Neuro Diseases

Question 1

Vertebrobasilar insufficiency

Answer 1

Decreased posterior circulation due to intermittent vertebral artery occlusion. May occur because of head rotation
Syncope, vertigo, dizziness, numbness/weakness in hands/feet, slurred speech

Question 2

Thrombosis of cavernous sinus

Answer 2

Nerves III, IV, V1, V2 and VI are located in the cavernous sinus. Abducens nerve is the closest to the internal carotid artery that also lies within the cavernous sinus. It will most likely be the first affected nerve. Patient will not be able to move their eye laterally

Question 3

Carotid sinus hypersensitivity syndrome

Answer 3

The carotid sinus may be hypersensitive to pressure, therefor excessive pressure to the carotid sinus can produces slow heart rate, drop in BP and fainting

Question 4

Subclavian vein puncture

Answer 4

Often site of entry for central line placement or other diagnostic purposes

Question 5

Scalp infection

Answer 5

Loose CT (layer 4) is dangerous because pus of blood spreads easily. Can also pass into the cranial cavity through small emissary veins to reach intracranial structure.

Question 6

Congenital deafness

Answer 6

May be associated with first arch syndrome (abnormality of the malleus, incus or lack of auricle) or rubella infection during 7th or 8th week.

Question 7

Absence of EAC

Answer 7

Results from failure of inward expansion of 1st pharyngeal groove and failure of meatal plug to disappear

Question 8

Coloboma

Answer 8

Incomplete closure of retinal fissure, creating a gap in eye structure. Can occur from cornea to optic nerve

Question 9

Retinochoroidal coloboma

Answer 9

Localized gap in the retina, usually inferior to the optic disc, typically bilateral

Question 10

Coloboma of iris

Answer 10

Defect in inferior sector of iris, keyhole appearance of pupil

Question 11

Retinal detachment

Answer 11

When inner and outer layers of the optic cup fail to fuse and obliterate the intraretinal space. May result from unequal rates of growth. Can also occur following a blow to the eye

Question 12

Persistant hyaloid artery

Answer 12

Distal part of hyaloid artery normally degenerates as proximal part forms central artery of the retina. If distal portion persist, it may appear like a worm-like structure projecting from the optic disc.

Question 13

Congenital cataracts

Answer 13

Can be caused by radiation, congenital galactosemia or rubella

Question 14

Congenital glaucoma

Answer 14

Increased intraocular pressure in neonates. Due to abnormal development of drainage mechanism of aqueous humor during fetal period. Abnormal development of scleral venous sinus or blockage of schlemms canal

Question 15

Aniridia

Answer 15

Lack of iris tissue or almost complete absence of the iris. Congenital cause due to mutation in PAX6. Arrest of development at the rim of the optic cup

Question 16

Aspiration of foreign body

Answer 16

Foreign body that enters through laryngeal outlet can be trapped at the vestibular folds. Apply pressure to abdomen to force air out of lungs and dislodge object

Question 17

Larynx growth

Answer 17

Larynx grows steadily until about age 3 when it starts slowing. At puberty, testosterone causes male laryngeal cartilage to enlarge. Cartilage tends to calcify around age 65 and can be seen on radiograph

Question 18

Brachial fistula

Answer 18

Abnormal patency of remnants of the 2nd pharyngeal pouch or groove, results in a canal b/w the tonsillar cleft and side of neck

Question 19

Brachial sinus

Answer 19

Results of embryonic cervical sinus failing to disappear. Opening for this sinus may exist anywhere along anterior border of SCM
Can also cause brachial cyst if the sinus does not communicate externally.

Question 20

Tracheoesophageal fistula

Answer 20

Congenital anomaly where esophagus ends in a blind-ended pouch and the stomach communicates with the trachea or with nothing.

Question 21

Stages of swallowing

Answer 21

One- voluntary compression of bolus against soft palate from mouth to oropharynx
Two- involuntary sealing of the nasopharynx from oropharynx with the suprahyoid and anterior longitudinal muscles that elevate larynx.
Three- involuntary sequential contraction of the three pharyngeal constriction muscles forces bolus into esophagus

Question 22

Craniosynostosis

Answer 22

Premature fusion of cranial structures, often associated with other skeletal defects. More common in males

Question 23

Scaphocephaly

Answer 23

Premature closing of sagittal suture causing cranium to become long, narrow and wedge shaped. 50% of cases

Question 24

Brachycephaly

Answer 24

Premature closing of coronal suture leading to high tower-like structure. 30% of cases

Question 25

Plagiocephaly

Answer 25

Premature closure of coronal suture on one side which leads to cranium being twisted and asymmetric

Question 26

Trigonocephaly

Answer 26

Premature closure of front/metopic suture causing deformities of frontal and orbital bones along with other abnormalities

Question 27

Cleft lip

Answer 27

Extends through the lip and often nose/maxilla. Maxillary prominences and medial prominences don’t form

Question 28

Reflux into nasal cavity

Answer 28

Damage to tensor veli palatini or levator veli palatini muscle can cause reflux of oral contents into nasal cavity and eustachian tube dysfunction. Tensor veli palatini innervated by trigeminal (PA1), levator veli palatini innervated by vagus (PA4/6)

Question 29

Preauricular sinus

Answer 29

Pit-like cutaneous depression or shallow sinuses anterior to the auricles. Incomplete fusion of auricular hillocks and defective close of dorsal part of first pharyngeal groove. Can become infected.

Question 30

Atresia of external auditory meatus

Answer 30

Blockage of external acoustic meatus result from failure of meatal plug to canalize. Auricle is severely affected. Deep part of meatus usually open. Abnormal development of 1st and 2nd pharyngeal pouches.

Question 31

Microtia

Answer 31

Small/rudimentary auricle appears. Can be indicator of birth defects such as atresia of external auditory meatus and middle ear anomalies

Question 32

Blockage of central retinal vein vs artery

Answer 32

Central artery blockage will cause instant blindness. Blockage of central vein will cause slow and painless blindness.