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Head and Neck Systems > Week 2 > Flashcards

Week 2 Flashcards

1
Q

What is the most important initial test for a neck lump?

A

fine needle aspiration cytology

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2
Q

what are features of a benign reactive lymph node?

A

oval
soft
smooth
mobile
tender

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3
Q

what are some benign causes of hoarseness?

A

nodules
cysts
vocal abuse
laryngitis
infection
smoking reflux

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4
Q

what is the sensation ‘feeling of something in throat’ called?

A

globus pharyngeus

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5
Q

what is the most common cancer of the head and neck?

A

90% squamous carcinoma

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6
Q

what are the features of a malignant neck node?

A

round
firm
irregular
fixed
non-tender

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7
Q

what is a quinsy?

A

peritonsillar abscess > complication of acute tonsilitis.
drainage will be required e.g. needle aspiration of pus

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8
Q

what are some worrying signs of oral malignancy?

A
  • area of redness.
  • combined (speckled) white/red lesion.
  • indurated area of ulceration.
  • an area of ulceration which has been present for 3 weeks or more.
  • a new area of melanin pigmentation.
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9
Q

what is a white patch in the oral mucosa called?

A

leukoplakia

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10
Q

what is a red patch in the oral mucosa called?

A

erythroplakia

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11
Q

what is a white and red patch in the oral mucosa called?

A

erythroleukoplakia

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12
Q

what is xerostomia?

A

dry mouth

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13
Q

discuss the different subjective assessments of hearing in a child with hearing loss based on age

A
  • 6-18 months: distraction test.
  • 12 months - 3 years: visual reinforced audiometry.
  • 3-5 years: play audiometry.
  • 4 years + : pure tone audiometry.
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14
Q

what are the different objective assessments of a child with hearing loss?

A
  • otoacoustic emissions.
  • auditory brain stem responses.
  • tympanometry.
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15
Q

what are the two age peaks in glue ear?

A

2 and 5 years old

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16
Q

what are common microorganisms in acute otitis media

A
  • haemophilus influenza
  • strep pneumonia
  • moraxella catarrhalis
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17
Q

what are some causes of a blocked/runny nose?

A
  • rhinitis > allergic vs non-allergic.
  • large adenoids > check for sleep apnea.
  • foreign body.
  • sinusitis and polyps.
  • choanal atresia > uncommon, bilateral manfiests as unable to breathe.
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18
Q

what are causes of bacterial and viral tonsilitis?

A

bacterial > B-haem strep B.
viral > epstein-barr virus.

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19
Q

what are some benign causes of neck lumps?

A
  • thyroglossal duct cyst.
  • branchial cyst.
  • cystic hygroma.
  • cervical lymphadenopathy.
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20
Q

label this eyeball

A
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21
Q

which structures compose the fibrous coat of the eyeball?

A
  • cornea
  • sclera
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22
Q

describe the cornea

A

anterior 1/6 of the fibrous coat which is transparent and is a window to allow light rays to enter the eyeball

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23
Q

describe the sclera

A

opaque posterior 5/6 of the fibrous coat which gives attachment to muscles moving the eyeball

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24
Q

which structures compose the vascular layer of the eyeball?

A
  • ciliary body
  • iris
  • choroid
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25
Q

which structure forms the sensory coat of the eyeball?

A

retina

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26
Q

what is the function of the ciliary body of the eyeball?

A
  • suspends the lens and produces aqueous humor.
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27
Q

what is the function of the iris?

A
  • controls the diameter of the pupil and thereby controls the amount of light rays entering the eyeball.
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28
Q

what is the function of the choroid of the eyeball?

A
  • supplies blood to outer layers of retina.
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29
Q

what is the function of the retina?

A
  • has light sensitive rods and cones which enables us to see.
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30
Q

describe the crystalline lens

A
  • a transparent, crystalline biconvex structure which is suspended by zonules (suspensory ligaments) from the ciliary body.
  • it can change shape (i.e. become less or more convex).
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31
Q

what is the segment in front of the lens of the eye called?

A

anterior segment

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32
Q

which anterior segment of the eye contains which fluid?

A
  • a watery fluid called aqueous humor.
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33
Q

what is the segment behind the lens of the eye called?

A

posterior segment

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34
Q

the posterior segment of the eye is filled with?

