H&N clinicals
Terms
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- Torticollis
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Spasmodic contraction of cervical muscles producing twisting of the neck with chin pointing upward and to opposite side
-Due to injury to SCM or avulsion of CN XI - Lesion of CN XI
- -Denervates trapezius leading to downward displacement or drooping of shoulder
- Carotid endarterectomy
- Excision of atherosclerotic plaque of internal carotid artery
- Thyroidectomy and what can be injured
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- INFERIOR THYROID VEIN is most vulnerable in this procedure
-Also can damage recurrent laryngeal nerve
-Can also inadvertently remove parathyroid glands which can be fatal - Retropharyngeal abscess or infection can spread to _
- Posterior mediastinum through retropharyngeal space
- Bells palsy
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Paralysis of facial muscles resulting from lesion of facial nerve.
- Distortions - sagging corner of the eye, inability to smile, whistle or blow, inability to close or blink the eye - Blink reflex
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Closure of the eye in response to blowing on cornea or touching it with wisp of cotton
Efferent limb - facial nerve
Afferent limb - nasocilary nerve of ophtalmic division of trigeminal nerve - Trigeminal neuralgia
- Pain along the course of the trigeminal nerve, especially radiating to maxillary and mandibular area. Can be treated by cutting sensory root of CN V
- Danger area of face
- Area of face near nose drained by facial veins. Skin infections on the side of nose and upper lip may spread to cavernous venous sinus via facial vein, pterygoid venous plexus and ophtalmic veins - this can lead to meningitis and cavernous sinus thrombosis
- Scalp hemorrhage
- Results from laceration of arteries in dense connective tissue layer - arteries are unable to contract or retract and remain open leading to profuse bleeding
- Scalp infection
- -Loose connective tissue spreads infection
- Rupture of middle meningeal artery
- -Fracture of squamous part of temporal bone and causes epidural hematoma
- Mumps
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Inflammation of parotid gland
-Pain is mediated by auriculotemporal nerve - Skull fracture at pterion can result in _
- Rupture of middle meningeal artery
- Subdural hematoma
- -Caused by rupture of bridging cerebral veins
- Lesion of olfactory nerve
- Anosmia
- Lesion of optic nerve
- Ipsilateral blindness + no direct pupillary light reflex
- Lesion of optic chiasma
- Bilateral tunnel vision
- Lesion of optic tract
- Contralteral tunnel vision
- Lesion of oculomotor nerve
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-Paralysis of ocular muscles resulting from damage to GSE fibers
-Paralysis of sphincter pupillae resulting in dilation of pupil
-Paralysis of ciliary muscle resulting in loss of accomodation because of damage to parasympathetic fibers
-Lesion interferes with pupillary reflex because of damage of parasympathetic fibers that mediate efferent limb of pupillary light reflex - Lesion of trochlear nerve
- Paralysis of superior oblique muscles
- Lesion of trigeminal nerve
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-Sensory loss of the face and motor loss of muscles of mastication with deviation of jaw toward the side of lesion
-If you lesion lingual nerve get loss of general and taste sensation to anterior 2/3 of tongue and salivary secretion of submandibular and sublingual glands
-Lose afferent limb of corneal reflex, sneeze reflex and jaw jerk reflex - Lesion of abducens nerve
- Paralysis of lateral rectus leading to medial deviation of the eye
- Lesion of facial nerve
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-Loss of SVE fibers to innervate muscles of facial expression
-Loss of SVA(taste) fibers from anterior 2/3 of the tongue
-Parasympathetic GVE fibers for glands
-Loss of eferent limb of corneal blink reflex - Lesion of glossopharyngeal nerve
- Loss of hearing and balance