Pathology

Question 1

Periorbital Ecchymosis:

• Black eye v. Raccoon eye
• Time frame?

Answer 1

Black eye- Can be unilateral. Local periorbital bleed. Occurs within hours post-trauma.

Raccoon eye- Always bilateral. One cause is a fx of the anterior basilar skull. Occurs 2-3 days post-trauma.

Question 2

Swelling/aneurysm of internal carotid artery presents how?

Answer 2

With vision problems, since it can put pressure on the optic nerve

Question 3

CSF rhinorrhea happens how? What else is affected?

Answer 3

Fracture of cribriform plate, when the dura and arachnoid tear. CSF leaks into nose. Olfactory n. CN I also affected.

Question 4

CST otorrhea happens how? What if eardrum also ruptures?

Answer 4

Fracture of petrous part of greater wing of sphenoid, including roof of middle ear and tear of dura and arachnoid. CSF leaks into middle ear. If tympanic membrane also ruptures, CSF enters the auditory canal and exits.

Question 5

Most strokes happen in which artery?

Answer 5

the internal carotid artery

Question 6

A fx of the pterion will rupture which artery? What kind of bleed would it cause?

Answer 6

The anterior br. of the middle meningeal a. it would cause an epidural bleed.

Question 7

Sign of lesion on CN XII? (2)

Answer 7

produces wasting of ipsilateral side of tongue, with spontaneous contraction. Tongue deviates toward affected side upon protrusion.

Question 8

Sign of lesion in CN VI?

Answer 8

Inability to look laterally. eye deviates medially due to no lateral muscle contraction

Question 9

Meningitis is due to what? Explain each symptoms/treatment.

Answer 9

1. fungal- not contagious. usually affects people w/compromised immune system. Anti-fungals.
2. viral- less severe, resolves w/o treatment
3. bacterial- can be contagious, very severe. There is a vaccine.
4. parasitic- not contagious. Fatal brain infection.

Question 10

Migraine symptoms? duration? treament? triggers? prevention?

Answer 10

most of the time unilateral. Throbbing, gradual but acheives great intensity. bright light, noise, moving, nausea, vomiting. No specific cure. OTC pain relievers, and triptans. Avoid/change “triggers” (nitrates, caffeine)

Question 11

cluster headache symptoms, duration, treatment, triggers, prevention

Answer 11

cluster headaches- unilateral. Sudden onset, quickly reaches greatest intensity. very painful. 30 min to 3 hours, occuring up to 3x a day. cycles can last up to years, almost daily. Triptans, steroids. For prevention, beta blockers, anti-seizure (topiramate), lithium, anti-depressants

Question 12

tension headache symptoms, duration, treatment, triggers, prevention

Answer 12

Tension headaches- moderate. Tightening across head. Can tighten head/neck muscles. Non-pulsatile. Last 30 min to a week. Treat symptoms w/OTC pain relievers, narcotics, muscle relaxants. Avoid triggers. Profalactic dose of SSRI/tricyclic antidepressants.

Question 13

What causes the three types of stroke? symptoms? risk factors? treatment?

Answer 13

Ischemic stroke- loss of blood flow due to blockage
Hemmorhagic stroke- loss of flow due to bleed. Surgery may be necessary.
Transient ischemic attack- loss of flow relatively short duration
Sudden numbness/weakness of face, arm leg, mostly on one side of body. Loss of coordination. Sudden severe headache. Trouble seeing in one or both eyes. Sudden confusion, trouple speaking/understanding. Risk factors are hypertension, high cholesterol, alcohol use, diabetes, obesity, heart disease. Treatment is TPA to break up clot, if w/in 4. 5 hours.

Question 14

CN V v3 motor lesion causes what?

Answer 14

atrophy of mm of mastication, and some weakness of bite

Question 15

What is trigeminal neuralgia?

Answer 15

severe pain over sensory area of v2 and sometimes v3

Question 16

What is a trigeminal ganglion nerve block?

Answer 16

anaesthetic administered through foramen ovale into the ganglion

Question 17

jaw jerk reflex (v3-v3 reflex)

Answer 17

Lightly tap jaw open, it then reflexively closes. Occurs when cortex is shut down in coma but does not occur under normal conditions.

Question 18

What is ptosis?

Answer 18

eyelid droop occurs. If either elevator is denervated, CN VII is unopposed and thus the eye closes.

Question 19

Explain Bell’s palsy.

Answer 19

Hemi-paralysis of face, including forehead and even the platysma. CN VII entrapment in facial canal. Depending on level of entrapment, can have other CN VII deficits. Generally treatable and reversible.

Question 20

What is the consensual corneal reflex?

Answer 20

when swabbing one cornea, both eyes close instead of just one. CN V v1 brings the sensation to the brain, and then CN VII sends the motor innervation to the eyes to close. Unsure why both close, but that’s normal. It’s a way to test the integrity of the pons (CN V1, CN VII)

Question 21

What is Horner’s syndrome?

Answer 21

Congenital mess ups in an with the sympathetic NS. Big symptom is that the pupil constricts, because it is unopposed. Other symptoms are anhydrosis, partial ptosis, vasodilation, and heterochromic iridis (light colored iris)

Question 22

What are the parasympathetic nuclei for CN III, VII, IX, and X

Answer 22

CN III- Edinger-Westphal nucleus
CN VII- superior salivatory nucleus
CN IX- inferior salivatory nucleus
CN X- Dorsal motor nucleus

Question 23

What is mastoiditis and how does it happen?

Answer 23

Infection of the mastoid air cells, by way of infection in the auditory tube.

Question 24

Levator veli palatini innervation?

Answer 24

CN X vagus n.