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63 Cards in this Set
- Front
- Back
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spasmodic torticollis
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in all ages: SCM inflammation & spasm
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congenital torticollis (wry neck)
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in children: SCM congenitally shortened
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Cervical Plexus block
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for Carotid endarterectomy & neck surgery e.g. lymph node removal
Landmarks for its surface anatomy: Mastoid process Sternocleidomastoid muscle; posterior border of the clavicular head Transverse process of C6 |
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Thoracic Outlet syndrome
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Some people may have an extra cervical rib (enlarged costal process of vertebra C7) that may compress or stretch inferior trunk of brachial plexus &/or subclavian artery causing pain & paresthesia in neck & upper extremity
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Referred Pain
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Irritation of hemi-diaphragm via diaphragmatic pleura or peritoneum innervated by phrenic nerve (C3,4,5) causes referred pain to the corresponding shoulder travelling via Supraclavicular nerves (C3,4)
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Facial (bell's) Plasy
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The facial nerve gets pinched through the fossa. paralysis of the facial nerve due to compression, inflammation injury ear disease, or stroke on on e side. Ipsilateral muscle of facial expresison are paralyzed affected side seems expressionless with loss transverse wrinkling of forhead, difficulty closing eyes, watery eyes, drooping.
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Trigeminal Neuralgia
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neuropathic facial pain due to inflammation of compression of CN 5. causes episodes of pain in eyes, lips, scalp, forehead and jaw.
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TMJ dislocation
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Commoly follows extreme opening of mouth eating yawning, trauma. anterior tmj is dislocated is most common. superior and post dislocations are rare and usually associated with trauma.
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TMJ Syndrome
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common in elderly ppl. usually in women. may present with pain tenderness, chewing , limited jaw movement, dizziness, earaches, headaches.
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AJV may drain a large communicating vein from facial vein along anterior border of SCM--
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it may cause bleeding in post-traumatic neck injury or during a tracheostomy
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Goiter
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may compress trachea & esophagus, causing difficulty breathing (dyspnea) or difficulty swallowing (dysphagia)
- Thyroid enlargement tends to be downwardly rather than upwardly causing retrosternal goiter - Goiter surgery may endanger particularly recurrent laryngeal nerve causing hoarseness of voice |
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Ectopic thyroid tissue
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Congenital Anomalies of the thyroid gland
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Thyroglossal duct and cyst formation
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Congenital Anomalies of the thyroid gland
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carotid sinus syncope
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In some individuals carotid sinus may become hypersensitive to external pressure, resulting in fainting (carotid sinus syncope); therefore, carotids are NOT recommended especially in elderly or cardiac patients to measure pulse
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Internal Carotid Artery
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Frequent site of atherosclerotic plaques that might lead to stroke
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Internal Carotid Artery--Cerebrovascular accident
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Temporary ischemia (transient ischemic attacks, TIAs) or long-term ischemia or hemorrahge (cerebrovascular accidents/strokes) cause loss of neurological function due to loss of cerebral blood flow
- Surgery to place a stent or to remove plaque (carotid endarterectomy) may be required |
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Chassaingac’s or carotid tubercle
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Common carotid artery may be compressed against the large anterior tubercle of vertebra Cv6 (Chassaingac’s or carotid tubercle) located bilaterally on the transverse processes of C6 to help control bleeding from branches of carotid artery
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IJV may distend
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if venous return to the right atrium is obstructed (e.g., in tension pneumothorax , cardiac tamponade, or superior vena cava syndrome, & heart failure)
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Chassaingac’s or carotid tubercle
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to control bleeding...may be compressed against the large anterior tubercle of vertebra Cv6, located bilaterally on the transverse processes of C6 to help control bleeding from branches of carotid artery
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Pancoast tumor
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may damage the apex of the lung. Apical tumor (Pancoast tumor) may damage neck structures (e.g. lower roots of brachial plexus, cervical sympathetic trunk, phrenic &/or recurrent laryngeal nerve
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Penetrating wound to the root of the neck
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May damage the apex of the lung. may damage neck structures (e.g. lower roots of brachial plexus, cervical sympathetic trunk, phrenic &/or recurrent laryngeal nerve
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Intracranial hemorrhage
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epidural hematoma- middle meningeal artery- after temporal bone trauma, does not cross suture lines-takes a bit of time to manifest(intercranial pressure manifests)
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Subdural Hematoma
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venous bleeding usually in elderly blunt trauma with delayed onset, may cross suture line
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Subarachnoid hemorrhage-
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congenital atervenous malformation or aneurysm rupture, sanguinous- spinal tap- is spontaneous.
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Brain Herniation-
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Abnormal protrusion of a specific part of the brain tissue through areas of deficient of dural folds –leads to neurological manifestations***
Draining of the blood flow through the sinuses--- brain drains its venous blood backwards from the major sinuses |
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botulinum toxin (botox)
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Corrugator supercilii (Paired)
Causes vertical wrinkling of forehead (e.g. frowning) surgically severed or paralyzed with botulinum toxin (botox) to treat migraine headache or for aesthetic reasons |
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cavernous sinus thrombosis
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Pterygoid plexus of veins. Infection of draining organs e.g. septic tooth can life-threatening
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TMJ (mandibular) dislocation
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commonly follows extreme opening of mouth (e.g. eating, yawning, laughing, singing, vomiting, dental treatment) & is less often caused by trauma.
Anterior TMJ dislocation is most common Superior and posterior dislocations are rare &usually associated with trauma |
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Tmj syndrome
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Fairly common in elderly people
(~ 60 Million Americans) Women usually seek medical treatment more than men (9:1) May present as pain & tenderness with chewing, limited jaw movement, earaches, headaches, dizziness, &/or neck pain & stiffness |
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Papilledema
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swelling of optic disc due to increased CSF pressure. it slows venous return and interferes with neuronal axoplasmic transport.
