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1
Q

rhinorrhea, otorrhea are due to what type of fracture

A

Basilar fracture

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2
Q

most frequent skull fracture

A

linear calivarial, occurs at POI, fracture lines radiate away in multiple directions

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3
Q

life threatening skull fracture

A

Fracture of the pterion

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4
Q

Extradural/epidural hemorrhage

A

rupture of the middle meningeal artery due to fracture of the pterion

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5
Q

order of events of a Extradural/epidural hemorrhage

A

Brief concussion → lucid interval of some hours → drowsiness and coma

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6
Q

Tearing of superior cerebral vein causes

A

Dural border/subdural hematoma

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7
Q

order of events for a Dural border/subdural hematoma

A

Tearing of superior cerebral vein → blood leaks → hematoma splits open dural border cell layer → creates a space at the dura arachnoid junction

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8
Q

Subarachnoid hemorrhage

A

Rupture of saccular aneurysm → Arterial blood escapes to subarachnoid space

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9
Q

Meningeal irritation/headache/stiff neck/loss of consciousness

A

symptoms of Subarachnoid hemorrhage

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10
Q

how do scalp injuries and infection enter the brain

A

Emissary veins pass through calvaria and reach intracranial structures such as the meninges

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11
Q

limitations of the spread of scalp infections

A

Can NOT pass laterally beyond zygomatic arches, Can NOT pass through neck

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12
Q

Ecchymoses

A

(purple patches) results of extravasation of blood into subcutaneous tissue and skin of eyelids and surrounding regions

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13
Q

SCALP

A

skin, connective tissue, aponeurosis, loose connective tissue, perostium

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14
Q

what nerves and vessels are in the cavernous sinus

A

occulomotor , trochlear, abducens, ophthalmic and maxillary. Internal Carotid Artery

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15
Q 
eyeball protrudes (exophthalmos) 
conjunctiva becomes engorged (chemosis)
pulsating exophthalmos are cased by what?
A

Cranial base fracture tear in the internal carotid artery leading to Arteriovenous (AV) fistula within cavernous sinus

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16
Q

thrombophlebitis of cavernous sinus and Arteriovenous (AV) fistula can affect what nerves

A

CN III, IV, V1, V2, VI

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17
Q

what procedure can cause dural headache

A

lumbar spinal puncture

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18
Q

pain due to distension of scalp or meningeal vessels

A

dural headache

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19
Q

Bruising occurs due to impact of moving brain/cranium → loss of consciousness

A

cerebral contusion

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20
Q

○ Brain trauma → pia stripped/torn from brain surface → blood enter subarachnoid space

A

cerebral contusion

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21
Q

Associated w/ depressed cranial fractures/gunshot wounds

A

cerebral lasceration

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22
Q

Ruptures of blood vessels and bleeding into brain and subarachnoid space → increased intracranial pressure and cerebral compression

A

cerebral lasceration

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23
Q

Cerebral compression produced by

A

○ Intracranial collections of blood
○ Obstruction of CS circulation/absorption
○ Intracranial tumors/abscesses
○ Brain edema due to increased water/sodium

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24
Q

Overproduction of CSF or an obstruction of flow/interference of absorption

A

hydrochephalus

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25
Q

(Otorrhea) and meninges superior to middle ear torn/tympanic membrane ruptured caused by

A

Fractures in floor of middle cranial fossa

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26
Q

(Rhinorrhea), Involves cribriform plate of ethmoid bone

A

fractures in the floor of the anterior cranial fossa

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27
Q

increase risk of meningitis due to

A

Rhinorrhea and otorrhea due to cranial floor fractures can cause Infection from ear/nose can transfer to the meninges

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28
Q

Sudden development of neurological deficits due to lack of blood to the brain

A

Ischemic stroke

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29
Q

common causes of Ischemic stroke

A 
CVA (cerebrovascular accidents
■	Cerebral embolism
■	Cerebral thrombosis
■	Cerebral hemorrhage
■	Subarachnoid hemorrhage
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30
Q

Saccular aneurysm/Rupture of artery can cause

A

Hemorrhagic stroke

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31
Q

Most common saccular aneurysm

A

Berry aneurysm = saccular aneurysm near Circle of Willis

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32
Q

Over time and w/ high BP can cause

A

Berry aneurym

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33
Q

Mini stroke” temporary clot that will go away

A

Transient Ischemic Attacks (TIA)

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34
Q

why do facial injuries gape widely

A

very loose subQ connective tissue and no deep fascia

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35
Q

Central lower lip, floor of mouth, apex tongue drains to where?

