Module 6: H + N (not spine) Flashcards
petrous apex
can get asymmetric marrow
what MRI sequence is useful and why
STIR fat satruation.
remove fat, can show a cholestrol grnauloma which might otherwise be hidden
Cephaloceles
what is it
herniation of CNS content through a cranium defect
two important carotid artery variant anatomy to be aware of
stapedial artery
aberrant internal carotid
what is the most common petrous primary lesion
cholestrol granuloma
cholestrol granuloma on MRI
T1 and T2 bright
T2 dark haemosiderin ring
what is a cholestrol grnauloma made from
blocked air cells with haemorrhage and inflammation continuining
What is a cholesteatoma
epidermoid (ectopic epithelial tissue)
congenital
How to define a choleastoma from a cholestrol granuloma
T1 dark for choleastoma and restrict diffusion
granuloma T1 and 2 are bright
otomastoiditis
trigeminal neuropathy
lateral rectus palsy
grandenigo syndrome
Endolymphatic sac tumour
ax to what condition
grow into where
how will they appear on CT
MRI?
vHL
CPA
calcifcaiton on CT
MRI - T2 bright
Paraganglioma in jugular region present with q
hoarse voice from vagus nerve
Large vestibular aqueduct syndrome is what
bony canal between vestibulae(inner ear) and endolymphatic sac.
enlarged causes progressive sensorineural hearing loss
VA vs PSCC size
in vestibular aqueduct syndrome
normall VA is not larger than the PSCC.
MRI appearance of labyrinthitis
inflammation of the membranous labyrinth.
cochlea and semicircular cancals enhance on T1 post contrast
what happens in layrinthitis ossificans
ossification of the membranous labyrinth
causes sensori neural hearing loss
two types of otosclerosis
fenestral
retrofenestral
Fenestral otosclerosis
bony resorption anterior to the oval window,
Footplate will fuse to the oval window
Retrofenstal otosclerosis
more severe form.
demineralization around the cochlea.
sensori neurla component. Bilateral and symeetric nearly 100% of the time
otitis media is infection where
middle ear
effusion
why do downs more commonly get otitis media
horizontal eustachian tube
definition of chronic for otitis media
6 weeks of fluid
complications of otitis media
coalescent mastoiditis
facial nerve pasly
dural sinus thrombosis
meningitis and labyrinthitis
Labyrinthine fistula can result from
a cholesteatoma
lateral semicircular canal most often involved in a fistula
superior semicircular canal dehiscene can cause
noice induced vertigo
causative bug of necrotising external otitis
pseudomonas
which bits of the facial nerve don’t enhance
cisternal
canalicular
labyrinthine
what can cause abnormal enhancement of the facial nerve
Bells palsy
Lymes
Ramsay hunt
Cancer
what are some compication of the pagets skull
deafness
cranial nerve paresis
if invading basilar, brainstem compression
high grade osteosarcoma
age variation of pagets vs fibrous dysplasia
pagets is over 80
Fibrous dysplasia is under 30
location variaton of pagets vs fibrous dysplasia
Fibrous dysplasia spares the otic capsule
What do McCune albright syndrome get
multifocal fibrous dysplasia
cafe au lait spots
precocoiuos puberty
Juvenile nasal angiofibroma is found on the ….
get expansion of the
sphenopalatine foramen
expansion of the pterygopalatine fossa
Juvenile nasal angiofibroma get blood supply fomr
ascending pharnygeal artery and internalmaxillary
inverting papilloma are found where
lateral wall of the nasal cavity
appearance of an inverting papilloma
focal hyperostosis at the tumour origin
Esthesioneuoblastoma is found where
….. and therefore appearance is
starts at cribiform plate
dumbell appearance
most common location for squamous cell sinuses
maxillary antrum
squamous cell sinuses mri appearance
low T21 due to packed cells.
with epistaxis, posterior bleeds can be N-IR embolised via what vessel
sphenopalatine artery.
with embolising nose bleeds what to watch out for
variant anastomosis between the ECA and opthalmic artery.
don’t want to embolize the eye
dermoid /epidermoid in the floor of the mouth has what appearance
sack of marbles
what is a Ranula
in the mouth
mucous retention cyst
Torus palatinus can be mistaken for what
cancer as it looks nasty
just bone overgrowth at the hard palate
Ludwigs angina is what (mouth)
aggro cellulitis.
gas everywhere
starts from odontogenic infection
What are the classical associated causes of ON of the mandible
bisphosphonates
radium paint licking
radiation
thyroglossalo duct cyst can appear where?
anywhere between the foramen cecum and the thyroid gland
thyroid nodules
microcalcificaitons think
papillary thyroid cancer
thyroid nodules
comet tail
colloid nodule
cause of large thyroid in UK vs AFrica
graves
africa likely low idoine
how does graves cause hyperthyroidims
antibodies directed towards tsh receptor
orbit and graves featurs
spares tendon insertion
IMSLO
Increased intra-orbital fat
hashimotos can cause increased risk of
primary thyroid lymphoma
what are the antibodies in Hashimotos
TPO and antithyroidglobulin
Level 6 node - delphian - think
laryngeal cancer met
subacute thyroiditis / De Quervains can be in repsonse to
upper airway infeciton
Reidels thyroiditis is one of what tpye of conditions
igG4 conditions
WHAT ARE THE OTHER iGg4 CONDITIONS
Orbital pseudo tumour
retroperitoneal fibrosis
sclerosing cholangitis
Papillary is…
popular
most common
Papillary cancer seen on imaging
microclacifications
How does follicular cancer metastatis
via blood
Medullary thyroid cancer is associated with what
MEN2
Medullary thyorid produces what
calcitonin
DOes medullary cancer respond to I-131
no
ANaplastic thyroid seen in
elderly
not repsond to i131 due to heavy differnetiation and no sodium idoine transporters
parathyroid anatomy
superior 2 from 4th branchial pouch
inferior 2 are from the 3rd
what are the causes of hyperparathyroidism ?
Hyperfunctioning adenoma
Multi-gland hyperplasia
Cancer
What factors does sestamibi prathyroid imaging depend on ?
mitochondrial density and blood flow
the partodi space contains
parotid gland
cranial nerve 7
retromandibular vein
Pleomorphic adneoma
MRI appearance
T2 bright
can be in parotid, submandibular and sublingual
Warthins will normally affect who
male
bilateral, smoker
most common malignant tuimour of the minor salivary glands
mucoepidermoid carcinoma
adnoid cystic carcinoma love what kind of spread
perineural