Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

FStCP 2 > Trauma > Flashcards

Trauma Flashcards

1
Q

What structures make up the external ear?

A

Pinna/auricle and external auditory canal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the pinna and what is it also known as?

A

The visible part of the ear made up of folds of cartilage with a fatty lobule.

Also known as the auricle.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What manoeuvre do you need to do in order to clearly see the tympanic membrane?

A

Pull the ear posteriorly and superiorly.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What membranes line the inner ear?

A

Mucous membranes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the function of the inner ear?

A

To amplify and transmit sound to energy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the normal appearance of the tympanic membrane?

A

Pink/grey colour

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the ossicles?

A

The three bones of the middle ear:

  • Malleus
  • Incus
  • Stapes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What are the two muscles in the middle ear?

A

1) Tensor tympani

2) Stapedius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What cranial nerve lies in the middle ear?

A

VII Facial Nerve

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

The inner ear is located in the _______ part of the temporal bone and contains the _______, the ____-_______ ______, the ______ and the ______.

A
  • Petrous
  • Cochlear
  • Semi-circular canals
  • Saccule
  • Utricle
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the role of the inner ear?

A

Detects movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the auricle surrounded by and what does it contain?

A

The perichondral layer that contains the blood vessels that supply the cartilage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What can a pinna haematoma lead to?

A

Separation of the perichondrium from the cartilage causing stasis of blood and avascular necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the management of a pinna haematoma?

A
  • Drainage of the haematoma as much as possible
  • Give abx
  • Large bulky ear dressing
  • Refer to ENT for follow-up
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What happens to the ear when a pinna haematoma isn’t treated properly?

A

Cauliflower ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What anaesthesia do you use for trauma to the auricle?

A

Posterior auricular block

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the difference between pinna cellulitis and pinna perichondritis?

A

Cellulitis affects the entire ear whereas in perichondritis you get sparing of the earlobe as it doesn’t contain any cartilage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the treatment for pinna cellulitis and pinna perichondritis?

A

IV (important that it is IV) abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What bacteria are usually the cause of pinna cellulitis, pinna perichondritis and otitis externa?

A
  • Staph aureus

- Pseudomonas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is polychondritis? (In reference to the ear)

A

A systemic inflammatory condition which tends to be bilateral perichondritis and is also milder and has nasal involvement

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is otitis externa?

A

Infection and inflammation of the external auditory canal caused by bacteria and fungi.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the risk factors for otitis externa?

A
  • Swimming
  • Underlying skin conditions
  • Diabetes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the presentation of otitis externa?

A
  • Ear pain
  • Thick yellow discharge
  • Conductive hearing loss
  • Tinnitus and/or vertigo
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What is the worry with otitis externa?

A

That it progresses to necrotising/malignant otitis externa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What can happen when you get granulation of tissue in otitis externa?

A

This can lead to osteomyelitis of the temporal bone which can lead to meningitis and encephalitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Under what circumstances should you consider a CT scan in a patient with otitis externa?

A
  • Diabetic
  • Recurrent infections
  • Over 65
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What is the treatment for otitis externa?

A

Steroid drops with abx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What should you do if a patient has a bug in their ear canal?

A
  • Kill the bug with mineral oil or lidocaine
  • Attempt to remove
  • If unable to remove refer to ENT as an emergency
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Even though most tympanic membrane perforations heal by themselves, why do patients need a follow-up in an ENT clinic?

A

To get their hearing tested

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Under what circumstances do tympanic membrane perforations occur?

A
  • Middle ear pressure secondary to fluid build-up as a result of infection
  • Trauma
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Why should you avoid gentamycin drops when treating a tympanic membrane perforation?

A

It can be toxic to the middle and inner ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What are the commonest pathogens causing otitis media?

A
  • Strep pneumoniae

- Haemophilus influenzae

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What is a common presentation of otitis media?

A

Children 3-6 years old following a recent upper respiratory tract infection suffering from:

  • Earache
  • Hearing loss
  • Fever
  • Deafness
  • Irritability
  • Lethargy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are you likely to see when examining the ear in a suspected otitis media?

