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77 Cards in this Set
- Front
- Back
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acute vs. chronic sinusitis img
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both have mucosal thickening (soft tissue density)
acute has air-fluid level though fig 8.74, 8.75 |
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in sinusitis, we do CT/ xray to rule out..
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polyp or air fluid level
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how to treat sinusitis
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let it run its course
if not done.. use low grade AntiB over long period of time - cuz sinus is not highly vasculairzed so it takes long time to reach area |
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epilepsy .. what is it
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brain impulses are temporailiy distrubed
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types of epilepsy
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petit mal - in kids, loss of conscicness and mild muscle twitch
grand mal - convulsions, hypersalivating, loss of bowel and urine control (petit vs grand - diff by how humiliating it is? LOL) aura - in petit and grand - lets them know epilepsy is coming - (titnnitus, tingling in extremtiies etc...) |
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what projections do you do for sinusitis x-ray
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erect, waters
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tripod fracture is..
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3 fracturs in zygo arch, lat orbital rm, maxiillary sinus
(tim said, # at sutures of frontal, temporal and maxi) - result in free floating zygoma |
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blowout # is...
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# of orbital floor or medial wall
best shown with water projection |
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what best shos blowout #
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waters projection (like in sinusitis)
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nasal bone #
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transverse # of nasal bone where the distal part of it depresses
epistaxis (nose bleed common with it) |
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LeFort (I, II, III) is for...
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facial fractures
I - horizontal fracture - result in seperation of body of maxilla from base of skull (above hard palate and below zygo process) - result in free floaing movable jaw (NOT A DISLOCATION) II - pyramidal # - vertical # thru maxilla at zygoma and nsal bones, forming a triangle sepation of maxilla III - transvse # - most serious - extends across orbit and result in sepateion of face from skull - zygomatic arch is involved too note the names too horizontal pyradmidal transverse |
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maxillia # are serious because...
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their prximity to nasal vaivty, sinus, orbit and brain
- has crainial nerves and vessels note the leFort I, II, III |
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contussion of brain
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bruise the brain
- happens when brain moves in the calvaria and bumps into it ch'ed by - vertigo, headache, vomit coup lesion - contusion formed on side of head trauma counter coup - contusion formed on opposite side of head where trauma happened |
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vertigo
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spinning feeling
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coup vs. counter coup lesion
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coup lesion
- contusion formed on side of head trauma counter coup - contusion formed on opposite side of head where trauma happened |
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epidural hematoma
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involve torn ARTERY
- middle meningeal artery - bleeds b.w skull and dura |
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subdural hematoma
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involves torn VEIN in subdural
bleeds into dura and subarachnoid |
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subaracnoid hemorrahage
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can involve tear of surface veins,cortical arteries, or injury to cerebral paranchyma
b/w subara and piamater |
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intracerebral hematoma
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can be from trauma or CVA
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how do you treat torn artery or vein in brain???
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artery - has continus pressure
venous - low pressure, so it will eventually clot and stop bleeding - once clotted we remove it via bore hole and drain it to relieve pressure |
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why are mandible fractures often bilateral (2 #?)
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they are horseshoe shapped bones
- that shape commonly has bilat # |
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mandible # takes longest to heal true?
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true
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depressed # in skull or face best shown with
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SMV< Water
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skull fractures (3) list them
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lienar
depressed basilar (# OF BASE OF SKULL) -(hard to see in x-ray) - some signs 0 air fluid lvl in sphenoid sinus, clouding of mastoid air cell) - get it form being hit in backj of head |
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clincal indication used with pat with head trauma for head x-ray...
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unexplained focal neuro signs
- focal neuro signs --> based on eye - ask them to follow finger with eye - - or ask them to follow light -one pupil dilated and other is not with light |
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CNS neoplastic
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Glioma
Glioblastoma astrocytoma ependymomas medulloblastomas oligodendrogliomas meningioma pituitary adenoma craniopharyngioma tumor of CN shealth cells (3) - acoustic neurilemmonma - acoutistc neuroma - schwannoma metastatic carcinoma spinal tumors (2class) - extradural - intradural (extra/intramedullary class) extramedullary - meningiomas (like in brain) - neurofibroma intramedulalry - astrocytoma |
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about spine tumors (not listing names)
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less common than brain tumors
x-ray sign - erosion of pedicles or bony destruction of it most common type of intramedulalry tumor is astrocytoma msot common type of spinal tumor are - meningioma and neurofibromas (both extramedullary) |
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Mets to brain usually get there by ______ and are from ___________
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circulatory system
breat, lung (mostly lung) |
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symptom of brain mets
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cranial pressure
headache ataxia- alck of coordination and movement |
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tumors of central nerve shealth cells most common site and symptoms (easy)
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8th cranial nerve (ACOUTSITC NERVE)
at this site, it compresses brain tissue and erode the temporal bone symptom - facial paralysis, tinnitus (sound in eary), paritial hearing loss on side affected 3 tumors - acoutisc neurilemmoma - acoutsitc neuroma - schwannoma |
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pituitary adenoma
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pit gland has tumor
- latearl x-ray shows changes in sella tursica (tumor can get so big, it erodes it ) |
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crainopharynigoma
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beign tumor growning from remannts of pit gland
usually arise sup to sella and extend upward into 3rd ventricle |
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most common priamry brain tumor...
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giloma - consist of glial cells
malignant form of giloma (glioblastomas) (50% are malign) common found in cerebral hemispehres and psoterior fossa |
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meningioma
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beign slow gorwing tumor that orignates in arachnoid lining cells and attaches to dura
only compresses brain as it grows |
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stroke aka ...
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cerebral vascular accident
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what is stroke/cerebral vascualr accident (CVA)
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atherosclerosis affecting blood supply to brain
two types: ischemic hemorrhagic |
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what is ischemic stroke?