A

submental lymph node

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36
Q

Lateral lower lip drain to

A

submandibular lymph nodes

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37
Q

Trigeminal Neuralgia (tic douloureux)

A

Disorder of CN V sensory root

Sensitive “trigger zone”→ paroxysm (sudden sharp pain) that can last 15 min or more

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38
Q

a way to relieve Trigeminal Neuralgia

A

remove blood vessels that may be putting pressure on sensory part of CN V

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39
Q 
Face (minus angle of mandible)
Cornea and conjunctiva
Anterior half of scalp
Mucous membranes of nose and paranasal sinus, mouth, anterior tongue
Paralysis of muscles of mastication
A

Legions (damage) of Trigeminal Nerve (CN V) cause wide spread anesthesia to.. (FCAMP)

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40
Q

Bells Palsy

A

injury to facial nerve and branches causing ○ Paralysis some/all facial muscles

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41
Q

○ Orbicularis oculi paralysis
■ Eversion of inferior eyelid → lacrimal fluid unable to lubricate/hydrate/flush cornea → infection/ulcer
■ Tears drip

A

Bells Palsy

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42
Q

○ Buccinator/ orbicularis oris paralysis
■ Food stuck in mouth/drooping of corner/saliva food drip
○ Lip muscle paralysis
■ Affect speech, can’t whistle/blow wind instrument

A

bells palsy

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43
Q

Mumps can cause infection of

A

parotid gland

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44
Q

Redness of parotid papillae where duct opens into the mouth opposite the second maxillary molar tooth

A

inflammation of partotid duct

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45
Q

makes up 80% of salivary gland tumors

A

parotid gland tumors

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46
Q

what is imbeded in partotid gland plexus

A

CN VII (Facial)

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47
Q

Intraorbital bleeding

A

exophthalmus

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48
Q

paralysis of levator palpebrae superioris, causes superior eyelid to droop (ptosis)

A

lesion of CN III

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49
Q

where can a Tumor in middle cranial fossa travel?

A

Enter orbital cavity through superior orbital fissure

50
Q

damage to CN VII

A

paralysis of orbicularis oculi

prevents eyelids from closing fully

51
Q

Ducts of ciliary glands become obstructed

A

red pus producing sty on eyelid

52
Q

Chalazia

A

cyst of sebaceous glands of the eyelids

53
Q

seepage of fluid b/w neural and pigmented layers of retina

A

detached retinal

54
Q

how does a detached retina effect vision

A

Straight lines will look wavy/crooked

55
Q

Increase in Cerebral Spinal Fluid slows venous return from the retina and causes edema of retina

A

Papilledema

56
Q

lenses become harder and flatter with age

A

presbyopia

57
Q

cataracts

A

cloudiness/loss of transparency of lens from areas of opaqueness

58
Q

Outflow of aqueous humor slower than aqueous is produced causing retinal compression

A

glaucoma

59
Q

Sensory damage to CN V1

A

can damage corneal needing transplant

60
Q

no corneal reflex are indicative of lesions on which CN?

A

lesion of CN V1 and CN VII

61
Q

Sign of compression of the CN III

A

ipsilateral slowness of the pupillary light reflex

62
Q

Eyelid can not be raised
Pupil dilated and nonreactive due to unopposed dilator pupillae
Down and out (abducted and depressed) due to unopposed LR6 SO4

A

symptoms of Oculomotor Nerve Palsy

63
Q

Anesthetizes auriculotemporal, inferior alveolar, lingual, and buccal branches of mandibular nerve

A

Mandibular nerve block

64
Q

All mandibular teeth are anesthetized, skin and mucous of lower lip, labial alveolar mucosa and gingiva and skin of chin as well since they are supplied by mental branch of this nerve

A

Inferior alveolar nerve block

65
Q

head of mandible can dislocate anteriorly by passing anterior to the articular tubercles now unable to close mouth

A

Dislocation of Temporomandibular Joint

66
Q

Malignant tumors of the posterior part of the tongue metastasize which lymph nodes

A

superior deep cervical lymph nodes

67
Q

paralysis of this muscle causes complete relaxation of the tongue causing posterior shift which can cause suffocation

A

Paralysis of Genioglossus

68
Q

Trauma to the hypoglossal nerve results in

A

paralysis and atrophy of one side of the tongue. Protrusion of the tongue will fall to paralyzed side.

