Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Head, Neck and Neurological Systems > Week 5 > Flashcards

Week 5 Flashcards

1
Q

Approximately how big are lymph nodes?

A

<0.5cm in length

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

In which position is it best to feel for a patient’s lymph nodes in the head/neck?

A

Standing behind the patient using both hands to lightly palpate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How can the areas draining to the upper and lower lymph nodes of the head/neck be distinguished?

A

Imaginary line from the medial aspect of the eye to the angle of the mandible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Why might the occipital lymph nodes become enlarged?

A

Head lice infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the location of the submental lymph nodes and what areas do they drain?

A

Under the chin

Tip of the tongue, anterior floor of the mouth, lower lip, incisors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the location of the submandibular lymph nodes and what areas do they drain?

A

Medial side of mandible, close to submandibular gland

Most of the mouth, nasal cavity, maxillary sinus, skin of the face

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the location of the parotid/pre-auricular lymph nodes and what areas do they drain?

A

Surface of parotid gland, in front of the ear

Upper face, forehead, scalp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the location of the posterior auricular lymph nodes and what areas do they drain?

A

Behind the ear

Scalp behind the ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the location of the occipital lymph nodes and what areas do they drain?

A

Upper neck

Posterior scalp

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the location of the deep cervical lymph nodes and what areas do they drain?

A

In line with internal jugular vein in the neck

Other nodes, thyroid gland, larynx, posterior tongue, pharynx, inner ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the location of the superficial cervical lymph nodes and what areas do they drain?

A

Posterior triangle

Local skin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the location of the jugulo-digastric lymph nodes and what areas do they drain?

A

Where digastric muscle crosses internal jugular vein

Palatine tonsil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the location of the jugulo-omohyoid lymph nodes and what areas do they drain?

A

Where omohyoid muscle crosses internal jugular vein

Lingual tonsil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the location of the supraclavicular lymph nodes and what areas do they drain?

A

Posterior triangle, above clavicle

Lower neck, chest/thorax/upper abdomen (oesophagus and stomach)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the lymphatic drainage of the tongue?

A

Front - submental nodes

Back - deep cervical nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the lymphatic drainage of the maxillary sinus?

A

Submandibular nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the lymphatic drainage of the pharynx and larynx?

A

Deep cervical nodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the lymphatic drainage of the palatine tonsil?

A

Jugulo-digastric node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the lymphatic drainage of the lingual tonsil?

A

Jugulo-omohyoid node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What are the features, attachments and function of the digastric muscle?

A

2 bellies with central tendon
Attached to hyoid bone via fascia and posterior belly to mastoid process
Lifts hyoid bone, opens the mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What are the features, attachments and function of the omohyoid muscle?

A

2 bellies with central tendon

Attached to clavicle via fascia and posterior bell to scapula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What infections affect the lymphatic system itself?

A

Glandular fever

Lymphoma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Which cartilage in the neck is the only complete ring?

A

Cricoid cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What type of cartilage are thyroid, cricoid and arytenoid cartilage?

A

Hyaline cartilage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What parts of the body are elastic cartilage?

A

Pinna of the ear

Epiglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the vocal fold and where does it extend to?

A

Fold in the mucosa inside the larynx which contains elastic fibres at its core
Arises from arytenoid cartilage and spans towards thyroid cartilage at the laryngeal prominence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Where do thyroid and cricoid cartilage meet?

A

At the inferior horn of the thyroid cartilage - cricothyroid joint

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What type of joint is the cricothyroid joint?

A

Synovial

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the cricothyroid muscle and what is its function?

A

Small muscle from side of the cricoid cartilage to the thyroid cartilage
Contracts to pull thyroid cartilage slightly upwards towards cricoid cartilage with simultaneous rotation at the cricothyroid joint which causes laryngeal prominence to tilt forwards slightly, tensing the vocal cords to increase the pitch of the voice by increasing the frequency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Where is the cricothyroid ligament/membrane found?

A

Between thyroid cartilage and cricoid cartilage anteriorly (thicker at the front)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How is an emergency airway placed?

