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Lucy Knox - Year 2 > 208 - ENT > Flashcards

208 - ENT Flashcards

1
Q

NAme the cartilagenous structures that make up the pinna

A

Helix
Antihelix
Tragus (concha dip)

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2
Q

What is atresia?

A

When there is no external auditory meatus

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3
Q

What is the function of the external auditory meatus?

A

Funnels and amplifies sound

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4
Q

What is otitis externa?

A

Skin infection in the canal

In the outer ear

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5
Q

What is another name for surfer’s ear? What is it?

A

Exostoses
Benign bony growths in the ear canal
- Can be removed surgically but usually left

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6
Q

What makes up the middle ear?

A

Ear drum
Ossicles (malleus, incus, stapes)
Eustacion tube
Mastoid

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7
Q

What is the function of the middle ear?

A

Transmits air vibration to the ossicles to liquid in the inner ear, and amplifies sound

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8
Q

What are 6 examples of middle ear diseases/problems

A 
Perforation
retraction
otitis media with effusion
Cholesteatoma
Ossicular disease
Osteosclerosis
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9
Q

What can cause a drum perforation?

A

Infection
trauma
surgery

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10
Q

What is the effect of a perforation?

A

Can cause hearing loss as the drum loses ability to vibrate properly
Pain may go if it was an infection as pressure relieved

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11
Q

What is a retraction?

A

The drum gets drawn inwards due to a pressure difference (low in middle ear)

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12
Q

Where do retractions usually occur on the drum/

A

In the pars flacida or posterior + superior quadrants

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13
Q

What is a common name for otitis media with effusion?

A

Glue ear

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14
Q

What part of anatomy makes children more likely to get glue ear?

A

Their Eustachian tube isn’t fully developed - it is at a less steep angle - so infection can travel up it, or milk (eg breast feeding baby on back). Children more prone to nasopharyngeal infections, adenoids swell + have exudates - irritates the tube and it closes up

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15
Q

What are the symptoms of glue ear?

A

Hearing loss

Developmental delay - may be missed, child may not complain of hearing loss, fall behind in school/

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16
Q

What are the management options of otitis media with effusion/glue ear?

A

Watch and wait
Grommets
+/- adinoidectomy
Hearing aid (great, but stigma from parents)

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17
Q

What is a cholesteatoma? What symptoms? What complications arise from it?

A

Abnormal growth of skin in the middle ear - ve pressure sucks in pars flaccida, some migrating epithelium gets trapped and proliferates

  • conductive hearing loss, painless, foul smelling greenish discharge
  • Can be destructive - can get facial nerve palsy, meningitis, mastoid abscess
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18
Q

What is osterosclerosis?

A

Calcification around the stapes footplate, becomes still/can’t move, so can’t transmit the vibrations - 60dbh conductive hearing loss

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19
Q

How common is osterosclerosis

A

10% have it, only 10% know
2:1 female to male
85% bilaterally
Autosomal dominant

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20
Q

What is the management of osteosclerosis

A

Hearing aids

Stapedectomy and piston

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21
Q

What makes up the inner ear?

A

Membranous labyrinth, coclear, semicircular canals, saccule, utricle

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22
Q

What turns sound waves into neural info in the middle ear?

A

Neuroepithelium - bathed in fluid that vibrates

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23
Q

What disorders are there of the inner ear?

A

Presbyacusis
Acoustic neuroma
Noise damage
Iatrogenic - ototoxic drugs

24
Q

What is presbyacusis?

A

Age associated hearing loss

High frequency lost first - can’t hear consonants

25
Q

Why does presbyacusis occur?

A

The neuroepithelial cells and spiral ganglion cells degenerate and don’t repair - so less function

26
Q

What is an acoustic neuroma? What does it cause?

A

A schwannoma - usually of superior vestibular nerve, as it passes through internal acoustic meatus

  • Compresses nerve and surrounding nerves and can expand to brainstem
  • Hearing loss , tinitus (unilateral), mild vertigo, facial weakness (later sign as harder to compress motor muscle)
27
Q

What passes through the internal acoustic meatus + can be affected by an acoustic neuroma?

A

Superior vestibular nerve (CNVIII)
Inferior vestibular nerve (CNIII)
Cochlear (CNVIII)
CNVII - Facial

28
Q

What sort of hearing loss is seen after prolonged noise damage?

