Anatomy Clinical Correlation Head And Neck

Front 1

Congenital Torticollis or "Wry Neck"

Back 1

More Common.
Born with a wry neck. Flexed and Rotated in Either Direction. Permenement.

Front 2

Spasmodic torticollis

Back 2

Less common
Flexed and Rotated in Either Direction. Accquired.

Front 3

Infection within the Carotid Sheath

Back 3

Conduit for infection spread between cranium & mediastinum

Front 4

Infection between investing & muscular pre-tracheal fascia

Back 4

Note: Stops @ manubrium

Front 5

Infection between investing & visceral pre-tracheal

Back 5

Note: Spread to thorax

Front 6

Infection within retropharyngeal space

Back 6

Swelling that affects swallowing & speech

Front 7

Infection posterior to/within pre-vertebral layer

Back 7

Neck swells posterior to sternocleidomastoid

Front 8

Swelling of "cervical sentinel nodes"

Back 8

indicates pathology; L: within the posterior triangle
Inferior deep cervical lymph nodes

Front 9

Tonsilitis

Back 9

Jugulodigastric lymph node or "Tonsilar Node"

Large & L: Within anterior triangle of neck; swells with tonsilitis

Front 10

Tracheotomy Surgical concern: Hemmorage

Back 10

In 10% of population, thyroid ima a. is midline to the isthmus

Front 11

Thyroid Gland
Abberant thyroid tissue

Back 11

Detatched tissue: Along thyroglossal duct, anywhere between tongue & thyroid gland, or as lateral masses

Front 12

Thyroid Gland,
Thyroglossal Cyst

Back 12

Remnant of thyroglossal duct

Front 13

Thyroid Gland,
Goiter

Back 13

Enlarged thyroid gland due to LACK of IODINE
can compress trachea, esophagus, & recurrent laryngeal n.

Front 14

Thyroidectomy

Back 14

Removal of thyroid gland

Surgical Concern: don't cut thyroid ima artery, the Recurrent laryngeal n., or the *parathyroid glands [essential for life]*

Front 15

Hyperthyroidism or "Grave's disease"

Back 15

Over-active gland can cause: exophthalmos (bulgy eyes) & large goiter typical

Front 16

Hypothyroidism

Back 16

Less active gland

Front 17

L: @ root of neck within Posterior triangle
Pulse

Back 17

Subclavian a. (@ just posterior to mid clavicle)

Front 18

L: @ root of neck within Posterior triangle
Central Line Placement

Back 18

Subclavian v. (aim @ venous angle)

AVOID: cupola of the lung (pneumothorax) & subclavian a.

Front 19

L: @ root of neck within Posterior triangle
Thoracic outlet Syndrome

Back 19

Compression of brachial plexus/subclavian a. or v. @ the 1st rib & clavicle OR within Scalene Gap

Causes: m. weakness, tingling, skin coolness, ischemia, & distension of superficial v.'s

Front 20

Broca's Lesion

Back 20

Can't speak or broken speech

Front 21

Wernicke's area

Back 21

Language integration; writing

Front 22

Ishemic Stroke

Back 22

Area of blood loss to brain

Front 23

Berry Aneurism (BA)

Back 23

Most common where Basil a. bifurcates

Front 24

Extradural or Epidural Hemorrhage

Back 24

Arterial blood (**middle meningeal a.) pools between skull & periosteal layer of dura

On axial CT of brain: can see a big white blob lateral to the brain inside skull

Front 25

Dural Border Hemorrhage

Back 25

Blood (**venous form sinus) forces open a space within sublayers of dura

Front 26

SubArachnoid Hemorrhage

Back 26

Blood (**arteries to the brain) escapes into SubArachnoid space

Typically one of the a. from Circle of Willis

Front 27

Highly Fractured area of skull: PTERION

Back 27

Damage to the middle meningeal vessel

Front 28

Age affect on Cranial sutures...

Back 28

Lose between age 30-40; looks fused

Front 29

damage to CN XII

Back 29

All somatic Motor to tongue (except palatoglossus m.)
affects: eating & talking

Front 30

Damaged Facial Nerve CN VII: BELL's PALSY
Can cause?

Back 30

Paralysis of some/all facial m. on affected side.
Inferior eyelid eversion
Weak buccinator
Weak mouth sphincter/dilator
Weak lip m.