A

Needle inserted between cricoid cartilage and thyroid cartilage, through cricothyroid ligament

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How is a planned/elective airway placed?

A

Horizontal incision along skin tension lines, push aside strap muscles, find isthmus of thyroid gland, clamp/divide/tie off gland, incision between 2nd/3rd/4th tracheal ring for ventilation tube

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

When placing an elective airway, why do surgeons avoid the 1st tracheal ring?

A

Risk of scar tissue and stricture formation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What important structure lies over the 2nd-4th tracheal rings?

A

Isthmus of the thyroid gland

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What shape is the cricoid cartilage?

A

Signet ring - narrow at the front, wider at the back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

How can aspiration of vomit be prevented clinically?

A

Pressing on cricoid (transcricoid pressure) closes lower pharynx to prevent vomit coming up

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Which muscle attaches the back of the tongue to the hyoid bone?

A

Hypoglossus muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Which muscle attaches the side of the tongue to the mandible?

A

Genioglossus muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

Which muscle attaches the top of the tongue to the styloid process?

A

Styloglossus muscle

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Which nerve innervates all extrinsic muscles of the tongue (except palatoglossus)?

A

Hypoglossal nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Which nerve innervated the palatoglossus muscle?

A

Vagus nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Which extrinsic tongue muscle does the vagus nerve innervate?

A

Palatoglossus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

Where might fish bones become lodged in the neck?

A

Piriform fossa

Vallecula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the glottis?

A

Part of the airway between the vocal folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Where is the sinus/ventricle of the larynx and what is its function?

A

Between vocal and vestigial folds

Provides mucus lubrication for vocal folds

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the anatomical basis of a cough?

A

Irritation of larynx mucosa → vagal afferents → deep breath in, glottis closes, diaphragm relaxes, abdominal and pelvic floor muscles contract → vocal folds move apart → dislodgement of irritant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

At what vertebral level is the cricoid cartilage?

A

C6

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the function of the mylohyoid muscle?

A

Supports structures in the floor of the mouth and separates it from the submandibular region

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What 2 factors prevent food from entering the larynx?

A

Epiglottis sphincter mechanism

Larynx moves up and forwards to meet epiglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Where does the parotid gland open in the mouth?

A

Next to the 2nd upper molar

51
Q

Where does the submandibular gland open in the mouth?

A

Floor, under the front of the tongue

52
Q

Where does the sublingual gland open in the mouth?

A

Floor

53
Q

What are the intrinsic tongue muscles responsible for?

A

Changing the shape of the tongue

54
Q

What are the extrinsic muscles of the tongue responsible for?

A

Tongue movement

55
Q

What nerve provides sensation to the larynx?

A

Vagus nerve (recurrent laryngeal, internal and external branches of superior laryngeal)

56
Q

At which vertebral level does the trachea bifurcate?

A

T4

57
Q

Where would a muscle graft for the tongue be taken from?

A

Unattached - wrist (palmaris longus) or thigh

Attached - pectoralis or platysma

58
Q

What is the function of a tracheostomy cuff?

A

Keeps the ventilation tube open and prevents blood/secretions entering the airway and air from escaping

59
Q

What is the normal function of the tongue?

A

Move and taste food

Make and direct sound

60
Q

What epithelium is present on the tongue?

A

Non-keratinised stratified squamous epithelium

61
Q

What is the optic disc?

A

Optic nerve head - point of exit for ganglion cell axons leaving the eye; blind spot; no rods or cones overlying

62
Q

What is the macula?

A

Functional central area of retina; 20/20 and best colour vision

63
Q

What is the fovea?

A

Central part of macula (500 microns)

64
Q

What cell type is found in the macula?

A

Cone photoreceptors

65
Q

What is the blood supply of the macula?

A

None - dependent on choroid for O2 and metabolic support

66
Q

What are the 2 types of age-related macular degeneration?

A

Exudative (wet)

Atrophic (dry)

67
Q

What is the pathology in exudative age-related macular degeneration?

A

New blood vessels growing under retina from choroid; rapid, distorted vision

68
Q

What is the pathology in atrophic age-related macular degeneration?