A

a gel called vitreous humor

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35
Q

describe aqueous humor and its function

A
  • a watery fluid anterior to the lens.
  • helps to maintain intraocular pressure.
36
Q

describe vitreous humor and its function

A
  • a transparent gel posterior to the lens.
  • it helps cushion the retina.
36
Q

what are the chambers of the anterior segment of the eye?

A
  • anterior chamber (AC) in front of the iris.
  • posterior chamber (PC) behind the iris but in front of the lens.
37
Q

the lens is also called the?

A

pupil

38
Q

what is the AP length of the eyeball?

A

24mm

39
Q

what is the AP length of the orbit?

A

40mm

40
Q

describe conjunctiva

A
  • thin vascular membrane that covers inner surface of eyelids and loops back over sclera.
  • does not cover the cornea.
41
Q

describe lacrimal glands and their function

A
  • lacrimal glands are serous type exocrine glands that secrete lacrimal fluid onto the surfaces of the conjunctiva and cornea of the eye.
42
Q

what is the function of lacrimal fluid

A
  • acts to clean, nourish and lubricate the eyes.
  • it forms tears when produced in excess.
43
Q

describe the sequence of events after lacrimal fluid is secreted by the lacrimal gland

A
  • lacrimal fluid empties into conjunctival sac (fornix).
  • fluid is spread across eye by the process of blinking.
  • fluid accumulated in the lacrimal lake before draining into the lacrimal sac via a series of channels.
  • lacrimal fluid then drains down the nasolacrimal duct and empties into the ifnerior meatus to the nasal cavity.
44
Q

what is the function of intrinsic ocular muscles?

A
  • control pupil diameter and helps alter lens curvature to enable us to see near objects.
45
Q

what is the function of extrinsic (extraocular) ocular muscles?

A
  • move the eye.
46
Q

is the ciliaris muscle intrinsic or extrinsic?
what is its function?

A
  • intrinsic eye muscle.
  • for focussing on near objects.
47
Q

what is the innervation of the ciliaris muscle?

A
  • parasympathetic component of oculomotor nerve (CN III).
48
Q

is the constrictor pupillae intrinsic or extrinsic?
what is its function?
what is its innervation?

A
  • intrinsic eye muscle.
  • constriction of pupil.
  • parasympathetic component of occulomotor nerve (CN III).
49
Q

is the dilator (radial) pupillae intrinsic or extrinsic?
what is its function?
what is its innervation?

A
  • intrinsic.
  • dilation of the pupil.
  • sympathetic from plexus around blood vessels.
50
Q

what are the four, straight extrinsic ocular muscles called?

A
  • medial rectus (MR)
  • lateral rectus (LR)
  • inferior rectus (IR)
  • superior rectus (SR)
  • collectively known as recti.
51
Q

what are the two oblique, extrinsic ocular muscles called?

A
  • superior oblique (SO)
  • inferior oblique (IO)
52
Q

describe the levator palpebrae superioris (LPS)

A
  • extrinsic ocular muscle lying just above the superior rectus (SR).
  • elevated the upper eyelid.
53
Q

what is the origin and insertion of the LPS?

A
  • origin: roof of orbit.
  • insertion: upper eyelid.
54
Q

what is the origin and insertion of all recti muscles? which nerves innervate them?

A
  • origin: tendinous ring.
  • insertion: sclera anteriorly.
  • oculomotor nerve (III) except for LR, which is abducent (VI) nerve.
55
Q

what is the origin and insertion of the superior oblique (SO) extraocular muscle?
which nerve innervates it?

A
  • origin: lesser wing of sphenoid.
  • insertion: sclera posteriorly.
  • trochlear nerve (IV)
56
Q

what is the origin and insertion of the inferior oblique (IO) extraocular muscle? what nerve innervates it?

A
  • origin: medial part of orbit floor.
  • insertion: sclera posteriorly.
  • oculomotor nerve (III).
57
Q

which cranial nerves are present in the orbit?

A
  • optic (II).
  • oculomotor (III).
  • trochlear (IV).
  • abducent (VI).
  • opthalamic and maxillary branches of trigeminal nerve (V1 and V2).
58
Q

what is the function of the optic (II) nerve?

A
  • carries visual impulses from the eyeball.
  • leaves orbit through optic foramen.
59
Q

what is the function of the oculomotor (III) nerve?