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Supranuclear Lesion
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CN7 lesion. Contralateral weakness of lower face. Relative sparing of upper face.
--Neurons that innervate muscles of upper face receive bilateral corticobulbar input. |
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Facial Paralysis/Palsy
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CN7 lesion. Lesion of facial nucleus or nerve.
-lower middle nerve signs -upper and lower face -one side is paralyzed throughout |
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Upper Motor Nerve of Cortex or Corticobulbar fibers
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CN7 lesions. Lower face--contralateral side. staring, can raise eyebrows.
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Perichondral Hematoma, Hematoma Auris-- Cauliflower ear.
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Common injury in:
Wrestling Boxing Rugby May cause discomfort May affect hearing If not drained it will calcify Perichondrium is sheared off of the ear and it will cause a hematoma |
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deviated septum
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is a displacement of the nasal septum that typically occurs where the perpendicular plate of the ethmoid articulates with the vomer. Too much growth- european descent ppl have this most esp for ppl who have narrow noses.
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Nasal polyps
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abnormal growths of tissue that arise from the nasal mucosa
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Rhinitis
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inflammation of the nasal mucosa. Stuffed up nose, normal level of swelling, but if tissue is inflammed you will have not ability to breath, try to blow nose but you cant
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Sinusitis
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is inflammation of one or more paranasal sinuses.
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rhinosinusitis
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When rhinitis and sinusitis occur at same time
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Foreign body
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may stuck in piriform fossa risking damage of internal laryngeal nerve located under mucosa of its lateral wall traversing thyrohyoid membrane
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Inferior (Recurrent) laryngeal nerve injury
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may occur during thyroidectomy, neck surgery, or by compression from a tumor such as Pancost tumor. In unilateral paralysis, poor or hoarse voice may occur due to slackness of a vocal cord. Bilateral paralysis may cause loss of voice from motionless cords.
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Internal laryngeal nerve injury
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may occur from a foreign body impacted in piriform fossa or from mainpulation during removal of foreign body. Anesthesia of vestibular mucosa on the ipsilateral side may occur
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External laryngeal nerve injury
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may result in monotonous voice
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Foreign body aspiration
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Acute symptoms: cyanosis, cough, choking
Early risks: dyspnea, laryngeal edema, asphyxia with respiratory depression. Cardiac arrest, pleural perforation & pneumothorax might occur Foreign body in vestibule initiates reflex coughing from laryngeal muscles spasm & closure of rima glottidis that may expel foreign body. Allow 5 min max OR: Heimlich maneuver: Diaphragmatic elevation & sudden air expulsion may dislodge foreign body from larynx |
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TRACHEOSTOMY
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Common indications:
Foreign body impaction Trauma Unconsciousness associated with head injury Tumors Types: - Cricothyrotomy High: between 1st & 2nd or 2nd & 3rd tracheal rings Trans-isthmus Percutaneous tracheostomy became very popular |
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Bony Orbit Blowout Fx
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Floor and medial wall of orbit weakest part, most prone to Fx with a blow to the eye. the eye is stuck and forced to move through soft tissue causing a blowout fx.
signs and symptoms: double vision, restricted upward gaze, sensory deficits, vomiting, nausea. can lead to a trapdoor fx in kids. |
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Chalazion
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The tarsal gland duct gets clogged and is chronically inflamed. can be treated with a warm compress
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External Hordeloum(stye)
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ciliary glands and sebaceous glands get infected and causes a stye. can be treated with a warm compress.
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Stye
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the tarsal glands get infected. rarely occurs because they are located on the inside of the eyelid.
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Glaucoma
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increased resistance to aqueous humor outflow and raises intraocular pressure
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Open angle glaucoma
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Obstruction of trabecular meshwork-increases intraocular pressure
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Closed angle glaucoma
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iris physically blocks inner surface of anterior chamber angle- increases intraocular pressure
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Conjunctival injection, Ciliary injection
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irritation of conjunctiva or ciliary body due to sand or particles, anything. causes dilation of vessels and inflammation.
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Ptosis
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sympathetic innervation of eyeball is aggravated.
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Corneal Reflex
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How you can test reflexes of the eye and if there is any damage. it joins the sensory and motor limbs, tests how well they are working.
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Perichondral Hematoma, Hematoma Auris
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Caused by trauma to the ear
common in Wrestling Boxing Rugby May cause discomfort May affect hearing |
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Acute purulent Otitis Media
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Acute infection, red, inflammed, bulging. can get infected.
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Otitis Media with Effusion
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no infection but fluid buildup, can be related to active infection in pharynx- not common
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Perforation
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hole in tympanic membrane. can heal spontaneously (only if its small) but leaves a scar
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Tympanostomy/ Myringotomy
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Otitis media is an extremely common Dx in children
A tube or grommet may be placed in the tympanic membrane- to help it drain Used to manage chronic otitis media with effusion As many as 30% of all children under 24 months may undergo this procedure 20% will require a second set of tubes to be put into place |
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Perforated Tympanic Membrane
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“Burst eardrum”
Often due to sports injury Opens the middle ear to the external ear Potential for infection high Potential for other problems high (e.g. hearing loss) |
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Mastoiditis
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inflammation of the mastiod air cells. because of the opening in the posterior wall, infection from the middle ear can flow to the mastoid air cells and visa versa
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Blocked Eustachian tube
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can be through illness (such as colds or allergies) or developmentally
pharyngotympanic tube smaller and more horizontal in children Result can be recurrent otitis media |
