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92 Cards in this Set
- Front
- Back
Symptoms of Osteoarthritis
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characterized by pain, edema, limited movement
erosion of articular cartilage |
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Hip Replacement
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metal prosthesis can replace femoral head and neck
plastic or teflon socket to replace acetabulum |
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Hip/Thigh contusion
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bleeding from ruptured capillaries
infiltration of blood into muscles, tendons, and soft tissue |
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Hip Pointer
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contusion of iliac crest
can also be an avulsion of bony muscle attachments (avulsion fracture) |
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Charley Horse
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cramping of thigh muscles because of Ischemia (low blood amount)
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Epiphysis of femoral head
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head slips away from neck due to weakened epiphyseal plate
caused by acute trauma or repetitive microtraumas |
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Loss of blood supply to Femoral Head
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avascular necrosis may occur
can be caused by compression of head or slippage of epiphyseal plate |
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Congenital Dislocation of Femoral Head
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femoral head slips out of joint
much more common than acquired dislocation car accident injury where hip is flexed, adducted, medially rotated and knew strikes dash board |
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Superior Gluteal Nerve Injury
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more loss w/ weakened abduction of thigh
compensation by moving center of gravity over supporting limb, impairing medial rotation of thigh |
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Trendelenburg Test
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patient w/ paralysis of sup. gluteal N asked to stand on one leg
pelvis on unsupported side descends, indication loss of function may also be fracture of greater trochanter |
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Sciatic Nerve Block
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result of injection of anesthetic agent inferior to midpoint of PSIS and greater trochanter
paresthesia can radiate inferior to foot |
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Sciatic Nerve Injury
"Piriformis Syndrome" |
compression by Piriformis, resulting in pain in buttocks
common in those that use gluteus (climbers, cyclists) often runs THROUGH piriformis, becoming entrapped |
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Complete loss of Sciatic Nerve
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leg is useless, extension and flexion of hip is impaired
no movement of ankle possible |
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Injections of Gluteal Region
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safe side=lateral side
danger side=medial side sciatic nerve on medial side always inject Sup. to line b/t PSIS and greater trochanter |
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Herniated Nucleus Puplposes
HNP |
lower back pain and motor weakness of lower limbs
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Myelography for HNP
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contrast injected into theca sac b/t L2-3
outlines of lower SN can be seen |
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Herniation of Disc
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through anterior annulus
may or may not pass through posterior longitudinal ligament |
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Symptoms of Herniated Disc
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movement of area where herniation is causes pain
secondary increased pressure of spinal fluid through coughing, sneezing can cause pain |
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Sciatica
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irritation of SN root from L4-S3
painful sensory disturbance from buttock to lateral thigh can cause reflex loss, weakness |
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L5-S1 herniation:
regions of pain |
sciatic (back of leg, buttock)
weak plantar flexion and achilles tendon reflex |
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L4-L5 herniation:
regions of pain |
numbness over dorsum of foot
weak dorsiflexion of ankle and big toe |
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L5 root compression:
regions of pain |
pain over dorsum of toes 1-3
no knee jerk reflex |
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S1 root compression:
regions of pain |
pain on lateral surface of foot to dorsum of toes 4-5
weakness of foot flexion |
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Radicular Pain Onset
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can be sudden, shooting pain down buttocks, leg
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Radicular Pain Position
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flexed and leaned toward side of pain
hip and knee flexed when standing reduces stretch of sciatic nerve |
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Straight Leg Test
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used to assess radicular pain and HNP
lies flat on back with leg/knee fully extended leg is slowly raised pain will present on back of leg if positive |
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Femur neck: angle of inclination
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normally around 126 degrees
varies w/ age and gender |
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Femur neck angle of inclination:
Coxa Valga |
increase in angle of inclination
allows greater mobility increases strain on neck of femur |
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Femur neck angle of inclination:
Coxa Vara |
decrease in angle of inclination
causes shortening of lower limb limits abduction |
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angle of Anteversion (forward tilting)
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occurs b/t neck and shaft
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Femoral Neck Fractures
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can result from traumatic force to foot or ankle
rare in contact sports due to young age of participants |
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Femoral Neck Fractures:
Subcapital |
completely intracapsular (within capsule)
can endanger blood supply of femoral head |
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Femoral Neck Fractures:
Transcervical |
transects neck of femur
intracapsular, along a line that crosses mid neck of femur can cause capsular tear involving medial and lateral circumflex aa |
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Femoral Neck Fractures:
Pertrochanteric Fractures |
through trochanter
Greater: direct blow or strong muscular pull Lesser: result from strong pull of Iliopsoas during abduction |