A

Permanent sensorineural loss

29
Q

Name 3 classes of drugs that have ototoxic effects

A

Aminoglycosides (gentamicin, neomicin)
Loop diuretcs (flurosomide)
Chemo (cisplatin, carbopentin)

30
Q

What is vertigo?

A

A Hallucination of movement

31
Q

Name 4 diseases/causes of vertigo

A

BPPV
Menieres
Vestibular neuritis
Labyrinthitis

32
Q

What is BPPV?

A

Benign paroxsysmal positional vertigo
Isolted vertigo, lasts seconds, often after getting out of bed, no deafness or tinitus
rotational nstagmus seen

33
Q

What is the pathophysiology of BPPV?

A

Otoconia get displaced, lidge in semicircular canals, stuck behind bupula - so when you move then it detects more movement than in reality - get vertigo

34
Q

What test proves BPPV, what action cures it?

A

Dix - Hallpike test = diagnostic

Epley manouver = treatment

35
Q

What symptoms are seen in menieres disease?

A

Hearing loss
Tinnitus
Vertigo (lasting hours)
+ nausea, aural pressure

36
Q

How do you treat menieres?

A

Resolves itself
Can try - salt restriction, anti-emetics, betahistamines (eg. serc)
Grommets sometimes help (don’t know why!)
Gentamicin to destroy labyrinth?

37
Q

What is the pathophysiology of menieres?

A

Function of endolymph regulating sac gets impaired, so there is a build up of endolymph -> Endolymph hydrops

  • This excess causes it to rupture, so it mixes with perilymph - there is a ionic disequilibrium - damages the neuroeptihelium - get symptoms
  • Once balance is restored symptoms get better
38
Q

What is vestibular neuritis?

A

Painless, viral or vascular occulsion - causes reduced neuronal activity in vestibular nerves on one side - vertigo and nstagmus

39
Q

What are the symptoms on vestibular neuritis?

A

Severe vertigo
Nausea
Vomiting
For a few days, takes 6 weeks to fully resolve

40
Q

What is labyrinthitis?

A

Painless, viral or bacterial infection, occasionally vascular, effecting the whole labyrinth - get vestibular + cochlear issues

41
Q

What symptoms are seen in labyrinthitis?

A

Severe vertigo, nausea, vomiting

Permanent changes in hearing and tinnitus

42
Q

How much more efficient does the middle ear make sound transmission?

A

18X more
(14 x conc going from tympanic membrane to oval window)
1.3X more having the stapes rock rather than lift up

43
Q

What are the 3 parts of the cochlear called? What type of fluid does each contain?

A 
Scale vestibuli (perilymph)
Scala Media (endolymph)
Scale tympani (perilymph)
44
Q

Hair cells are found on the organ of ….. in the cochle

A

Organ of corti

45
Q

In the vestibular system, what is the name of the longest hair on the hair cell?

A

Kinocilium

46
Q

When the cilia move towards the kilocilium what happens to the tonic firing?

A

Firing increases as cilia move towards kinocilia

47
Q

What type of movement does the utricle and saccule detect?

A

Linear movements - flat - side to side, front to back

48
Q

What type of movement do the semicircular canals detect?

A

Angular movements - hear turns, up and down

49
Q

How do we detect overall movement of the head?

A

The vestibular apparatus acts in functional pairs - so you can work out which way you turn combining the info

50
Q

What is the vestibular-occular reflex?

A

Each vestibular canal is connected to a pair of extraoccular muscles, so as you turn your head, the firing increases in the respective nerve - causes you to move your eyes the other way - ie. so even if you move your head your eye can fix on the same object

51
Q

What is the clinical sign you can see if the vestibular-occular reflex is disrupted?

A

Nstagmus

52
Q

When does the frontal sinus develop?

A

From age 2, size increases from 6 to teens

53
Q

When do the ethmoid sinuses develop?

A

Fluid filled at birth, pneumotise until 12

54
Q

When do the maxillary sinuses develop?

A

1st

0-3 months, and ones grow 6-12 years

55
Q

When does the sphenoid sinus reach full size?

A

Late teens

Lucy Knox - Year 2 (17 decks)

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