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1
Q

Neuropraxia

A

Compression and ischemia. Comes back in hours to weeks, and no wallerian degeneration occurs.

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2
Q

Axonotmesis

A

Has disruption of the neuronal axon, but with maintenance of the myelin sheath. Wallerian degeneration occurs, but regeneration occurs over weeks to years.

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3
Q

Neurotmesis

A

Not only the axon, but the encapsulating connective tissue lose their continuity. Has wallerian degeneration, with permanent loss.

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4
Q

Charcot Leyden crystals

A

allergic fungal rhinosinusitis

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5
Q

Furstenburg test

A

encephalocele expands with compression of IJ

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6
Q

Potts puffy tumor

A

fonticulus nasofrontalis subperiostial abscess

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7
Q

Local anesthetic allergy - which are amides?

A

contain 2 “i”s

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8
Q

Local anesthetic allergy - which are esters?

A

contain 1 “i”

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9
Q

Rapid Sequence medications

A

100mg Succinylcholine, 20mg Etomidate

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10
Q

Sunderland’s Classification

A

Nerve Injury

First-degree (Class I)

Seddon’s neurapraxia and first-degree are the same.

                                                                                       Second-degree (Class II)

Seddon’s axonotmesis and second-degree are the same.

                                                                                       Third-degree (Class II)

Sunderland’s third-degree is a nerve fiber interruption. In third-degree injury, there is a lesion of the endoneurium, but the epineurium and perineurium remain intact. Recovery from a third-degree injury is possible, but surgical intervention may be required.

                                                                                       Fourth-degree (Class II)

In fourth-degree injury, only the epineurium remain intact. In this case, surgical repair is required.

                                                                                       Fifth-degree (Class III)

Fifth-degree lesion is a complete transection of the nerve. Recovery is not possible without an appropriate surgical treatment.

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11
Q

Nerve layers

A

Epineurium

Perineurium

Endoneurium

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12
Q

How much blood is in a human?

A

Obese Female: 60cc/kg
Adult Female: 65cc/kg
Obese Male: 70cc/kg
Adult Male: 75cc/kg
Infant: 80cc/kg
Term Neonate: 85cc/kg
Premature Neonate: 95cc/kg

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13
Q

List the cranial nerves

A

I - Olfactory nerve
II - Optic nerve
III - Oculomotor nerve
IV - Trochlear nerve
V - Trigeminal nerve/dentist nerve
VI - Abducens nerve
VII - Facial nerve
VIII - Vestibulocochlear nerve/Auditory nerve
IX - Glossopharyngeal nerve
X - Vagus nerve
XI - Accessory nerve/Spinal accessory nerve
XII - Hypoglossal nerve

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14
Q

What is Frey’s syndrome?

A

(Gustatory Sweating)

Pathophysiology

injury to the auriculotemporal nerve (sympathetic
fibers) results in aberrant innervation of cutaneous sweat glands (which share the same neurotransmitter) by postganglionic
parasympathetic fibers

  • may occur up to 5 years postoperatively
  • less incidence with the use of “thick” skin flaps

Symptoms

sweating and reddening of skin during meals

Treatment

  1. Medical Management: antiperspirant and anticholenergic preparations (scopolamine, glycopyrrolate, diphemanil methylsulfate)
  2. Surgical Management: tympanic neuronectomy (chorda tympani nerve section via tympanotomy approach), interpose a sheet of fascia lata or dermis between skin and parotid gland
  3. Radiation Therapy: reserved for failed management with severe symptoms
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15
Q

What is the only cranial nerve to both enter and exit the skull?

A

CN XI (spinal accessory)

This nerve derives from the brainstem, enters through the foramen magnum, then exits the skull via the jugular foramen

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16
Q

What are the Paradise Criteria for Tonsillectomy?

A

7/1 5/2 3/3

  • 7 episodes in previous year
  • 5 episodes in each of the previous 2 years
  • 3 episodes in each of the previous 3 years

Clinical features

  • Sore throat plus at least one of the following features qualifies as a counting episode:
  • Temperature of greater than 100.9°F (38.3°C)
  • Cervical adenopathy (tender lymph nodes or lymph node size greater than 2 cm)
  • Tonsillar exudate
  • Culture positive for group A β-hemolytic streptococcus
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17
Q

What are the criteria for placement of pressure-equalizing tubes?

A

>3 episodes in 6 months, > 4 episodes in 12 months (3/6, 4/12)

  • Severe acute otitis media
  • Hearing loss > 30 dB in patient with otitis media with effusion
  • Poor response to antibiotic for otitis media
  • Impending mastoiditis or intra-
  • cranial complication due to otitis media
  • Otitis media with effusion > 3 months
  • Recurrent episodes of acute otitis media (more than 3 episodes in 6 months or more than 4 episodes in 12 months)
  • Chronic retraction of tympanic membrane or pars flaccida
  • Barotitis media control.
  • Autophony due to patulous eustachian tube.
  • Craniofacial anomalies that predispose to middle ear dysfunction (e.g., cleft palate)
  • Middle ear dysfunction due to head and neck radiation and skull base surgery
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18
Q

How many cells are there in the human body?

A

10^14, or 100,000,000,000,000

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19
Q

How many bacteria are there in the human body?

A

10^15, or 10 times more than there are human cells

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20
Q

What hormones are secreted from the anterior pituitary?

A

FLATT-PMG

  • Follicle-Stimulating hormone
  • Luteinizing hormone
  • Adrenocorticotropic hormone
  • Thyroid-stimulating hormone
  • Tropic hormone
  • Prolactin
  • Melanocyte-stimulating hormone
  • Growth hormone
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21
Q

What hormones are secreted from the posterior pituitary?

A
  • Oxytocin
  • Vasopressin (ADH)
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22
Q

What is Klumpke Paralysis?

A

Palsy of the lower roots of the brachial plexus

Usually C8 and T1 involved

Caused by shoulder dystocia leading to a pulled arm

Leads to “claw hand”

“Klumpke the monkey hung from a tree”

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23
Q

Osteoclasts vs Osteoblasts

A

Osteoclasts

Removes bone tissue by breaking mineralized matrix down (bone resporption)

Osteoblasts

Responsible for bone formation

Specialized fibroblasts that produce a matrix of osteoid (type 1 collagen)

24
Q

What are the 5 types of collagen?

A
  1. Collagen I: skin, tendon, vascular ligature, organs, bone (main component of the organic part of bone)
  2. Collagen II: cartilage (main component of cartilage)
  3. Collagen III: reticulate (main component of reticular fibers), commonly found alongside type I.
  4. Collagen IV: forms bases of cell basement membrane
  5. Collagen V: cell surfaces, hair and placenta
25
What is **Scrofula**?
_Tuberculous cervical lymphadenitis_ Lymphadenitis of the cervical lymph nodes associated with **TB** (95%) as well as atypical mycobacterium (more common in **immunocompetent children**)
26
What are the indications for hemodialysis?
**AEIOU** 1. Acidosis 2. Electrolyte abnormalities-hyperkalemia 3. Ingestion of substances like barbiturates, salicylates, lithium, methanlo, etc 4. Overload fluid (unresponsive to diuretics) 5. Uremia symptoms (pericarditis, encephalopathy)
27
What is another name for the tubal tonsil?
**Tonsil of Gerlach**
41
What is the Torus Tuberius?
42
What is Torus Palatinus?
Bony protrusion on the palate Can also occur on the mandible (**torus mandibularis**) Multifactorial
43
What is the maximum dose of Lidocaine **with** epi?
**_7mg/kg_** ex: 70kg male: 70kg\*(7mg/kg) = 490mg 490mg/(10mg/mL) = 49mL max dose Can give more due to the decrease blood flow from the epinephrine, and therefore the decreased systemic concentrations reached
44
What is the maximum dose of Lidocaine **without** epi?
**_4.5mg/kg_** ex: 70kg male: 70kg\*(4.5mg/kg) = 315mg 315mg/(10mg/mL) = 31.5mL max dose
45
On MRI, T1 vs T2?
**_World War 2_** **water** looks **white** in **T2** T1 weighted: enhances fat, water is DARK T2 weighted: enhances water, fat appears DARK
46
What does an amalgam tattoo look like?
47
What are otowicks composed of?
sea sponge
48
What is the confluence of sinuses?
**torcular herophili** * connecting point of the superior sagittal sinus, straight sinus, and occipital sinus.
49
What is the vomeronasal organ?
**Jacobson's organ** * Auxiliary olfactory sense organ that is found in many animals * Discovered by Frederik Ruysch and later by Ludwig Jacobson in 1813 * Sense organ involved in the **_flehmen response_** in mammals * Seen as a vestigial line in the septum in humans during sinus surgery
50
What is the Flehmen Response?
* Animal curls back its upper lips exposing its front teeth, inhales with the nostrils usually closed and then often holds this position for several seconds * Facilitates the transfer of pheromones and other scents into the vomeronasal organ located above the roof of the mouth via a duct which exits just behind the front teeth of the animal
51
What is dysphagia lusoria?
* abnormal condition characterized by difficulty in swallowing caused by aberrant right subclavian artery * lusus naturæ means sports of nature or natural anomaly * During development of aortic arch, if the proximal portion of the right fourth arch disappears instead of distal portion, the right subclavian artery will arise as the last branch of aortic arch. * It then courses behind the esophagus (or rarely in front of esophagus, or even in front of trachea) to supply blood to right arm. This causes pressure on esophagus and results in dysphagia. It can sometimes result in upper gastrointestinal tract bleeding
52
What is the opposite of the Valsalva maneuver?
**Toynbee maneuver** Pinch nose, and swallow Pulls eustachian tube open
53
Anatomy of the Carpals
54
What are the steps of skin graft healing?
1. **Plasmatic Imbibition** - 0 - 48 hours, passive absorption 2. **Inosculation** - day 3-5, vascular network forms from capillary buds 3. **Revascularization** - day 5 and on, new blood vessels grow into graft
55
What are the steps of the reconstructive ladder?
56
What is Von Hippel–Lindau disease?
* Rare, autosomal dominant genetic condition that predisposes individuals to benign and malignant tumours * The most common tumours found in VHL are central nervous system and _retinal hemangioblastomas, clear cell renal carcinomas, pheochromocytomas, pancreatic neuroendocrine tumours, pancreatic cysts, endolymphatic sac tumors and epididymal papillary cystadenomas_ * VHL results from a mutation in the von Hippel–Lindau tumor suppressor gene on **chromosome 3p25**
57
What is the frequency of post tonsillectomy bleeding?
2-4% bleed rate 1/15,000-30,000 mortality rate
58
What bacteria is commonly seen in human bites?
**_Eikenella corrodens_** Gram negative bacillus Infections most commonly occur in patients with cancers of the head and neck It is also common in human bite infections, especially "reverse bite" or "fight bite", or "clenched fist injuries" It also causes infections in insulin-dependent diabetics and intravenous drug users who lick their needles ("needle-licker's osteomyelitis") It is one of the HACEK group of infections which are a cause of culture-negative endocarditis.
59
Mucocele vs mucous retention cyst
Mucoceles do not have a true lining/wall Mucous retention cysts are true cysts, and have a cyst wall (dont grow, invade, erode)
60
What is sternberg's canal?
Lateral craniopharyngeal canal Medial to foramen rotundum Thought to be the cause of spontaneous CSF leaks
61
What is Ondine's Curse?
**Congenital Central Hypoventilation Syndrome** Disorder of autonomic nervous system Must think about breathing, otherwise go apneic Often fatal, particularly in sleep Require tracheostomy, ventilator
62
Describe the features of Plummer-Vinson Syndrome
Triad of **dysphagia**, **esophageal webs**, and **iron** **deficiency anemia**. It most usually occurs in postmenopausal women. Genetic factors and nutritional deficiencies may play a role. In these patients, esophageal squamous cell carcinoma risk is increased; therefore, it is considered a premalignant process. Dysphagia Pain Weakness Odynophagia Atrophic glossitis Angular stomatitis Increased risk of carcinoma
63
Pathology from Granular Cell Tumor
**Pseudo-epitheliomatous hyperplasia** very important, as it may mimic or look very similar to SCC
64
Only cranial nerve thats not part of the peripheral nervous system?
The **optic nerve** is derived from the diancephalon, and is therefore a direct extension of the CNS.
65
Describe features of "Acute calcific tendinitis of the longus colli muscle"
Retropharyngeal inflammatory process Typically present with neck pain, stiffness, headache CT w/ constrast shows calcification in the longus colli muscle, small RP effusion Treat with NSAIDS and PT
66
Are Aminoglycosides more *cochleotoxic* or *vestibulotoxic*?
**Vestibulotoxic** * Streptomycin * Gentamicin * Neomycin * Kanamycin * Amikacin * Tobramycin
67
How many muscles are there in the human face?
42
68

ENT (17 decks)

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