve
spinal accessory nerve
32
Q

surface landmark the internal jugular vein

A

runs lateral and parallel to common carotid (under SCM from earlobe to jugular notch)

33
Q

surface landmark the external jugular vein

A

runs from angle of mandible to middle of clavicle

34
Q

surface landmark insertion of central line

A

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
Q

Palpate the cervical lymph nodes

A

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
Q

Innervation of the superior oblique muscle

A

CN 4 Trochlea

37
Q

Innervation of the lateral rectus muscle

A

CN 6 Abducens

38
Q

Extraocular muscles innervated by the oculomotor nerve (CN 3)

A

medial rectus
inferior oblique
superior rectus
inferior rectus

39
Q

function of the superior oblique muscle

A

depression, abduction and medial rotation of the eyeball

40
Q

function of the inferior oblique muscle

A

elevation abduction and lateral rotation of the eyeball

41
Q

function of the medial rectus muscle

A

adduction

42
Q

function of the lateral rectus muscle

A

abduction

43
Q

function of the superior rectus muscle

A

elevation, adduction, medial rotation of the eyeball

44
Q

function of the inferior rectus

A

depression, adduction, lateral rotation of eyeball

45
Q

Test the function of the extrinsic muscles of the eye

A

H-test exam
30-40cm away
cover one eye
repeat with other eye

46
Q

test the ipsilateral and consensual pupillary light reflex

A

penlight
check ipsilateral pupil and then contralateral pupil
repeat for other eye

47
Q

afferent pathway for pupillary constriction (accommodation reflex)

A
  1. ganglionic cells in the eye
  2. CN2 (optic)
  3. Optic tracts
  4. pretectal nucleus
  5. Edinger-westphal nucleus
48
Q

efferent pathway for pupillary constriction (accommodation reflex)

A
  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
Q

afferent arms of the corneal reflex

A

touch sensation to CN 5 (opthalmic branch) –> spinal trigeminal nucleus in medulla –> facial motor nucleus

50
Q

efferent arms of corneal reflex

A

from facial motor nucleus in brainstem –> along CN 7 (facial) –> orbicularis oculi (quickly shutting the eye)

51
Q

test sensory function of the trigeminal nerve

A

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
Q

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

A

palpate masseter muscle (anterior to temporomandibular joint) and temporalis muscle (over temples) on both sides while patient clenches their teeth

53
Q

test the motor functions of the facial nerve

A

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
Q

motor branches of the facial nerve (CN 7)

A 
Temporal 
Zygomatic
Buccal 
Mandibular 
Cervical
55
Q

test the glossopharyngeal nerve

A

test patients gag reflex with a wooden tongue depressor

56
Q

test the motor function of the vagus nerve

A

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
Q

test the motor function of the hypoglossal nerve

A

ask patient to stick their tongue out and look for deviation from the midline (will deviate towards side of lesion)

58
Q

test the motor function of the accessory nerve

A

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
Q

list teeth in a quadrant of a complete set of adult teeth

A

2 x incisors
1 x canine
2 x premolars
3 x molars

8 in a quadrant, 32 in complete adult set

60
Q

features of the external auditory meatus and eardrum that can be seen through an otoscope

A

pars flacida
pars tensa
lateral process of malleolus
cone of light

61
Q

cricothyroidotomy

A

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
Q

tracheostomy

A

transverse incision made between 2nd and 3rd cartilage rings palpable below cricoid cartilage (used for temporary intubation or long-term airway access)

63
Q

7 bones that make up the orbit of the skull

A 
Frontal
Sphenoid
Lacrimal
Ethmoid
Maxilla
Zygomatic
Palatine
64
Q

afferent and efferent arms of corneal reflex

A

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
Q

identify the 4 paranasal sinuses

A 
maxillary sinus (under orbit) 
sphenoid sinus (under sella turcica) 
frontal sinus (above nose) 
ethmoid air cells

Y2 OSPE (8 decks)

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