69
Q

Nerves involved in Gag Reflex

A

CN 9 (afferent and muscle) CN 10 (muscle contraction)

70
Q

Infection from ear/nose can transfer to the meninges

A

Middle and Anterior Cranial fossa fractures

71
Q

Epistaxis (nosebleed)

A

most cases due to trauma
comes from anterior third of nose (Kiesselbach)
are also associated with infections and hypertension

72
Q

Deviation of nasal septum

A

may result from birth injury, or trauma during adolescence and adulthood

  • in severe cases, the nasal septum contacts the lateral wall of nasal cavity
  • obstructs breathing, exacerbates snoring
  • corrected by surgery
73
Q

Rhinitis

A

nasal mucosa is swollen and inflamed in severe upper resp. infections & allergic reactions

74
Q

wryneck

A

Congenital torticollis, fibrous tissue tumor forms on SCM before or after birth

75
Q

Muscular torticollis

A

head pull during birth tears fibers in SCM forming a hematoma
fibrous mass that forms traps CN XI denervation of the SCM

76
Q

adulthood, abnormal tonicity, most commonly involves the SCM and trapezius

A

Spasmodic torticollis (cervical dystonia

77
Q

Central line placement

A

R/L subclavian vein

78
Q

External Jugular Vein

A

Internal Barometer, Protrusion of EJV signals heart Failure (Right EJV), distension, or obstruction of SVC, enlarged supraclavicular LN, or increased intrathoratic pressure.

79
Q

Uncommon, drooping of shoulder, unable to elevate the shoulder

A

Lesions of CN XI Accessory nerve

80
Q

Severance of the Phrenic nerve results in

A

paralysis of corresponding half of diaphragm. A nerve block in lung operation, trauma, surgery will cause temporary paralysis. Used in treatment of hiccups

81
Q

anesthetic is injected on posterior edge of SCM for surgical procedures of neck or upper limb

A

Cervical plexus block

82
Q

For anesthesia of upper limb inserted superior to midpoint of clavicle

A

Supraclavicular brachial plexus block

83
Q

External Carotid artery ligation

A

Control bleeding from an inaccessible branch

Descending occipital artery provides main collateral circulation and joins vertebral and deep cervical arteries.

84
Q

Thickening of intima of internal carotid artery

A

Atherosclerosis of the artery resulting in stenosis and decreased blood flow. This can cause TIA or stroke

85
Q

carotid endarterectomy

A

removes the plaque relieving the stenosis

86
Q

What nerves can be injured during surgery of the internal carotid artery

A

CN- IX, X (OR SUPERIOR LARYNGEAL), XI, XII

87
Q

Internal jugular artery

A

pulsation visible in Trendelenburg position

88
Q

Increased internal jugular pulse is caused by

A

mitral valve disease which increases pressure in the right side of the heart and pulmonary circulation

89
Q

relieves vascular spasm of brain and upper limb, surgery for patient with excessive vasoconstriction of ipsilateral limb

A

Cervico-thoracic ganglion block

90
Q

Horner syndrome

A

(lesion of the cervical sympathetic trunk)

91
Q

Horner syndrome symptoms

A

• Results in Pupillary constriction
• Ptosis (drooping of upper eyelid)
• Enophthalmos (sinking in of eyeball)
vasodilation and anhidrosis- absence of sweating on face and neck, caused by lack of sympathetic nerve supply to blood vessels and sweat glands

92
Q

vasodilation and anhidrosis- absence of sweating on face and neck, caused by

A

lack of sympathetic nerve supply to blood vessels and sweat glands

93
Q

Tetany

A

is a sever convulsive disorder that occurs when the parathyroid is accidentally removed during surgery.

