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Questions and Answers
A patient reports ear pain (otalgia) due to a tumor. If the pain is referred, which cranial nerves are most likely involved in transmitting the sensory information from the tumor to the ear?
A patient reports ear pain (otalgia) due to a tumor. If the pain is referred, which cranial nerves are most likely involved in transmitting the sensory information from the tumor to the ear?
- Hypoglossal nerve (CN XII) and spinal accessory nerve (CN XI)
- Olfactory nerve (CN I) and optic nerve (CN II)
- Glossopharyngeal nerve (CN IX) and vagus nerve (CN X) (correct)
- Facial nerve (CN VII) and trigeminal nerve (CN V)
A patient faints during an ear examination. Irritation of which nerve is the MOST likely cause of this vasovagal response?
A patient faints during an ear examination. Irritation of which nerve is the MOST likely cause of this vasovagal response?
- Auditory nerve (CN VIII)
- Trigeminal nerve (CN V)
- Facial nerve (CN VII)
- Vagus nerve (CN X) (correct)
Where is the sphenoethmoidal recess located within the nasal cavity?
Where is the sphenoethmoidal recess located within the nasal cavity?
- Inferior to the middle concha
- Inferior to the inferior concha
- Superior to the middle concha
- Superior to the superior concha (correct)
Paralysis of the stapedius muscle can result in which of the following auditory symptoms?
Paralysis of the stapedius muscle can result in which of the following auditory symptoms?
Which nerve innervates the stapedius muscle?
Which nerve innervates the stapedius muscle?
During a thyroidectomy, which laryngeal nerve is MOST at risk of injury due to its proximity to the superior thyroid artery and vein?
During a thyroidectomy, which laryngeal nerve is MOST at risk of injury due to its proximity to the superior thyroid artery and vein?
During a cricothyrotomy, which of the following structures is penetrated FIRST after the skin?
During a cricothyrotomy, which of the following structures is penetrated FIRST after the skin?
In performing a cricothyrotomy, what is the LAST structure that is incised before entering the airway?
In performing a cricothyrotomy, what is the LAST structure that is incised before entering the airway?
What embryologic process is disrupted in a patient with a cleft palate?
What embryologic process is disrupted in a patient with a cleft palate?
Damage to which structure within the cochlea leads to sensorineural hearing loss?
Damage to which structure within the cochlea leads to sensorineural hearing loss?
How do cochlear implants function to restore hearing in individuals with sensorineural hearing loss?
How do cochlear implants function to restore hearing in individuals with sensorineural hearing loss?
What is the underlying cause of Pierre Robin sequence?
What is the underlying cause of Pierre Robin sequence?
Which of the following physical features is characteristic of Pierre Robin sequence?
Which of the following physical features is characteristic of Pierre Robin sequence?
In Pierre Robin sequence, what is the primary reason for the development of a U-shaped cleft palate?
In Pierre Robin sequence, what is the primary reason for the development of a U-shaped cleft palate?
A patient presents with dysphagia, a firm mass at the base of the tongue, and a history of heavy smoking. What is the most likely diagnosis?
A patient presents with dysphagia, a firm mass at the base of the tongue, and a history of heavy smoking. What is the most likely diagnosis?
Histological examination of a tumor reveals irregular nests of cells with keratinization and intercellular bridges. This is MOST indicative of which type of cancer?
Histological examination of a tumor reveals irregular nests of cells with keratinization and intercellular bridges. This is MOST indicative of which type of cancer?
Which of the following histological features is commonly associated with Head and Neck Squamous Cell Carcinoma (HNSCC)?
Which of the following histological features is commonly associated with Head and Neck Squamous Cell Carcinoma (HNSCC)?
In Head and Neck Squamous Cell Carcinoma (HNSCC), what is the significance of observing 'intercellular bridges' during histological examination?
In Head and Neck Squamous Cell Carcinoma (HNSCC), what is the significance of observing 'intercellular bridges' during histological examination?
A heavy smoker presents with a palpable mass at the base of the tongue and cervical lymphadenopathy. Which diagnostic finding would MOST strongly suggest a diagnosis of Head and Neck Squamous Cell Carcinoma (HNSCC)?
A heavy smoker presents with a palpable mass at the base of the tongue and cervical lymphadenopathy. Which diagnostic finding would MOST strongly suggest a diagnosis of Head and Neck Squamous Cell Carcinoma (HNSCC)?
Flashcards
Otalgia
Otalgia
Ear pain, which, if caused by tumors in the hypopharynx, larynx, or base of the tongue may be due to sensory contributions from the glossopharyngeal and vagus nerves.
Otitis Externa
Otitis Externa
Inflammation of the outer ear and ear canal. Also known as swimmer's ear.
Sphenoethmoidal Recess
Sphenoethmoidal Recess
The space located superior to the superior concha in the nasal cavity.
Hyperacusis
Hyperacusis
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External Branch of Superior Laryngeal Nerve
External Branch of Superior Laryngeal Nerve
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Cricothyrotomy
Cricothyrotomy
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Cleft Palate
Cleft Palate
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Cleft Lip
Cleft Lip
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Sensorineural Hearing Loss
Sensorineural Hearing Loss
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Pierre Robin Sequence
Pierre Robin Sequence
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Head and Neck Squamous Cell Carcinoma (HNSCC)
Head and Neck Squamous Cell Carcinoma (HNSCC)
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Study Notes
Otalgia (Ear Pain)
- Tumors located in the hypopharynx, larynx, or base of the tongue can lead to ear pain
- This is due to sensory contributions from the glossopharyngeal and vagus nerves
Otitis Externa (Swimmer's Ear)
- Fainting during an ear exam is likely due to vasovagal causes, resulting from vagus nerve irritation
Nasopharynx
- The sphenoethmoidal recess is located superior to the superior concha
Middle Ear Anatomy
- Paralysis of the stapedius muscle results in hyperacusis, which is an increased sensitivity to sound
- The stapedius nerve, a branch of the facial nerve, innervates this muscle
Laryngeal Nerves
- The external branch of the superior laryngeal nerve is vulnerable to injury during thyroidectomy
- This is because of its close proximity to the superior thyroid artery and vein
Cricothyrotomy
- An emergent airway is needed, so this procedure goes through the neck
- The layers to go through are skin, superficial cervical fascia, investing and pretracheal layers of the deep cervical fascia, and the cricothyroid membrane
Cleft Lip and Palate
- Cleft palate is a failure of fusion of the palatine prominences
- Cleft lip is a failure of fusion of the maxillary and nasal prominences
- These conditions are caused by polygenetic and environmental interactions
- Most cases involve a multifactorial pathophysiology with complex interactions between genetic and environmental factors
Hearing Loss
- Sensorineural hearing loss is caused by damage to the hair cells in the cochlea
- Cochlear implants bypass the damaged cochlea and send signals directly to the auditory nerve endings
Pierre Robin Sequence
- This is a congenital sequence caused by an abnormality in the pharyngeal arch 1/2
- Presentation includes a small mandible (hypoplasia of the mandibular prominence, leading to micrognathia), a posteriorly displaced tongue, and a U-shaped cleft palate
Cancers
- Head and Neck Squamous Cell Carcinoma (HNSCC) is indicated by;
- Dysphagia in an older patient
- History of heavy smoking
- Firm, palpable mass at the base of the tongue with cervical lymphadenopathy
- Histology includes irregular nests of cells with keratinization, keratin pearls, and intercellular bridges
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