A
  • supplies all the muscles going to the eye except 2 and also supplies levator muscles of eyelid.
  • carries parasympathetic fibres which synapse at the ciliary ganglion in the orbit.
60
Q

what is the function of the trochlear (IV) nerve?

A
  • arises from the dorsal part of the midbrain and supplies the superior oblique muscle.
61
Q

what is the function of the abducent (VI) nerve?

A
  • supplies the lateral rectus muscle.
62
Q

what are the branches of the opthalamic division of the trigeminal nerve called?

A
  • nasociliary nerve.
  • lacrimal branch.
  • frontal branch > supraorbital and supratrochlear branches.
63
Q

describe the opthalamic artery

A
  • a large branch of the internal carotid artery.
  • it supplies all sructures in the orbit, and also some branches to the nasal cavity and head.
64
Q

venous drainage of the eyeball?

A
  • superior and inferior opthalamic veins which drain into the cavernous sinus.
65
Q

which branch of the maxillary branch of the trigeminal nerve (V2) is present within the orbit?

A
  • infraorbital nerve.
66
Q

what embryological structure does the eye develop from?

A
  • the eye develops from the neural tube = neurectodermal in origin.
67
Q

embryology of the eye

describe the formation of optic vesicles

A
  • optic vesicles grow outwards from diencephalic part of neural tube towards surface ectoderm
68
Q

embryology of the eye

formation of lens placode

A

optic vesicles reach surface ectoderm > cells of surface ectoderm thicken > lens placode.

69
Q

embryology of the eye

formaton of optic cup

A
  • the lens placode starts to push inwards (invaginate), which causes the optic vesicle too, to form and optic cup.
70
Q

embryology of the eye

what does the surface ectoderm around the optic cup form?

A
  • eyelids, conjunctiva, corneal epithelium.
71
Q

embryology of the eye

what does the mesenchyme around the optic cup form?

A
  • choroid, stroma of cornea, sclera and extraocular muscles.
72
Q

Label the histology of the cornea

A
  1. epithelium > non-keratanised stratified squamous epithelium.
  2. Bowman’s membrane (basement membrane of corneal epithelium).
  3. Stroma - regularly arranged collagen, no blood vessels.
  4. Descemet;s layer.
  5. Endothelium - single layer.
73
Q

how is the transparency of the cornea maintained?

A
  • histologically > regular arrangement of collagen in stroma.
  • no blood vessels.
  • endothelium cell layer has a pump that actively keeps the aqueou humor out.
74
Q

how does the avascularity of the corne play an important role in corneal transplant?

A
  • avascularity of the cornea is a benefit to surgeons when performing a graft surgery as it means there is a lesser chance of foreign antigens from a corneal graft being recognised by the recipient, so lesser chance of a graft rejection.
  • ‘immune-privileged site.
75
Q

what is the choroid composed of? and what is its function?

A
  • fenestrated blood vessels of varying diameter.
  • these supply the outer layers of the retina with blood by diffusion.
76
Q

this histological image is from which tissue(s)?

A

retina and choroid

77
Q

what is lens opacification called?

A

cataract

78
Q

what are the functions of tear film?

A
  1. keeps cornea moist, prevents drying.
  2. washes away any particular foreign bodies.
  3. has antibodies and lysozymes to kill microbes.
  4. smooths outer surface of cornea providing smooth surface for refraction.
79
Q

describe the 3 layered structure of typical tear film

A

layer 1: mucinous layer (30%) overlying corneal epithelium.
layer 2: aqueous layer (69%) lies over the mucinous layer.
layer 3: oily layer (<1%) is the most superficial.

80
Q

how is a further blink stimulated?

A

when the aqeous layer of tear film evaporates causing the oily layer and mucin layer to interact and break down > ocular discomfort > blink.

81
Q

what is the mainstay of treatment for nasal polyps?

A

nasal steroids

82
Q

what are some conditions associated with nasal polyps?

A
  • cystic fibrosis
  • asthma
  • Churg-strauss syndrome
  • allergic rhinitis
83
Q

What is a commonly used scoring system for the assessment of a child with a sore throat in primary care?

A

CENTOR

84
Q

which organsim is mostcommonly associated with acute rhinosinitus?

A

strep. pneumoniae

85
Q

when are antibiotics considered for children under 2 years with otitis media?

A

Antibiotics are only considered for children under two years if they have bilateral otitis media or systemtic infection or symptoms >3 days.

Head and Neck Systems (3 decks)

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