94
Q

treatment for Tetany

A

Needs calcium replacement

95
Q

Subtotal thyroidectomy

A

most posterior part of thyroid is preserved. usually prevents removal of parathyroid

96
Q

paralysis of vocal fold causing no adduction for phonation, or abduction for increased respiration causing stridor ( high pitch noisy respiration)

A

Inferior laryngeal nerve injury

97
Q

monotonous voice

A

injury to superior laryngeal nerve

98
Q

Fractures of laryngeal skeleton

A

sub mucous hemorrhage, edema, respiratory obstruction, hoarseness, no speech

99
Q

foreign body aspiration

A

trapped superior to vestibular folds, rima glottidis close, no air in, asphyxiation in 5 min if no intervention

100
Q

tracheostomy

A

Upper airway obstruction, respiratory failure

1-2 or 2-4 tracheal rings, transverse incision

101
Q

Radical neck dissection

A
  1. Usually done to remove cancer
  2. deep cervical lymph nodes and tissue removed
  3. cervical sentinel lymph nodes are often enlarged as first clue to cancer
  4. cutaneous branches of cervical plexus removed
102
Q

Adenoiditis

A
  1. Inflammation of pharyngeal tonsils
    Causes obstruction of airways, nasal obstruction, hearing due to blockage of pharyngotympanic membrane, also infection can spread to middle ear- otitis media
103
Q

Tonsillectomy

A

removal of palantine tonsil

Surgeon needs to be careful of bleeding due to location of CN IX, internal carotid artery. and external palantine vein

104
Q

Zones of Penetrating Trauma

A

Zone 1,2,3. Zones 1 and 3 have increased risk of mortality, zone 2 easier to treat.

105
Q

Zone 1

A

Clavicles and manubrium to inferior cricoid cartilage

106
Q

zone 2

A

Cricoid cartilage to angle of mandible

107
Q

zone 3

A

angle of mandible up to top of head

108
Q

Emmetropia

A

Normal eyesight.
Far images are in focus without lens accommodation. (relaxed ciliary muscles)
Near images are in focus with lens accommodation (flexed ciliary muscles)

109
Q

myopia

A

Near sighted
Far images are in front of retina without accommodation (looks blurry)
Near images are in focus without accommodation
Need concave lens to focus far image on retina
Eyeball long or lens is too strong

110
Q

hyperopia

A

Far sighted
Far images are focused on retina with accommodation
Near images are blurring with accommodation (focused behind retina)
Need convex lenses to focus near image
Eyeball is short or weak lens

111
Q

Diplopia, treatment and causes

A

double vision
1st they put a prism onto of the lens step. After adapted they will merge the prism with the glass
usually caused by unsynchronized muscle contraction

112
Q

astygmatism

A

Misshapen lens causes multiple focal points for light
measured in degrees
blurry vision

113
Q

Ethmoidal Cells Infection

A

infection can cause fracture to the fragile medial wall of the orbit
close to optic canal causing blindness
optic neuritis inflammation of optic nerve

114
Q

Pansinitus

A

Multiple sinuses are inflamed due to infection

115
Q

Most commonly infected sinus due to small ostia

A

Maxillary sinus

116
Q

Causes of blockage to maxillary ostia

A

mucous membrane congestion
high location on medial wall makes it impossible to drain until full
Medially located ostia requires rolling to opposite side to drain
Close to molars, concern during teeth extraction

117
Q

Acute otitis externa

A

inflammation of external acoustic meatus due to bacterial infection
causes itching and pain, which increases by pulling on tragus
commonly called swimmers ear

118
Q

Otitis Media

A

earache, bulging tympanic membrane due to pus or fluid in middle ear.
Leads to blockage of pharyngotympanic tube
Ear popping
Amber colored blood fluid
Lead to scaring of auditory vesicles

119
Q

Myringotomy

A

incision to release pus from middle ear abscess

incision is made postero-inferiorly through the tympanic membrane because the superior is so vascularized

120
Q

Tympano Stome/ Pressure equalization (PE) tube

A

enables drainage and equalizes pressure from chronic middle ear infections

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