A

An inflamed and bulging tympanic membrane with loss of light reflex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What are the complications of otitis media?

A
  • Drum perforation

- Secondary acute mastoiditis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What do most doctors tend to do when treating otitis media?

A

Give a delayed prescription of abx if there has been no improvement in 72 hours

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What causes acute mastoiditis?

A

A build-up of purulent exudate within the middle ear blocking the entrance to the mastoid antrum. The pus moves into the air cells of the mastoid process leading to infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is the presentation of acute mastoiditis?

A

Red hot lump over the mastoid process behind the ear with forward displacement of the pinna

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What are the three causes of peripheral vertigo?

A

1) BPPV (benign paroxysmal positional vertigo)
2) Labyrinthitis/Vestibular neuritis
3) Meniere’s disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is BPPV?

A

Benign Paroxysmal Position Vertigo is a peripheral vertigo characterised by shot, sudden onset of vertigo associated with head movements.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What causes BPPV?

A

A small crystal of calcium carbonate (called an otoconia) enters the semi-circular canals of the inner ear creating an illusion of movement/exacerbating the perception of movement by irritating the hair cells that line the inner ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What are the two manoeuvres you use in suspected BPPV?

A

1) Hallpike test to confirm

2) Epley’s manoeuvre to remove the otoconia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What is labyrinthitis/vestibular neuritis and what does it present with?

A

A type of peripheral vertigo that presents as constant vertigo over hours or days. It presents with nausea and vomiting following a viral infection

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is Menirere’s disease?

A

A type of peripheral vertigo characterised by gradual, short episodes of vertigo associated with hearting loss, pressure sensation in the ear and tinnitus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is Kiesselbach’s plexus?

A

A vascular network of five arteries that supply the nasal septum.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What does Kiesselbach’s plexus lie in?

A

Little’s/Kiesselbach’s area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

At what point in the nose do branches of the internal and external carotid arteries anastamose?

A

Little’s/Kiesselbach’s area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What is the anterior bloody supply to the nose?

A

Branches of the internal carotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What is the posterior blood supply to the nose?

A

Distal branches of the external carotid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Where do 90% of anterior epitaxies occur from?

A

Little’s/Kiesselbach’s area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is Trotter’s method?

A

A way to stop nose bleeds:

  • Patient sits up
  • Pinch soft part of the nose for 5-10 minutes
  • Head bent forward
  • Mouth open
52
Q

Why should you get a patient who has a nose bleed to spit out any blood?

A

Because swallowing the blood will cause them to vomit making the situation more distressing

53
Q

What can posterior epistaxis sometimes present as?

A

Blood coming out of both nostrils

54
Q

What is the management for an epistaxis if the Trotter’s method is unsuccessful?

A
  • Look into the nose to identify the bleed
  • Evacuate any clots
  • Spray with topical vasoconstrictor
  • Cauterise
55
Q

Why should you avoid multiple attempts at cauterisation?

A

You can perforate the septum

56
Q

If cauterisation of epistaxis fails what do you do?

A

Tamponade the bleeding using a ‘rapid rhino’ i.e. packing

57
Q

How long do you need to keep a rapid rhino pack inserted? What should you do if it stays longer than this?

A

24h

If longer start on abx

58
Q

What do consultants sometimes do for severe posterior bleeds when a rapid rhino hasnt worked?

A

Place a urinary foley catheter through both nostrils, inflate the balloons and pull back to create a posterior tamponade.

59
Q

What are the complications of epistaxis?

A
  • Severe haemorrhage
  • Hypoxia, hypercarbia (i.e. respiratory failure)
  • Sinusitis
  • Otitis media
  • Necrosis of the columella or nasal ala
60
Q

What are the columella and nasal ala?

A

Columella = inferior margin of the nasal septum

Nasal ala = lateral aspects of the nostrils

61
Q

What is 7th nerve palsy also known as?

A

Bell’s palsy

62
Q

What is the cause of most cases of 7th nerve palsy?

