HNF Clinical cases head neck face brain neutoanatomy nerves

This presentation contains the the clinical cases of head neck face anatomy. This comes under the human anatomy helpful for the university exams

1. HNF Clinical Cases

2. A 14-year-old boy presented with a complaint of rapidly growing painful swelling on face in front and below the of ear on the right side. He also told that the pain increases while taking meals but subsides to some extent after finishing the meal. On examination, the physician found that the ear lobule is lifted on the affected side. The examination of oral cavity revealed congestion in mucous membrane of vestibule of mouth opposite the second upper molar tooth on the right side. He was diagnosed as a case of acute parotitis. Questions 1. What is the commonest cause of acute parotitis?-----1 2. Why parotid swellings are painful?-----1 3. Why does pain increase during meal-time and is relieved after taking meals?--------1 4. Name the two structures present within the substance of the parotid gland?------2

3. A 55-year-old woman complained of midline nodular swelling on the front of her neck, which moved up and down during swallowing. On physical examination, it was found that she had slight tremors on outstretched hands, her pulse rate was 110 per minute, BP 150/100 mm Hg and there was slight bulging of her eyes. She also told that she had lost weight and felt feverish. She was diagnosed as a case of toxic goitre . Questions 1. What is goitre ?---1 2. Why thyroid swellings move up and down during swallowing?-----1 3. Mention the anatomical basis of high body temperature, weight loss, high blood pressure, and exophthalmos .------3  

4. A 47-year-old man came in the emergency OPD and complained that while eating fish something got stuck in his examination of throat revealed that discomfort increases on throat. It was causing pain and lot of discomfort. The physical moving the thyroid cartilage from side to side. The physician concluded that the fish bone was stuck in the piriform fossa. Questions 1. What is piriform fossa?----2 2. What are medial and lateral boundaries of the piriform fossa?------2 3. Which nerve is likely to be injured during the removal of the fish bone?----1

5. A 12-year-old boy while playing in the school ground during the lunch break suddenly started bleeding from nose. His mates took him to the principal's office where teachers tried to stop the bleeding by pinching the nose and pouring cold water on the nose. When bleeding did not stop, the student was taken to the nearby dispensary. The doctor diagnosed him a case of nose bleeding . He packed his nose with gauze soaked with Gelfoam , and Floseal , ready made nasal packs are also easily available to stop bleeding and sent back the boy to the school. Questions 1. What is the commonest cause of nose bleeding in children?--------1 2. What is Little’s area ?---------1 3. Name arteries anastomose in this area?-------3  

6. An 18-year-old girl was suffering from acne vulgaris in the mask area of her face. After few weeks, the acne got infected and converted into pustules. She scratched pustules which spilled pus. After few weeks, she felt sharp severe headache, swelling and bulging of the eyes and surrounding tissues, high temperature, and double vision. She went to an ophthalmologist who after thorough examination diagnosed her as a case of cavernous sinus thrombosis . Questions 1. How does the infection from mask area of her face reached the cavernous sinus?------1 2. What are the nerves present in the cavernous sinus? -------3 3. What is location of cavernous sinus?-----1  

7. Mr Ramu , a young taxi driver, suffered a head injury following a collision of his taxi with a truck. He became unconscious. He was taken to the emergency room by the traffic police. Radiographs of the skull were taken. The lateral view of skull radiograph revealed a fracture in the region of temporal fossa and an underlying epidural/extradural haematoma . He was referred to the Department of Neurosurgery where he was operated. The surgical procedure involved the removal of haematoma and ligation of ruptured artery the next day. Mr Ramu regained consciousness and he was discharged from the hospital. He was diagnosed as a case of extradural haematoma . Questions 1. What is extradural haematoma /epidural haematoma ? ------1 2. What is pterion?------1 3. Can this surface landmark be visualized or palpated? If not, then tell the method to locate it.------1 4. Name the vessels which ruptured to cause extradural haematoma and were ligated by the neurosurgeon------2