A

Atrophy of outer retina; slow, blurring

69
Q

What is metamorphopsia?

A

Distorted vision

70
Q

How is visual acuity recorded? Give examples

A

As the distance chart is read/distance at which it should be read
E.g. 6/6 - normal (reads at 6 metres what should be seen at 6)
6/12 - reads at 6 metres what should be seen at 12

71
Q

How is visual acuity <6/60 tested?

A

Count fingers, hand motions, light perception

72
Q

How do fundus fluorescein angiograms work?

A

Inject fluorescein intravenously; fluorescein bound to albumin (remains within normal capillaries because of blood-retinal barrier); use blue flash and yellow filter to see details of retinal circulation

73
Q

What is optical coherence tomography and what images can be taken using it?

A

Low-powered laser interferometry

Generates detailed cross-sectional image of retina

74
Q

How does AMD lead to blindness?

A

Blood vessels and scar tissue grow under retina → leaking vessels cause retinal oedema → block transport of O2 and nutrients from choroid → eventual scarring causes destruction of photoreceptors

75
Q

How is AMD initiated?

A

Photoreceptors continue to produce photosensitive pigment throughout life → ends of photoreceptor cells decay and are removed by retinal pigment epithelium → end products accumulate, causing drusen

76
Q

What are drusen?

A

Yellow deposits under the retina made up of lipids

77
Q

What are the major risk factors for AMD?

A 
Smoking 
Age (>70) 
Diet
Family history 
Genetics
78
Q

How is diet implicated in AMD?

A

High doses of vitamin A and C and zinc may be protective

79
Q

What genetic components are implicated in AMD?

A

Polymorphisms in complement factor H gene strongly linked (7.4x increased risk)
Complement genes (CFB, CF1, C2 and C3)
Lipids (genes for HDL and LDL)
Extracellular matrix (collagen and matrix metalloproteinase)

80
Q

What is the normal function of complement factor H?

A

Regulates inflammation, prevents complement-mediated attack on own cells

81
Q

What pathological changes are seen in AMD?

A 
Thickening and elevation of macula
Retinal distortion 
Intraretinal haemorrhage
Intraretinal fluid
Subretinal haemorrhage 
Choroidal neovascularisation
82
Q

What treatments are available for AMD?

A

Anti-VEGF drugs – ranibizumab, bevacizumab, aflibercept

83
Q

What is VEGF?

A

Vascular endothelial growth factor

Up-regulation of VEGF promotes growth of new vessels

84
Q

How are anti-VEGF drugs administered?

A

Given locally via intra-vitreal injections, sterile procedure, needs clean room, repeated monthly for three doses (then as required)

85
Q

What is the IVAN trial and what were its findings?

A

Comparison of ranibizumab (expensive, monthly) and bevacizumab (cheap, as required) - no major difference in efficacy at 12 months

86
Q

Why is ranibizumab used instead of bevacizumab despite it being more expensive and inconvenient?

A

Bevacizumab is not licensed

87
Q

What are the major causes of blindness/visual impairment?

A 
Cataract
Glaucoma
AMD
Corneal scarring 
Diabetic retinopathy
88
Q

What is the psychosocial impact of blindness/visual impairment?

A

Economic (unable to work, increased care, health risks)
Loss of independence (domestic, shopping, finance, navigation)
Communication (hearing impairment, non-verbal, social interaction, TV/film/media)
Social/psychological (increased isolation, anxiety, depression)

89
Q

What can peripheral neuropathy lead to?

A

Selective proprioceptive loss

90
Q

What is the consequence of selective large fibre sensory neuronopathy?

A

No sensory feed-back from muscle, skin or joint from below the neck

91
Q

What is proprioception?

A

Signals contributing to conscious and subconscious mechanisms of motor control

92
Q

What is position sense?

A

Conscious awareness of the relative positions of our body parts in space

93
Q

What is kinaesthesia?

A

Sense of movement, speed of movement, direction of movement (heaviness or sense of effort)

94
Q

What receptors provide important proprioceptive signals?