A

Idiopathic linked to HSV

63
Q

Why do you need to determine between upper and motor neuron causes of 7th nerve palsy symptoms?

A

Upper neuron causes tend to be stroke and are forehead sparing (but this can be quite subtle)

64
Q

What is the House-Brackmann scale?

A

A scale used to measure and track the degree of facial nerve palsy. Beyond grade IV you need to include opthalmology.

65
Q

What are the signs and symptoms of sinusitis?

A
  • Headache
  • Facial pain where sinuses are
  • Purulent yellow/green rhinorrhoea
  • Fever
66
Q

What circumstance in sinusitis suggest a superimposed bacterial infection?

A

An upper viral respiratory tract infection followed by sinusitis

67
Q

What are the causes of acute bacterial sinusitis?

A
  • Gram positive bacteria

- Haemophilus influenzae

68
Q

What are the causes of chronic bacterial sinusitis?

A
  • Anaerobes

- Gram negative bactiera

69
Q

What is the treatment for sinusitis?

A
  • Co-amoxiclav
  • Decongestants
  • Analgesia
  • Heat
70
Q

What are the complications of sinusitis?

A
  • Ethmoid sinusitis
  • Orbital cellulitis and abscess
  • Frontal sinusitis
71
Q

What is the worry when sinusitis progresses to frontal sinusitis?

A

This may erode the bone causing Potts puffy tumour and/or a brain abscess

72
Q

When do you do a CT in a patient with sinusitis?

A

When you suspect the infection has spread to the facial or skull bones

73
Q

What is the most common cause of facial cellulitis?

A
  • Group A streptococcus

- Staphylococcus

74
Q

Why is there a much lower threshold for admission and prescription of IV abx in facial cellulitis?

A

Because of the sensitive and essential structures around the face that the infection can spread to

75
Q

What is the most common cause of parotiditis?

A

Paramyxovirus

76
Q

Parotiditis can be secondary to _______________________________.

A

Stones in the salivary gland (sialolithiasis)

77
Q

What are the causes of pharyngitis?

A
  • Irritants (reflux, trauma, inhalation of gases)
  • Viruses (EBV, adenovirus)
  • Bacterial (GABHS, mycoplasma, gonorrhoea, diphtheria)
78
Q

What is GABHS?

A

Group A beta haemolytic strep

79
Q

What is the presentation of tonsilitits?

A
  • Sore throat
  • Difficulty swallowing
  • Fever
  • Swollen tonsils ± purulent exudates
80
Q

What is the treatment of acute tonsilitits?

A

IV:

  • Paracetamol
  • Dexamethasone
  • Fluids
  • ABx
81
Q

Why do you need to do a mono-spot test in a patient with tonsilitis?

A

To look for EBV infective mononucleosis

82
Q

What discharge advice do you need to give a patient with tonsillitis caused by EBV infective mononucleosis?

A

They can get splenomegaly so need to avoid contact sports for 8 weeks to avoid rupture

83
Q

What is a quinsy?

A

Peritonsillar abscess - a complication of tonsillitis

84
Q

What can an inferior quinsy cause?

A

Medial displacement of the tonsil and uvula

85
Q

What are the symptoms of a quinsy?

A
  • Dysphagia
  • Ear pain
  • Muffled voice
  • Fever
  • Trismus (unable to fully open the mouth)
  • Stertor (snoring sound from pharyngeal obstruction)
86
Q

What is the treatment of a quinsy?

A

Treat as tonsillitis and drain the abscess

87
Q

Why must the drainage of a quinsy be done by an experienced doctor?

A

Because the carotid artery is close by

88
Q

What is a centor score?

A

A score to determine if a patient with various respiratory tract infections needs abx. A score of ≥3 needs abx.

89
Q

What does a cough suggest in ENT medicine?

A

A viral upper respiratory tract

90
Q

What are the signs of epiglottitis?

A
  • Rapid onset
  • Patients prefer to sit
  • Muffled voice
  • Dysphagia
  • Drooling
  • Restlessness
    The body is attempting to keep the airway clear
91
Q

What does it indicate if a patient doesn’t want you to look in their throat when you suspect epiglottitis?