Front 31

Damaged Facial Nerve CN VII: BELL's PALSY
inferior eyelid eversion

Back 31

Can't spread tears

Front 32

Damaged Facial Nerve CN VII: BELL's PALSY
Weak buccinator

Back 32

Food accumulates in oral vestibule

Front 33

Damaged Facial Nerve CN VII: BELL's PALSY
Weak mouth sphincter/dilator

Back 33

Drooping of mouth; dribbling of saliva

Front 34

Damaged Facial Nerve CN VII: BELL's PALSY
Weak lip m.

Back 34

Affected speech; no whistling; no blowing wind instruments

Front 35

Scalp Injury

Back 35

CT layer through the emissary v. is a route for infection to the cranial cavity

Front 36

Orbital Fractures due to Traumatic Injury
Direct

Back 36

Damage to orbital rim

Front 37

Orbital Fractures due to Traumatic Injury
indirect

Back 37

"Blow-out" fracture… eye can go into another cavity

Front 38

Inflammation of Palpebral Glands:
Sty

Back 38

Blocked excretory duct--> infection of either ciliary or tarsal glands

Very painful & irritating

Front 39

Inflammation of Palpebral Glands:
Chalazion

Back 39

Blocked tarsal gland--> Cyst

Painles, usually goes away on its own

Front 40

Inflammation of Conjunctiva or "pink eye"

Back 40

Most commonly caused by viral (or bacterial) infection; coud be caused by allergic rxn. Of the conjunctiva

Front 41

Focus of the Lens
Hyperopia

Back 41

Far-sightedness

Front 42

Focus of the Lens
Myopia

Back 42

Near-sightedness

Front 43

Visual Field Defects
Optic N. Palsy or Monocular Blindness

Back 43

Blind in one eye on same side as lesion of optic n.

Front 44

Visual Field Defects
Optic Chiasm Palsy or Bitemporal Hemianopsia

Back 44

Narrow vision; lose both temporal (peripheral) fields of vision

Possible cause: pituitary gland tumor compressing optic chiasm

Front 45

Visual Field Defects
Optic Tract Palsy or Homonymous Hemianopsia

Back 45

R optic tract lesion: lose visual fields from L tract of both eyes

therefore, R eye- lose central & L eye- lose peripheral

Front 46

Reflexes of Eye
Pupillary Light Reflex

Back 46

inc. light in one eye --> pupillaries should contract in BOTH eyes
CN III : contricts pupil & CN II : percieves light

Front 47

Reflexes of Eye
Corneal Reflex

Back 47

Touching the cornea --> eyelid Blink should occur
V1: Sensory to cornea & CN VII : motor "blink"

Front 48

Ptosis

Back 48

Droopy eye due to loss of sympathetic inn. To superior tarsal m.

Front 49

Abducent Nerve Paralysis CN VI

Back 49

Weakens lateral rectus--> medial strabismus (deviation) of affected eye
Most common eye n. lesion; looks like "cross-eye"

Front 50

Oculomotor N. Paralysis CN

Back 50

Affected eye looks down & lateral with a dilated pupil

Parasympathetic to Constrictor pupilae & ciliary m. lost--> see **dilated pupil; only m. Active still are lateral rectus & superior oblique --> ptosis drooping of eye

Front 51

Trochlear N. Paralysis

Back 51

"Active" test of the superior oblique m.; ask pt to "move eye into medial & down position"-- + parylisis, eye CANNOT move down!

Front 52

Pterion Fracture

Back 52

Middle meningeal a. - anterior br.

Blows to temporal fossa may --> intra-cranial hemorrhage

Front 53

Mandibular n. Block

Back 53

Extra-oral injection @ mandibular notch anesthetizes all of CN V3
DON’T inject the parotid gland or facial n. CN VII

Front 54

Inferior Alveolar n. Block

Back 54

Intra-oral injection @ near mandibular foramen, palpate for lingula

Front 55

TMJ (temporormandiubular joint)
anterior dislocation

Back 55

Opening mouth TOO wide (large bites, yawning) w/ excessive lateral pterygoid contraction

Front 56

TMJ (temporormandiubular joint)
lateral dislocation

Back 56

Blows to sides of head/jaw

Front 57

TMJ (temporormandiubular joint)
posterior dislocation

Back 57

RARE; associated w/ broken mandible due to lateral temporomandibular lig.

Front 58

TMJ (temporormandiubular joint)
posterior dislocation/ regional surgery

Back 58

Endanger CN VII facial n. and auriculotemporal n.

Front 59

TMJ (temporormandiubular joint)
auriculotemporal n. damage + w/ ligament damage

Back 59

Can result --> TMJ laxity

Front 60

Lesion of CN V3 -

Back 60

Mandibular division of the trigeminal n.

Would see: atrophy of masseter & temporalis; deviation to IPSILATERAL weak side when opening the jaw via lateral pterygoid m.

Front 61

Lesion of CN V3 -
motor-

Back 61

Weak/parlyzed m. of mastication

Front 62

Lesion of CN V3 -
sensory-

Back 62

Anesthetized skin of mandible

Front 63

Adenoids

Back 63

Enlarged tonsils that obstruct the flow of air from nose through the nasopharynx, making mouth breathing necessary

Front 64

Palatine Tonsilectomy

Back 64

Surgical removal of "tonsils" common for people with re-occuring infections/swellings

Front 65

Pharynx Surgical Concern:

Back 65

Highly vascularized so is a concern for Bleeding

Front 66

Gag reflex (oropharynx)

Back 66

Sensory afferent in on CN IX - triggers vomiting; Sensory efferent out on CN X- motor reflex

Front 67

Vagus n. CN X Motor test for Lesion

Back 67

Ask pt. to say "ahhhh"… + lesion --> uvula deviates toward strong unaffected contralateral side; (ex. If deviates to R side, lesion is on L side)

Front 68

Infection of Cranial Nerves in the cavernous sinus: CN III, IV, V1, V2, & VI

Back 68

Spread of infection (from face, orbit, nose, etc); pituitary tumor; or aneurism of internal carotid a.

Front 69

Rhinitis

Back 69

Mucosal lining of nasal conchae swells rapidly w/ infection and pus drainage is prevented

Front 70

inflammation of nasal mucosa can spread to what areas?

Back 70

Anterior Cranial Fossa
Nasopharynx & Retropharyngeal soft tissues
Middle ear
Paranasal sinuses
Lacrimal apparatus/conjunctiva

Front 71

How can the inflammation of nasal mucosa can spread to anterior cranial fossa

Back 71

via Cribiform plate

Front 72

How can the inflammation of nasal mucosa can spread to nasopharynx & retropharyngeal soft tissues

Back 72

via Choanae

Front 73

How can the inflammation of nasal mucosa can spread to middle ear

Back 73

via Pharygotypanic (eustachian) tube

Front 74

How can the inflammation of nasal mucosa can spread to paranasal sinuses

Back 74

via Communications

Front 75

How can the inflammation of nasal mucosa can spread to lacrimal apparatus/conjunctiva

Back 75

via Nasolacrimal duct

Front 76

Rhinorrhea

Back 76

Dischage from mucous membrane

Front 77

CSF Rhinorrhea

Back 77

Discharge of CSF via Nose

Front 78

Meningitis

Back 78

Discharge of CSF via nasal cavity

Front 79

maxillary sinusitis

Back 79

Most commonly infected paranasal air sinus; difficult to drain; maxillary teeth & floor of maxillary sinus share Sensory innervation

Surgical way to promote draining: create an opening through the inferior meatus near the floor

Front 80

Clinical Test: transillumination of frontal and maxillary sinus

Back 80

Warm, red glow on forehead or hard palate indicates healthy, air filled sinus

Front 81

sphenoidal sinus

Back 81

Direct apporach surgically to the pituitary gland through the spenoidal sinus and nasal cavity

Front 82

Blow-out fracture of orbit affects Maxillary Sinus

Back 82

Inability to look up due to entrapped inferior rectus muscle

Front 83

optic neuritis

Back 83

Ethmoid sinus & optic n. CNII

Front 84

Epistaxis

Back 84

Nose bleed

Front 85

Epistaxis Kiesselbach's Area

Back 85

Area of anastomoses

Front 86

Epistaxis spurting

Back 86

Arterial

Front 87

Epistaxis non-spurting

Back 87

Venous

Front 88

Anosmia
And 2 possible causes?
Test?

Back 88

Loss of smell
1. Injury to olfactory n. @ the cribiform plate
2. Compression of the olfactory tracts

Test: unilaterally; occus w/ aging; commonly pt. complains of "loss of taste"

Front 89

Anosmia from injury to olfactory n. @ the cribiform plate?

