Download PPT - UCLA Health

Chapter 145
Management of Temporal Bone
Trauma
Quinton Gopen, M.D.
UCLA Medical Center
Question 1:
Temporal Bone fractures are classified as
longitudinal or transverse based on the fracture line
relationship to:
A. Coronal Plane
B. Axial Plane
C. Sagital Plane
D. Petrous Ridge
E. Temporal Line
Question 2
Temporal bone fractures entering into the otic
capsule generally result from blows to the
A.
B.
C.
D.
E.
Temporal Region
Occipital Region
Parietal Region
Frontal Region
Parasaggital Region
Question 3
The incidence of otic capsule involvement is
generally considered to occur in what percentage of
temporal bone fractures?
A.
B.
C.
D.
E.
5%
10%
20%
40%
80%
Question 4
Question
Text
PediatricEnter
temporal
bone fractures
differ from adult
temporal bone fractures in that pediatric fractures
have a lower incidence of
A.
B.
C.
D.
E.
Facial nerve involvement
Intracranial complications
Comminuted fractures
Concurrent C-spine injuries
None of the above
Question 5
Question
Text
An 18y.o.Enter
man sustains
a temporal bone
fracture based on
initial head CT on presentation to the ER. The patient
complains of pain over the fracture site and hearing loss. The
patient has no vertigo, nystagmus or other neurologic
symptoms. What is the next best test to obtain?
A.
B.
C.
D.
E.
MRI scan brain
CT angiography
Caloric testing
VEMP testing
CT temporal bones
Question 6
A 74 y.o.
man sustains
a temporal bone
fracture. The
Enter
Question
Text
fracture extends through the geniculate ganglion and is
comminuted. The man has near complete facial paralysis
but does have some minimal movement of the face on
maximal effort. His hearing is grossly intact. The best
treatment plan is:
A. Oral corticosteroid therapy
B. Facial nerve decompression via
a transmastoid approach
C. Facial nerve decompression via
a middle fossa approach
D. Facial nerve decompression via
a combined transmasoid-middle
fossa approach
E. Facial nerve decompression via
a translabyrinthine approach
Question 7
Enter
Question
Text
The site
of facial
nerve injury in
the majority of
temporal bone fractures is the:
A.
B.
C.
D.
E.
Vertical segment
Horizontal segment
Perigeniculate region
Meatal segment
Second genu of the facial
nerve
Question 8
Entertime
Question
Text
The theoretical
for the maximal
regeneration of
axoplasmic flow is considered to be how long after
the injury
A.
B.
C.
D.
E.
Immediately following the injury
1 day
3 days
10 days
21 days
Question 9
An ENoG
results
showing thisText
percentage of
Enter
Question
degeneration or greater of the facial nerve is generally
considered to be an indication for surgical exploration
and decompression (Fisch criteria)
A. 50%
B. 75%
C. 90%
D. 95%
E. 100%
Question 10
Enter
Question
Text
The best
initial treatment
for acute
posttraumatic
CSF otorrhea is:
A.
B.
C.
D.
Bed rest
Serial lumbar punctures
Lumbar drain
Surgical exploration with
closure of the ear canal
E. Surgical exploration with
mastoid obliteration
Chapter 129
Physiology of the Auditory
System
Quinton Gopen, M.D.
UCLA Medical Center
Question 1
Question
What isEnter
the resonant
frequencyText
of the external
auditory canal?
A. 5300 Hz
B. 3000 HZ
C. 1200 Hz
D. 800 Hz
E. 100 Hz
Question 2
What is labeled as “?” in
the adjacent
histopathologic slide?
A.
B.
C.
D.
E.
Helicotrema
Scala Tympani
Scala Media
Scala Vestibuli
Organ of Corti
?
Question 3
A patient presents with a mixed hearing loss. The
vestibular evoked myogenic potential response is
recorded at a sound threshold of 120dB? What is the
most likely diagnosis
A. Otosclerosis
B. Superior semicircular canal
dehisence
C. Meniere’s Disease
D. Connexin 26 gene mutation
E. Usher’s syndrome
Question 4
Type I spiral ganglion cells:
A. Less common than type II
spiral ganglion cells
B. Are myelinated
C. Project to between 3 and 5
inner hair cells
D. Project to between 3 and 5
outer hair cells
E. None of the above
Question 5
The auditory cortex is located within the
A.
B.
C.
D.
E.
Temporal lobe
Occipital lobe
Parietal lobe
Brainstem
Midbrain
Question 6
The speed of sound waves in air is roughly
A.
B.
C.
D.
E.
120 meters per second
340 meters per second
630 meters per second
1220 meters per second
1500 meters per second
Question 7
The cochlear duct is filled with
A.
B.
C.
D.
E.
Endolymphatic fluid
Perilymphatic fluid
Dense collagen like material
Cerebrospinal fluid
Loose fibrous tissue
Question 8
What is considered the first relay station for all
ascending auditory information
A.
B.
C.
D.
E.
Lateral lemniscus
Auditory nerve
Medial geniculate body
Cochlear nucleus
Heschyl gyrus
Question 9
Binaural squelch refers to
A. The ability of the brainstem
auditory nuclei to increase the
signal to noise ratio
B. Signal received by both ears is
greater in amplitude than the signal
received by a single ear
C. Outer hair cell control over the
inner hair cells
D. Uncomfortable feedback created
by hearing aids
E. The sound in your mind created by
reading this question
Question 10
The primary auditory cortex is tonotopically tuned
such that the highest frequencies are at the
A.
B.
C.
D.
E.
medial aspect
lateral aspect
superior aspect
inferior aspect
Central aspect