A

Joint receptors
Cutaneous receptors
Golgi tendon organ receptors
Muscle spindle receptors

95
Q

What joint receptors are slowly adapting?

A

Type I - Ruffini endings
Type III - Golgi endings
Type IV - free nerve endings

96
Q

What joint receptors are rapidly adapting?

A

Type II - Panciniform endings

97
Q

What sensory endings do muscle spindles have and what do they respond to?

A

Primary and secondary
Both respond to stretch of the muscle and signal changes in length
Primary ending also has high dynamic sensitivity and responds to changing length and tapping/vibrating

98
Q

What do primary endings of muscle spindles respond to?

A

Muscle stretch

Changing length, tapping, vibrating

99
Q

What muscle efferent (motor) axons are there?

A

α - skeletomotor

γ - fusimotor

100
Q

What muscle afferent (sensory) axons are there?

A

Ia - muscle spindle (primary)
Ib - tendon organ
II - muscle spindle (secondary)
III - pressure/pain receptors

101
Q

What cutaneous afferent axons are there?

A

II - touch, temperature

III - pain, temperature

102
Q

What is the maximum conduction velocity of sensory axons in humans?

A

87 m/s

103
Q

What is Hursh’s conversion factor?

A

total fibre diameter in μm

104
Q

What is the relation between fibre diameter and conduction velocity for large myelinated fibres?

A

6

105
Q

What is the relation between fibre diameter and conduction velocity for small myelinated fibres?

A

4.5

106
Q

What constitutes the total diameter of a fibre?

A

Diameter of axon plus myelin sheath

107
Q

What descending pathway is activated in transcranial magnetic stimulation?

A

Corticospinal

108
Q

What principle is used by transcranial magnetic stimulation?

A

Electromagnetic induction

109
Q

Briefly outline the process of TMS

A

Magnetic stimuli applied to motor cortex → activation of descending motor pathway (corticospinal tract) → magnetic field produced within cortex which leads to current flow (electromagnetic induction) → APs produced in pyramidal neurons with long axons to spinal cord → connect directly/indirectly with motoneurons → twitch contractions are elicited in skeletal muscles

110
Q

How is TMS being researched for therapeutic use?

A

Repetitive rhythmic TMS (rTMS) for depression and stroke

111
Q

What are platinum grid array electrodes used for?

A

Seizure monitoring and brain mapping on subdural cortical surfaces in conscious patients

112
Q

What happens to proprioception when the tendon is vibrated?

A

Impaired

113
Q

What is a muscle twitch?

A

Brief contraction

114
Q

How can muscle contraction be controlled?

A

Adjustment of number of motor axons firing at any one time - recruitment
Varying frequency of action potentials in motor axons - summation

115
Q

At what stimulation interval is intracellular calcium able to revert to baseline levels, maintaining separate muscle twitches?

A

200ms

116
Q

At what stimulation interval is intracellular calcium unable to revert to baseline levels, causing a stronger contraction due to summation?

A

200-75ms

117
Q

At what stimulation interval is intracellular calcium unable to revert to baseline levels and relaxation prevented, causing tetany?

A

<75ms

118
Q

What muscles are responsible for movement of the thumb towards the fingers?

A

Adductor pollicus

Flexor muscles of thumb

119
Q

What muscles are responsible for bending of the wrist?

A

Flexor carpi radialis and ulnaris

120
Q

What muscles are responsible for movement of all fingers and pulling of thumb towards index finger? What nerve innervates these?

A

Intrinsic hand muscles

Ulnar nerve

121
Q

Fell asleep with hand over the back of a chair. Numbness in the back of the hand and weakness of the wrist. Wrist drop. Weakness of wrist and finger extension. Sensory loss over the radial aspect of the posterior surface of the hand and the posterior surface of the forearm. What is the diagnosis?

A

Saturday night palsy

122
Q

What nerve is affected in Saturday night palsy and how?

A

Radial

Nerve becomes compressed in radial groove/spiral groove of humerus

123
Q

What nerves can be injured by compression?

A

Sciatic nerve - disc prolapse

Median nerve - carpal tunnel syndrome

Head, Neck and Neurological Systems (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions