Shelf Notes Flashcards
Cribriform plate/anterior cranial fossa fracture
May cause anosmia (olfactory nerve), periorbital bruising, CSF leakage from the nose
Epidural hematoma
Skull fracture near pterion often causes this because of a torn meningeal artery
Causes unconsciousness and death quickly because bleeding dissects a large space as it strips dura mater from the inner surface of the skull
What passes through the cavernous sinus
Internal carotid artery and internal carotid plexus Abducens nerve Structures on lateral wall of sinus: Oculomotor nerve Trochlear nerve
What is a route of infection to the cranial fossa
Ophthalmic vein- pass through superior and inferior orbital fissures, drain into cavernous sinus
Symptoms of bells palsy
Unable to close lips and eyelids on affected side
Eye on affected side is dry
Unable to whistle, blow a wind instrument or chew effectively
Facial distortion due to contractions of unopposed contralateral facial muscles
Will also affect taste from anterior 2/3rds of tongue carried by chorda tympani
Loss of secretion from submandibular/sublingual
Arteries in kiesselbachs area
Sphenopalatine, anterior ethmoidal, greater palatine and superior labial
Infection oh sphenoid sinus
May erode walls to reach cavernous sinuses, pituitary gland, optic nerves or optic chiasma
Gag reflex absence
Caused by injury to glossopharyngeal nerve because it is the afferent limb to the oropharynx
Efferent limb is vagus nerve
Palatine tonsillectomy risk
May injury glossopharyngeal nerve- loss of taste and feeling from posterior 1/3rd of tongue
Hemorrhage typically caused from hitting the tonsillar branch of facial artery
If superior constrictor is penetrated, a high facial artery or tortuous internal carotid artery could be injured
Palatine tonsil lymph drains where
Jugulodigastric lymph node, the bodies most commonly enlarged node
Nerve supply to tonsils
Tonsillar plexus formed by CN IX and X
Submental lymph nodes receive lymph from
Tip of tongue
Lower incisors
Central lips
Submandibular nodes receive lymph from
Front of scalp Nose, adjacent cheek Upper/lower lip Frontal, maxillary and ethmoid air sinuses Upper/lower teeth Anterior 2/3rds of tongue Floor of mouth, gums and vestibule
Blow out fracture of the orbit may damage what
Inferior rectus
Infraorbital nerve/artery
Not common in children because maxillary sinus is small and orbital floor is not a weak point
Oculomotor nerve palsy
Affects most of extraocular muscles
Ptosis
Fully dilated pubil
Eye is depressed and abducted- down and out
OcuLOVEmotor palsy- not lovable when you are down and out
Trochlear nerve palsy
Paralysis of superior oblique impairs ability to turn the eyeball inferomedially- pupil will look superolaterally
Double vision when looking downwards
Compensated by inclining head anteriorly and laterally toward side of normal eye
Abducens nerve palsy
Inability to abduct due to lateral rectus dysfunction
Eye is fully adducted
Corneal reflex
Blinking in response to touching cornea
Involves reflex connections b/w sensory afferent fibers in the ophthalmic nerve that make synaptic connections with motor fibers of facial nerve which supplies orbicularis oculis muscle
Horner syndrome
Can be caused by penetrating injury to neck, thyroid carcinoma or Pancoast tumor
Interrupting ascending preganglionic sympathetic fibers anywhere b/w their origin in upper thoracic spinal cord and their synapse in the superior cervical ganglion
Constriction of pupil
Ptosis
Redness and increased temp of skin (vasodilation)
Absence of sweating
Otitis media
Taste can be altered because chorda tympani is affected
Infection spreading posteriorly causes mastoiditis
Infection spreading to middle cranial fossa can cause meningitis or temporal lobe abscess
Infection through floor can produce sigmoid sinus thrombosis
TM perforation
Chorda tympani directly relates to posterior surface of TM, it could be damaged resulting in loss of taste of anterior 2/3 of tongue and secretion of sublingual/submandibular glands
Common carotid artery in relation to thyroid gland
Posterolateral