Back 89

Loss of smell

Front 90

Anosmia from compression of the olfactory tracts?

Back 90

Signal a skull fracture or could be ass. w/ CSF rhinorrhea

Front 91

surgical: Intubation landmark

Back 91

Valleculae - separates the posterior 1/3 oropharynx which less mobile

Front 92

lesion of CN XII Hypoglossal

Back 92

Affects all extrinsic m. of the tongue (except palatoglossus- CNX)

Front 93

Cricothyrotomy or Tracheotomy

Back 93

Emergency operation in cases of sudden obstruction of the airway (swallow foreign body, edema of larynx, paralysis of vocal cords); open the airway into the trachea in the midline through the "median cricothyroid ligament" between the infrahyoid m. of the neck

Front 94

Laryngocele

Back 94

Abnormal expansion of laryngeal ventricle

Example: Xray of a babpipe player

Front 95

Laryngoscopy

Back 95

Examination of the internal larynx via mirror (indirect) or larygoscope (direct)

Front 96

Cough Reflex

Back 96

Irritant (cough) receptors are located mainly on posterior wall of the trachea & pharynx; when triggered, sensory impluse travels afferently via Internal br. Of the superior laryngeal n. (from CN X: vagus); afferent motor pathway from brain provides the mechanism of the cough

Can be impaired in people: swallow foreign object, with weak abdominal or respiratory m.; or lesions of the internal br. Of the superior laryngeal n.

Front 97

Heimlich Maneuvers

Back 97

Exert pressure on bottom of the diaphragm to compress the lungs and exert pressure on any object lodged in the trachea, hopefully expelling it; essentially causes an artificial cough

Front 98

Lesions of the laryngeal n. locations?

Back 98

Superior laryngeal n.
Recurrent (inferior) laryngeal n.
unilateral vs. bilateral

Front 99

Lesions of the laryngeal n. at Superior laryngeal n.

Back 99

Hoarseness, diminished cough reflex

Front 100

Lesions of the laryngeal n. at Recurrent (inferior) laryngeal n.

Back 100

Hoarseness/near absent voice, breathing affected (loss of vocal fold AB-duction), some cough reflex

Front 101

Lesions of the laryngeal n. unilateral vs. bilateral

Back 101

Look for paralysis of vocal fold on the affected side (deviate toward lesion) during laryngoscopy

Front 102

"throat clearing"

Back 102

Piriform recesses (or laryngopharynx)

Front 103

Cancer of Larynx

Back 103

most originate in the glottis including vocal cords; less common are epiglottis & subglottis; hoarseness, Swollen lyph nodes, earache

Might metastasize to: regionally cervical lymp nodes or more distantly to the lungs

Front 104

Laryngectomy

Back 104

Removal of larynx

Front 105

Danger Triangle

Back 105

Anastomeoses between the angular v. and the superior & inferior opthalmic v. can lead to venous spread of infection into the cavernous sinus

Infections of the upper lip, cheeks, and forehead may spread through the facial and angular v. into the opthalmic v. and then into the cavernous sinus; thrombosis in this sinus can affect the abducent n. and cause dysfxt of the lateral rectus m.

Front 106

Trigeminal Neuralgia

Back 106

Demyelination of sensory axons causing sudden attacks of facial pain.

Front 107

Otitis Media

Back 107

Otitis media is inflammation of the middle ear, or middle ear infection. It occurs in the area between the tympanic membrane and the inner ear.

Front 108

Hyperacusis

Back 108

An over-sensitivity to certain frequency ranges of sound.

It can be acquired as a result of damage sustained to the hearing apparatus, or inner ear. (Listening to loud music.)

Front 109

Tinnitus

Back 109

Perception of sound within the human ear in the absence of corresponding external sound.

Most common cause is noise-induced hearing loss.

Front 110

Cochlear implants

Back 110

Cochlear implants may help provide hearing in patients that are not deaf because of damage to sensory hair cells in their cochleas. In those patients, the implants often can enable sufficient hearing for better understanding of speech.

Front 111

Motion Sickness

Back 111

A disagreement exists between visually perceived movement and the vestibular system's sense of movement.

Front 112

Benign Positional Vertigo

Back 112

A spinning sensation caused by changes in the position of the head

When the Statoconic Membrane migrates into the semicircular canals.