Referred Pain Flashcards
when is the facial nerve (CNVII) exposed in the ear?
middle ear
why is there risk of facial palsy in otitis media?
it is exposed in the middle ear so it can be aggravated by pus causing it to swell
where are middle ear infections most likely to spread?
posterior to the mastoid (meningitis risk) through the aditus meatus anterior to eustachian tube
what increases the chance that otalgia is referred pain?
no discharge
no hearing loss
nerves that can refer pain to the ear
trigeminal V2 and V3
facial nerve
glossopharyngeal nerve
vagus nerve
how does the facial nerve cause referred pain?
it innervates the sphenoid sinus, soft palate and uvula
how does the glossopharyngeal nerve refer pain?
posterior 1/3rd of the tongue
parapharyngeal space
pretracheal space
tonsil removal
how does the vagus nerve cause referred pain?
innervates larynx, lingual surfaces and epiglottis
causes of referred pain
infective/inflammatory (dental/biting tongue)
neoplasia
trauma
degenerative disorder in TMJ (teeth grinding) leads to secondary inflammation
define Ramsay Hunt syndrome
this is herpes zoster (shingles) of the facial nerve which affects the pinna of the ear (facial palsy can be a common feature too)
which spinal nerves can be perceived as otalgia?
C2 (greater auricular)
C3 (lesser occipital)
sensory innervation to the face
referred pain 5T’s
teeth tongue TMJ throat trigeminal nerve
dizziness nerve cause?
vestibular nerve
presentation of stylomastoid foramen tumour
facial palsy
no dryness of mucosal membranes
presentation of facial canal tumour
no loss of lacrimation but loss of taste (chorda tympani)