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Femoral Neck Fractures:
Intertrochanteric |
b/t greater and lesser trochanters
"extracapsular" fast healing, due to well nourished spongy bone |
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Importance of Medial Circumflex Artery
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supplies blood to head and neck of femur
often torn when femoral neck is fracture or hip dislocated |
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Femoral Shaft Fractures:
General Features |
very long heal time, up to one year
displacement of bones depends on muscular pulls |
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Femoral Shaft Fractures:
Upper 1/3 |
proximal fragment pulled anterior, rotated lateral, and abducted
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Femoral Shaft Fractures:
Middle 1/3 |
proximal fragment segment abducted, causing it to lateral to distal segment
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Femoral Shaft Fractures:
Lower 1/3, Supracondylar |
gastrocnemious pulls shaft, displacing distal segment posteriorly
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Femoral Shaft Fractures:
Lower 1/3, Intracondylar |
T-Type
two distal articular surfaces of femur are separated |
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Retroperitoneal Pyogenic infection of abdomen
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if pus passes b/t psoas and fascia to inguinal/thigh region
pain can refer to hip, thigh, or knee joint could be result of edema of proximal thigh |
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Paralyzed Quadraceps Femoris
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cant extend leg against resistance
inadvertent flexion of knee can occur during walking |
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Innervation of Biceps Femoris
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both heads have different innervating branches of the psiatic N
injury can paralyze one head but not the other |
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Hamstring Length Variation
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Short: can prevent from touching toes when knees are straight
Long: easily touch toes, can do high kicks |
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Hamstring Injuries
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common in sports with strong muscular exertion
can cause tearing of proximal tendinous insertions from ischial tuberosity |
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Tear of Proximal Tendinous Insertion of Hamstring
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more common than quadriceps strains
usually accompanied by contusion/tearing of muscle fiber and rupture of blood vessel can result from inadequate warmup |
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Hurdlers Injury
Avulsion of tuberosity at Proximal attachment of Biceps Femoris and Semitendinosus |
results from forcible flexion of hip with knee extended (ball kicking)
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Adductor Longus Strain
"Riders Strain" |
Ossification of accessory bone may occur in tendons due to great Adduction of Thigh
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Femoral Artery Palpation
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can occur w/ supine patient
inferior to midpoint of inguinal ligament can also compress here |
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Cannulation of Femoral Artery
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occurs at base of Femoral Triangle
for left cardinal angiography, catheter is inserted into femoral artery, then run up to heart |
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Areas of Vulnerability of Femoral Artery
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very superficial in femoral Triangle
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Aberrant Obturator Artery
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closely related to free margin of lacunar ligament and neck of a femoral hernia
must be careful during endoscopic repair of hernia for this common variant |
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Femoral Hernia
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appears as mass in the femoral triangle
can pass inferiorly into saphenous opening strangulation can occur through femoral ring |
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Ankle Sprain
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torn ligaments
common at Talocrural joint (no side-side motion) |
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Eversion Ankle Sprain
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medial malleolus usually broken before tearing deltoid ligament
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Inversion Ankle Sprain
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most often anterior talofibular ligament
most common type of sprain |
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High ankle sprain
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tear of the anterior tibiofibular ligament
takes longer to heal |
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Plantar Fasciitis
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pain in the plantar aponeurosis, may involve inflammation
thought to be an overuse injury worse at beginning of day, better in middle, worse at end |
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Stress Fracture
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calcaneal stress fracture may present as plantar fasciitis
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Infection of Central Compartment of Foot
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the thick plantar aponeurosis can cause internal pressure to form in infection rather than external swelling
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Accessory Bones of the Feet
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fairly common, often asymptomatic
most common are accessory naviculars, can cause chronic or acute pain |
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Auricular Tags and Ear Pits
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absence of 1 or more hillocks (Treacher Collins Syndrome) causes malformation of auricle
failure to fuse completely may result in "ear pit" (prearicular cyst) |
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Insufficient Migration of Neural Crest Cells:
First Arch-Teacher-Collins Syndrome |
underdeveloped zygomatic and mandible bone
hearing loss from underdeveloped malleus and incus malformed external ear |
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Insufficient Migration of Neural Crest Cells:
First Arch-Robin Sequence |
underdeveloped mandible
tongue posteriorly placed in mouth unfused palate ear malformation |
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Deletion of Chromosome 22 long arm:
DiGeorge Syndrome |
cardiac defects, conotruncal malformation
abnormally wide face cleft palate hypocalcemia |
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Deviated Septum
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usually result of injury
can obstruct breathing can lead to sinusitis |
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What is the overlying factor in facial and palatal defects in Development?
