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ANATOMY HEAD AND NECK > Test > Flashcards

Test Flashcards

1
Q

Patient suffers penetrating knife wound that paralyzed his right diaphragm, which blood vessels are likely lacerated?

A

Diaphragmn is innervated by the phrenic nerve.

The transverse cervical (superior)

And suprascapular

Cross over the phrenic nerve

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2
Q

Relative positions fyi

A

Carotid sheath is directly lateral to the retropharyngeal space

Internal laryngeal enters the thyrohyoid membrane.

sympathetic trunk is medial to vagus

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3
Q

An infant has few small retinal hemmorhages. Diagnoses is shaken baby syndrome. What is the cause?

A

Tearing of the bridging veins leading to a subdural hemorrhage

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4
Q

Tumor increases CSF in third ventricle. What could be obstructed?

A

Cerebral aqueduct (sylvia)

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5
Q

When told to look ahead, patients eye is abducted and depressed. What other symptom?

A

Ptosis of upper eyelid (levator palpebrae)

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6
Q

Unilateral dislocation of the mandible. What is true in the patient?

A

The mandibulqr condyle anterior the articular tubercle

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7
Q

What would you observe in your examination of a patient with otosclerosis in the left temporal bone?

A

Vibrating fork in the midline would be heard from the ipsilateral side of conductive hearing loss.

Vibrating fork near the left external ear canal would not be heard if the vibration is too low to be heard against the left mastoid process.

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8
Q

What do each of these muscles do?

Vocalis, posterior cricoarytenoid, lateral cricoarytenoid, cricoarytenoid, stylohyoid

A

Vocalis - relaxes the vocal folds

Posterior cricoarytenoid - abducts vocal folds

Lateral cricoarytenoid - adducts vocal folds via medial rotation of the vocal process.

Cricoarytenoid - tilts thyroid cartilage anteriorly which lengthens the vocal cord

Stylohyoid - lifts the hyoid bone for production of high notes

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9
Q

Patient has hyperacusis, paralysis of facial muslces, diminished taste but can still cry (fucked up) where is lesion

A

Distal to the greater petrosal nerve branch off the genu

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10
Q

Stenosis of sphenopalatine foramen can result in…

A

Reduction of blood flow to the mucosa lining the posterior nasal septum

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11
Q

Would a lesion of the mandibular nerve passing through the foramen ovale affect taste?

A

No because the chorda tympani joins the lingual nerve distal to this lesion

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12
Q

What causes a unilateral cleft lip and unilateral cleft primary palate

A

Incomplete fusion of the maxillary prominences and intermaxillary segment of the medial nasal prominences

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13
Q

Patient has mass in anterior neck midline and mass moves with protrusion of tongue (hypoglossal- genioglossus)

Why?

A

Thyroglossal cyst

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14
Q

Someone lacks neural crest migration into first pharyngeal arch. What is likely underdeveloped?

A

Facial bones - first pharyngeal arch mesenchyme forms much of the viscerocranium.

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15
Q

Improper fusion of lateral lingual swellings…

A

Results in bifid tongue

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16
Q

A patient has ptosis of the upper eyelid. Constriction of the pupil is fine. What lesion could cause this?

A

Any of the cervical ganglion that carry sympathetics.

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17
Q

Your patient has a fixed dilated pupil. What is the likely cause?

A

Since the pupil is dilated, there is nothing wrong with sympathetics and therefore can not be lesion of the ciliary ganglion. This is affecting the parasympathetics so oculomotor only. An uncal herniation, herniation of the temporal lobe trhgou hthe tentorial notch pushing the oculomotor against the brain stem, is the likely culprit

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18
Q

A high CSF pressure in the lateral ventricle of 200 mm H2O and CSF pressure in the lumbar subarachnoid space of 200 mm H2O indicates what?

A

Communicating hydrocephalus. The CSF is not being reabsorbed into the sinus via the arachnoid granulations.

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19
Q

A patient exhibits medial strabismus of the right eye. What are two possible causes?

A

So this must be compression of the abducens nerve.

  1. Aneurysm of the internal carotid running in the cavernous sinus because it is directly adjacent the abducens nerve.
  2. Aneurysm of the Anterior Inferior Cervical Artery at its origin from the vertebral artery.
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20
Q

What runs through the petrotympanic fissure and what does it connect?

A

It connects the middle ear cavity to the infratemporal fossa.

The chorda tympani of cranial nerve 7 goes through this fissure to join the lingual nerve.

21
Q

A patient’s mandible deviates to the left upon OPENING the mouth. What could be causing this?

A

Spasm of the right lateral pterygoid muscle

22
Q

Secretion from which glands can be affected by a middle ear infection?

A

Secretion from:

Submandibular gland and sublingual gland

Parotid gland (glossopharyngeal nerve of the tympanic plexus)

NOT lacrimation because the genu is at the boundary of inner and middle ears. So the greater petrosal nerve has come off by then.

23
Q

What provides sensation and blood supply to the piriform recess.

A

Sensation: internal laryngeal nerve senses food in the recess

Blood supply: superior and inferior thyroid arteries.

24
Q

Patient has blood and CSF leaking from the nose. What is a cause of this?

A

Fracture of the ethmoid bone (CSF) and lesion of a branch of the opthalmic artery (blood)

25
Q

Where does the nasolacrimal duct drain into?

