Exam 3: Head Handout Part 4
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Persons with facial palsy are unable to whistle because:
air blows out through their paralyzed lips on one side
What is facia palsy?
paralysis of facial nerve
What happens when persons with unilateral facial paralysis are asked to show their teeth?
the nasolabial fold does not form on the injured side and the angle of the mouth does not rise
pralysis of facial muscles (orbicularis oris, supplied by nerve)
What is cleft lip?
congenital malformation of upper lip that occurs about once in 1000 births
The clefts vary from:
small notch in transitional zone and vermilion border to ones that extend through lip into the nose; cleft extends deeper and is continuous with cleft in palate
What happens when the genioglossus muscle is paralyzed?
- tongue has a tendency to fall posteriorly and obstruct the airway
- presents risk of suffocation
When does total relaxation of the genioglossus muscle occur?
during general anesthesia
A lesion which cuts completely through the hypoglossal nerve (CN XII) results in:
paralysis and eventual atrophy of one side of the tongue
With lesion of hypoglossal nerve which way does the tongue deviate during protrusion?
to the paralyzed side because action of unaffected genioglossus muscle on other side
Asking patietns to stick out their tongues is a good test of the function of which nerve?
Fracture of the mandible may injure which nerve?
Injury to the hypoglossal nerve causes what?
paralysis of tongue musculature
When quick absorption of a drug is desired, they are placed where?
under the tongue where they dissolve and ente the deep lingueal veins in less than 60 seconds
Why would excision of the submandibular gland be necessary?
calculus in duct or tumor in gland
What do calculi in the ducts of the sublingual glands produce?
pain, esp. during eating because saliva can't escape from glands
How are calculi of glands detected?
What do mumps cause?
swelling of parotid and submandibular glands
Where is swelling of the submandibular gland?
ovoid enlargement that extends anteroinferiorly from angle of mandible
What happens when salivary glands swell within their tight fibrous coverings?
condition becomes painful
What are the bony parts of the nose?
perpendicular plate of ethmoid bone and vomer
Why are fractures of the nose quite common?
because bony parts of nose are thin
Fractures of the nose are usually:
What happens if the fracture of the nose results from a direct blow?
cribriform plate of ethmoid bone may be fractured
How might the nasal septum be displaced/deviate from median plane?
- birth injury
- congential malfromation
- postnatal trauma (fist fight)
What happens when deviation of the nasal septum becomes severe?
- nasal septum comes into contact with lateral wall of nasal cavity
- obstructs breathing, surgical repair is necessary
What are nasal discharges commonly associated with?
upper respiratory tract infections
Although nasaldischarges are commonly associated with upper respiratory tract infections, a nasal discharge associated with a head injury may be what?
nasal discharge of CSF
What causs CSF rhinorrhea?
- fracture of cribrifom plate
- tearing of meninges
- leadkage of CSF
What is anosmia?
loss of sense of smell
Is anosmia a serious handicap?
no, occurs gradualy w/ age
Disorders of olfaction may result from conditions affecting:
- 1. olfactory receptor cells in nasal mucous membrane
- 2. secondary olfactory neurons in olfactory bulb and tract
- 3. intracranial connections
When does the nasal mucosa become swollen adn inflamed?
during upper respiratory infections and with some allergies
What is rhinitis?
swollen/inflammed nasal mucosa
Why does swelling of the nasal muscous membrane occur readily?
because of its vascularity
Where might infections of the nasal cavities spread to?
- 1. aterior cranial fossa through cribriform plate
- 2. nasopharynx and retropharyngeal soft tissues
- 3. middle ear through auditory tube
- 4. paranasal sinuses
- 5. lacrimal apparatus and conjunctiva
What is epistaxis?
nasal hemorrhage; nosebleed
Why are epistaxis relatively common?
richness of blood supply to nasal mucosa
What is the cause of epistaxis?
Where is the bleeding associated with epistaxis located?
anterior third of nose
What is the result of nose picking?
- mild epistaxis
- tears veins in vestibule of nose around anterior nares
Are infections and hypertension assoicated with epistaxis?
What is spurting of blood from the nose a result of?
rupture of arteries, particularly at site of anastomosis of sphenopalatine and greater palatine arteries
What happens if nasal bleeding is so profuse that it can't be stopped by usual treatments?
external carotid arteries sometimes clamped in the neck
What is the source of the blood passing to the nose through the branches of the maxillary arteries?
external carotid arteries
Are the maxillary sinuses small at birth?
When do the maxillary sinuses stop growing?
- grow slowly until puberty
- not fully developed until all permanent teeth have erupted
Which sinus is the one most commonly involved in infection?
Why is the maxillary sinus the one most commonly involved in infection?
its aperture is located superior to the floor of the sinus (a poor location for its natural drainage
Whn the muscos membrane of the sinus is congested, the maxillary aperture may be:
When is gravity drainage from the maxillary sinus best?
when one is lying on side oppite the infected sinus
Why is the proximity of the maxillary molar teeth to the floor of the maxillary sinus important?
- fracture of one of the roots may occur with removal of teeth
- broken piece may be driven superiorly into maxillary sinus
- communication created between oral cavity and maxillary sinus
- infection can spread to maxillary sinus from abscessed maxillary molar tooth
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