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failure of neural crest cells to migrate or proliferate
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Cleft Lip General Features
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more common in men, left side, and asian descent
Orbicularis oris muscle fibers curve upward in parallel to cleft, rather than ending at angle to it |
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Cleft Lip: Unilateral
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maxillary prominence and medial nasal prominence fail to fuse
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Cleft Lip: Bilateral
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result of anterior displacement of intermaxillary segment
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Cleft Palate: Anterior
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anterior to incisive foramen
may split maxilla from premaxilla all the way up |
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Cleft Palate: Posterior
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posterior to incisive foramen
-palatine shelves too small to fuse -palatine shelves fail to elevate -Tongue doesnt drop and palatine shelves cant fuse |
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Facial Clefts:
Median Cleft Lip |
bifid nose and lip
result of Shh mutation can also have CNS problems: no fusion of lateral ventricles of brain |
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Facial Clefts:
Lower Cleft Lip |
can result from Van Der Woude Syndrome, failure of 1st arch to form
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Facial Clefts:
Oblique Facial Cleft |
maxillary process doesnt fuse w/ lateral nasal process
cleft occurs along course of nasolacrimal duct |
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Facial Clefts:
Lateral Facial Cleft |
this is when mouth is too wide b/c maxillary prominences havent grown
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Microstomia
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tongue doesnt drop, palatal shelves cant fuse
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Injury to Middle Meningeal artery
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located directly under pterion of skull, very thin
blow to the head here may lacerate artery nowhere to drain, increases cranial pressure unconsciousness and death |
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Importance of Pterygoid plexus of veins
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due to their connections w/ cavernous sinus via the deep facial, inferior ophtalmic and emissary veins in the sphenoid
facial infections can lead to meningitis |
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what is the most common area for nasopharyngeal carcinoma?
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pharyngeal recess
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what muscle is commonly involved in pharyngeal carcinoma, and where is it commonly detected?
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levator veli palatine
enlarged cervicale lymph nodes |
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what are the reasons for a tonsillectomy, and what are complications?
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obstruction of airway
unstoppable bleeding from lingual artery |
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Bell’s palsy
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lesion of facial nerve leading to unilateral paralysis of face
distortion of facial features |
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Trigeminal neuralgia
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Paroxysmal pain along course of Trigeminal
relieved by sectioning sensory root of V |
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Corneal blink reflex
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Bilateral contraction of orbicularis oculi
Reflex arc efferent limb – facial nerve Afferent limb – nasociliary nerve of V1 |
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Horner’s syndrome
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constriction of the pupil, drooping of upper eyelid, retraction of eyeball, absence of sweating
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III Nerve Palsy
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Ptosis: eye drop
Loss of upward, downward and medial movement of the affected eye eye is in a 'down and out' position |
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IV Nerve Palsy
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Eye movement inferior laterally
can no longer look down and out |
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VI Nerve Palsy
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double vision due to lateral rectus loss
if left is affected, double vision occurs when looking right |
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clinical eye movement tests
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Inward: Medial rectus
Outward: Lateral rectus Upward and outward: Superior rectus Downward and outward: Inferior rectus Upward and Inward: Inferior oblique Downward and inward: Superior oblique |
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what is the integrity test for IX?
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gag reflex
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