A

The inferior meatus

26
Q

What nerve transmits the pain of an ethmoidal sinusitis?

A

Nasociliary nerve.

27
Q

The mucosa of the epiglottis is derived from which arch with which cranial nerve?

A

Laryngeal cartilage - pharyngeal arch 4

You know superior laryngeal nerve of vagus is responsible for everything above the vocal folds which includes epiglottis.

28
Q

The infant lacks a philtrum but has a primary palate. What structure was affected?

A

The medial nasal prominence of the intermaxillary segment responsible for the philtrum.

The medial nasal prominence still come together to form a primary palate.

29
Q

What runs with the superior thyroid artery?

What enters the thyrohyoid membrane.

A

With the superior thyroid artery is the external laryngeal nerve.

The internal laryngeal nerve with the Superior Laryngeal Artery.

30
Q

The right maxillary artery is obstructed immeediately proximal to entering the pterygomaxillary fissure. Which arteries can have retrograde blood flow?

A

Nasal branches of the sphenopalatine artery
Infraorbital artery
Descending palatine artery
Lesser palatine artery

31
Q

What provides sensation from the mucosa covering the conus elasticus?

A

The reccurent laryngeal nerve.

32
Q

A patient has weakness in turning his head to the left against resistance. What other symptom of head movement would be seen?

A

That is the right sternocleidomastoid/accessory nerve. The trapezius is the other thing that is innervated by the accessory. That would be tilting his head to the right against resistance.

33
Q

When the left cornea is touched, only the left eye blinks. What can you say with certainty?

A

There is a lesion of the right facial nerve.

34
Q

Muscles of mastication are innervated by the mandibular division. However, what specific branch innervates the pterygoids and masseter?

A

Inferior alveolar nerve.

35
Q

Ligation of the superior thyroid artery can damage a nerve leading to what symptom regarding the larynx?

A

You can damage the external laryngeal nerve which travels with the superior thyroid artery. This will damage the cricothyroid muscle leading to a defect in tensing the vocal folds.

36
Q

A lesion of the structures lying on the promontory of the middle ear cavity can also result in loss of what?

A

Secretion of the parotid gland.

37
Q

What do the aortic arches 4 and 6 form?

A

Aortic arch IV forms the right subclavian and the aortic arch on the LEFT.

Aortic arch VI forms the ductus arteriosis and the pulmonary artery –ON THE LEFT>

This is why the left reccurent laryngeal nerve needs to loop under because it gets caught in the ductus arteriosis and pulmonary artery connection.

38
Q

What does lymphocyte do?

What do monocytes do?

What does neutrophil do?

A
  1. Involved in immune system
  2. Monocytes are precursors to macrophages. They are the largest circulating leukocytes
    - They produce CSF which spurs formation of specific lines of developing (Colony Forming Unit)
  3. Neutrophil - phagocytoses bacteria
39
Q

What does basophil and eosinophil do?

A

Basophil - releases histamine and other shit

Eosinophil - attacks parasites and reduces inflammation created by the products of basophils and mast cells.

40
Q

What are the branches of the maxillary artery after it enters the pterygopalatine fossa?

A

The infraorbital artery traveling through the inferior orbital fissure

The sphenopalatine artery after passing through the sphenopalatine foramen

The Descending palatine artery after going through the greater palatine foramen.

41
Q

How do sympathetics reach the nasal cavity and palate?

A

The DEEP petrosal nerve carries the postganglionic sympathetics through the pterygoid canal to the pterygopalatine ganglion and then it disperses all over.

42
Q

Describe the pathway for lacrimation

A

The greater petrosal nerve comes off at the genu >

> it combines with DEEP to form the nerve of the pterygoid canal

> it goes up the pterygopalatine nerves

> it joins the maxillary nerve and travels with its branch the zygomatic nerve

> it then travels through the communicating branch that allows the connection between the zygomatic and the lacrimal nerve

> it reaches the lacrimal gland.

43
Q

How does the greater petrosla nerve go from the inner ear to the pterygopalatine fossa?

A

It starts in the inner ear. Then it goes through the hiatus for the greater petrosal nerve.

Then its in the middle cranial fossa.

To get into the pterygopalatine fossa it goes through the foramen lacerum

Enters the pterygoid canal and reaches the PG.

44
Q

The sinus that lies in the margin of the tentorium cerebelli and runs from the posterior end of the cavernous sinus is affected and joins the transverse is infected. What is this sinus?

A

The superior petrosal sinus.

45
Q

What goes through the inferior orbital fissure? (3 things)

A
  1. inferior opthalmic vein
  2. Infraorbital nerve (V2)
  3. Zygomatic nerve (V2)
46
Q

What three nerves superiorly are not in the common ring tendon

A
  1. Frontal nerve
  2. Lacrimal nerve
  3. Trochlear nerve.
47
Q

A patient can move his eyeballs normally and see distant objects but cannot focus on near objects. This condition could arise from what?

A

Lesion of the short ciliary nerves and ciliary ganglion. (constrictor pupillae and cilliary muscle)

48
Q

The tonsillar artery which supplies the palatine tonsils is a branch of which artery?

A

The facial artery

ANATOMY HEAD AND NECK (14 decks)

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