Neck Clinical Correlations Flashcards
what is clinically relevant about the retropharyngeal space?
it is a potential space that allows the structures of the visceral compartment to glide against the prevertebral fascia during swallowing an infection in this space may spread inferiorly into the superior mediastinum
what is the baroreceptor reflex? disruption of the reflex results in what?
maintains blood pressure in response to changes in posture disruption of the reflex results in orthostatic hypotension- a decrease in BP when patient assumes an upright position
what is the chemoreceptor reflex?
maintains blood gases by adjusting respiration, cardiac output, and peripheral BP a decrease in oxygen tension (PO2) and an increase in carbon dioxide tension (PCO2) will result in an increase in respiration, HR, and peripheral BP
lesion of the stellate ganglion, cervical part of the sympathetic trunk or the superior cervical ganglion can cause what? what symptoms are associated?
Horner’s syndrome- anhydrosis (lack of sweat), ptosis (eyelid dropping), miosis (constricted pupils)
what can be performed for patients who exhibit excessive vasoconstriction or sweating in the upper limb?
stellate ganglion block
what occurs with a lesion to the accessory nerve within the posterior triangle?
weakness of the trapezius muscle–>patient has difficulty elevating the scapula (shrugging shoulder) and in laterally rotating the scapula during abduction of the arm if the lesion is inferior to the jugular foramen, may also have weakness in the SCM–>decreased ability to turn the chin to the side opposite the lesioned nerve
what is jugular foramen syndrome and what are the symptoms associated?
lesions of the glossopharyngeal nerve can occur in conjunction with the vagus nerve and accessory nerve in jugular foramen syndrome it is diagnosed by loss of the gag reflex
what can be lesioned during tonsilectomy and what symptoms does this result in?
lingual branch of CN IX loss of all sensation from the posterior 1/3 of the tongue
middle ear infections can infect what nerve and will result in what associated symptoms?
preganglionic parasympathetic axons of CN IX that synapse in the otic ganglion reduced parotid gland secretions this is difficult to evaluate because the submandibular and sublingual salivatory glands which are innervated by the facial nerve continue to contribute to the volume of saliva
what occurs with lesions to the vagus nerve?
complete lesions result in weakness of palate, pharyngeal, and laryngeal muscles weakness of the levator veli palatini–>drooping of palate on side of the injured nerve and a deviation of the uvula to the opposite site; nasal speech and nasal regurgitation of liquids during swallowing weakness of pharyngeal constrictors–>dysphagia (difficulty swallowing) if the lesion includes the laryngeal nerves–>weakness of all laryngeal muscles on the affected side so that the vocal cord assume a fixed position midway between abduction and adduction–>hoarse speech and week lesions of the pharyngeal branch and laryngeal nerves–>loss in motor limb of the gag reflex and cough reflex, respectively
what symptoms are associated with lesions to the superior laryngeal nerve?
largely asymptomatic because its fibers are mainly sensory if the motor fibers to the cricothyroid are affected by a lesion of the external branch–>mild hoarseness and slight decrease in vocal strength with tendency to produce monotonous speech
during surgeries involving the thyroid gland, which nerves are susceptible to injury? what symptoms will this result in?
both recurrent laryngeal nerves fixed vocal cord and transient hoarseness
which recurrent laryngeal nerve is more at risk for injury? why?
left recurrent laryngeal nerve injured more frequently because in the superior mediastinum it hooks around the arch of the aorta and might be compressed during an aortic aneurysm the right is found only in the neck where it hooks around the subclavian artery
