Session 2 & 3 - Group work

Question 1

Apart from thoracic pain and possible complications arising from blood clots what possible complications may a patients with an abdominal aortic aneurysm suffer from?

Answer 1

Hoarseness of voice due to the aneurysm impinging on the left recurrent laryngeal nerve

Question 2

2.14 What branch, of which cranial nerve and of which side
of the body recurs (or branches off) in relation to the course
of the right subclavian artery? What would be the consequence of
unilateral damage to this nerve?

Answer 2

The recurrent branch of 
the right vagus nerve, 
known as the right 
recurrent laryngeal nerve 
leaves the body of the 
vagus nerve at the level 
of the right subclavian 
artery and recurs 
upwards to supply 
muscles controlling the right vocal cord

Question 3

Give two anatomical markers which show bifurcation of common carotid artery?

Answer 3

Upper border of the thyroid cartilage at the level of C4

Upper border of thyroid cartilage preferable as a landmark

Question 4

Why might an infection deep in the pterygoid region be of danger to the eye?

Answer 4

The pterygoid venous plexus, which lies deep within the temporal fossa,
is connected with both the ophthalmic and anterior facial veins. Thus
the plexus drains into the cavernous sinus and so pus within the venous
plexus may cause direct increased ophthalmic venous pressure or may
even lead to a cavernous sinus thrombosis with resultant paralysis of
extraocular muscles.

Question 5

Explain why does the skin, mucous membrane of the
lower lip together with the labial alveolar mucosa
and the gum are also anesthetised during the
inferior alveolar nerve block?

Answer 5

Mental nerve, which supples skin and mucous membrane of the lower lip, the skin of the chin and the vestibular gum also anaethatised

Question 6

Why does the tounge become numb during inferior alveolar nerve block?

Answer 6

The anaethetic solution may spread to the side of the tongue and involve the lingual nerve that lies immediately in front of the inferior alveolar nerve

Question 7

On clenching the jaw tight shut, what structure can yuou palpate luing on the contracted masseter muscle?

Answer 7

The parotid duct lies 
about ¾ of an inch 
below and parallel to 
the zygomatic arch; on 
clenching the jaw, the 
duct can be rolled on 
the tensed masseter 
muscle, particularly 
along its anterior 
border before it 
pierces the buccinator.
Opens into the mouth, after piercing the buccinator muscle, opposite to the second molar tooth

Question 8

Why might you dislocate the TMJ on yawning or taking a large bite of food?

Answer 8

The lateral pterygoid muscles protrude and depress the jaw. If the
other muscles of mastication are relaxed, excessive contraction of the
lateral pterygoids may cause the head of the mandible may ‘click’ over
the articular tubercle and dislocate anteriorly to lie just alongside the
zygomatic arch. In this position the mandible remains wide open