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a blood clot that blocks a blood vessel to brain
- majority of all strokes by ischemic!!!!! - can lead to necrossi after occulusion - try to take aspirin to help break up clot ischemic stroke can happen two ways - thrombus - embolism (ex from deep vein thrombus) two types of thrombsm that can cause stroke |
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what two types of thrombosis can cause stroke?
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large vessel thrombosis
small vessel thrombosis (ex. lacunar infarction - 20% all stroke) lrg vessel often in lrg ateries - bifurcation of common carotid artery - carotid sinus - end of internal carotid artery |
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common location for large vessel thrombosis in ischemic stroke
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lrg vessel often in lrg ateries
- bifurcation of common carotid artery - carotid sinus - end of internal carotid artery |
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what is lacunar infaction in ischemic stroke?
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its small vessel thrombosis that leads to ischemic stroke
20% of all strokes!!! |
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infact by thrombosis of A cerebral artery is called
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atherothrombic brain infarction (ABI)
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what is atherothrombic brain infarction (ABI)?
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infarct by thrombosis of cerebral artery
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what can atherothombic brain infarction (ABI) lead to?
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rmbr its infact by thrombosis of cerebral artery
it can lead to transisnet ischemic attack (TIA) - a tempory period of stroke symptoms less than 24 horus casues of TIA - temporry embolis occuluding cerebral artery (TEMPORARY) |
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TIA is like a mini stroke true?
(transisent ischemic attack |
TRUE
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what is transisnet ischemic attack?
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like mini stroke
commonly by emoblism in CEREBRAL ARTERY (caused by atherothrombic brain infarction - thrombis in cerebral artery leading to infacr) signs - forget something immediately - cuases small infarctions but rmbr its temproary ct - sm necrosis will ead to calficication over time - will see tiny microcalcification in CT |
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hemorrhagic strokes arre...
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result of weaking in vessel wall
- leads to BLEEDING into brian (unlike ischemic stroke) hypertension usually weakens the wall common location - white matter - basal ganlia - thalamus complications - rupture into ventricles or Subarachnoid space intense headache two types subarachnoid intracerebral |
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two types of hemorrhagic stroke
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subarachnoid
intracerebral |
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what CNS vascular disease has intesnse headache?
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brain hemorrhage
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hemiplegia
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half of body paralyzed
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signs of brain hemorahge
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intense headache
loss of consciusness hemiplegia death |
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whats more severe, brain hemorrhage or ischemic stroke?
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brain hemorrahgic stroke
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list CNS degenerative disease
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degen. disk disease
herniated nucleus pulposus cervical sponylosis (nerve root compression from OA of Cspie) multiple sclerosis aging alzhimer (like aging brian but younger age) huntingtons disease (dementia) parkinson disease (degne in nerve cells, low dopamine, involuntary tremor of limbs that stop with voluntary movement) amyotrophic lateral sclerosis (lou gehrig disease) (widespread cerebral atrophy with unknown cause and loss of MOTOR NERVE CELL |
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aging..
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CNS degen disease
gradual loss of neurons, enlarging ventricles and sulci more space exist b/w skull surface and inner table of cranial vault *********** |
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alzhemier disease
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like aging, but at an earlier age
- cerebral atrophy |
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huntington's disease
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inherited autosmal DOMINANT
- dementia and involuntary mvoement |
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parkingson's diseas
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- low dopamine
- involuntary movement of limbs that stops with voluntary movement of limbs |
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amyotrophic lateral sclerosis (lou gehrig diseas)
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unknown casue
widespread cerebral atrophy loss of MOTOR NERVES lead to paralysis and death |
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multiple sclerosis
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demyelination disorder interfereing with neuron conduction
they are sensitive to heat hate humid hot like dry hot palces like h |
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cervical spondylosis
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compression of nerve root
source: OA that changes neck to compress nerve root with osteophytes |
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congenital and heriditary diseae of CNS
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menigocele
myelocele meningomyelocele hydrocephalus |
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meningocele
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least common
meninges not cord protrude out of defect |
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myelocele
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protrusion of spinal cord out of defect (vertebral arch)
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myelomenigocele
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most serious
spinal cord protrudes out of defect meningeal membrane forms a sac in back |
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meningitis
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inflammation of meninges (dura, ara, pia)
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spinal bifida
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congenital disease where nerual tube do not fuse proeprly
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CNS inflammatory disease (lsit them)
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meningitis
encephalitis meningoencephalitis brain abscess epidural empyema osteomelitis of skull |
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encephalitis
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viral inflam of BRAIN TISSUE
if inflam invovles meninges too.. meningoencephalitisits |
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meningoencephalitis
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inflam of brain and meninges
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brain abscess
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ENCAPSULATED accumalation of puss
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subdural empyemea
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requires immediate draininage
puss accumulates in dura and arachnoid |
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epidural empyema
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pus b/w skull and dura
ASSOCIATED with osteomyelitis |
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osteomyelitis of skull
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infection of bone in skull
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degenerative disc disease DDD
or herniated nucleus pulposus or hernatied disc |
weak or torn annulus fibrosus leads to rupture allowing nucleus pulposus to protrude and compress spinal nerve roots
common site C and L spine |
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common site for hernatied disc of DDD
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C and L spine
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source of ifnection for osteomyelitis in skull
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mastoid air cell
scalp paranasal sinus |
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rad app of osteomyelitis
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mutlple, small lucent, poor defined areas in lat skull
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what is the battle sign?
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attle's sign consists of bruising over the mastoid process, as a result of extravasation of blood along the path of the posterior auricular artery.[1]. The sign is named after William Henry Battle.[2]
NOTE: its bruising not fracture of mastoid process |