A

That the movement required to look will block their throat so don’t attempt to look

92
Q

What should you do when you come across a patient with epiglottitis?

A

Take them straight to resus as an airway emergency

93
Q

What is the treatment for epiglottitis?

A
  • IV abx
  • Steroids?
  • Adrenaline nebs to help manage airway
94
Q

What do you see on an x-ray of the neck in epiglottitis?

A
  • Thumb print sign

- Vallecula sign

95
Q

What is the anatomical location of a retropharyngeal abscess?

A

Anterior to prevertebral space and posterior to the pharynx

96
Q

In what age group do you usually see retropharyngeal abscesses?

A

Children under 4 as they have more lymphoid tissue in that space

97
Q

What are the symptoms of a retropharyngeal abscess?

A
  • Neck pain
  • Dysphagia
  • Dyspnoea
  • Neck stiffness
  • Fever
98
Q

What is the management and treatment of a retropharyngeal abscess?

A

Similar to epiglottitis

99
Q

What is Ludwig’s angina?

A

Rapidly progressive cellulitis of the floor of the mouth

100
Q

What are the symptoms of Ludwig’s angina?

A
  • Raised tongue
  • Dysphagia
  • Pain
  • Fever
  • Swelling of the mouth
101
Q

What is angioedema?

A

Swelling of the deep dermal submucosal and subcutaneous tissues caused by vascular leakage affecting the eyes, lips, tongue, larynx and GI tract

102
Q

What are the causes of angioedema?

A
  • Infection
  • Hypersensitivity reaction
  • ACE inhibitors
103
Q

What is the treatment for angioedema?

A
  • Antihistamines
  • Steroids
  • Adrenaline
104
Q

What is a FNE scope and when is it used?

A

Flexible nasendoscopy

When you can’t remove foreign bodies in the throat e.g. a bone

105
Q

What can help a patient pass a foreign body stuck in the throat?

A
  • Fizzy drinks

- IV buscopan

106
Q

What sex are more likely to suffer a spinal injury?

A

Males (>2:1)

107
Q

What is the most common form of spinal injury?

A

Cervical spine injuries

108
Q

10% of patients with a cervical spine fractures have a second, ___-__________ vertebral column fracture.

A

Non-contiguous (does not share a common border)

109
Q

What is the main problem with spinal injuries?

A

Not the fracture themselves but if the fractures have impinged on the spinal cord

110
Q

What sign on an x-ray suggests a spinal compression injury?

A

If the above vertebra is wider than the one below it.

111
Q

What is the consequence of an injury to the corticospinal tract?

A

Ipsilateral loss of motor function.

112
Q

What is the consequence of an injury to the spinothalamic tract?

A

Contralateral loss of pain and temperature

113
Q

What is the consequence of an injury to the dorsal columns?

A

Ipsilateral loss of vibration and proprioception

114
Q

What is a primary spinal cord injury?

A

Where there is nothing you can do to save the injury. This is unavoidable.

115
Q

What are the features of primary spinal cord injuries?

A
  • Injury has an immediate effect
  • Often caused by compression, contusion, shear injury
  • Spinal cord often appears normal immediately after injury (unless penetrating trauma)
116
Q

What is a secondary spinal cord injury?

A

Where you can minimise the negative effects of the injury i.e. preventable.

117
Q

What are the features of secondary spinal injuries?

A
  • Occurs over minutes, hours
  • Ischaemia, hypoxia and inflammation is seen
  • Progressive neurological deterioration
118
Q

What can happen in a secondary spinal cord injury if you don’t stabilise the spine properly?

A

Subsequent damage following initial injury

119
Q

What is the initial assessment in a suspected spinal injury?

A

ABCDE approach:

  • Airway with cervical protection
  • Breathing
  • Circulation
  • Disability (neurology - GCS)
  • Exposure
120
Q

Under what circumstances should you do a full in-line spinal immobilisation?

A
  • Spinal pain
  • Intoxication
  • Significant distracting injuries
  • Confused/uncooperative
  • Reduced GCS
  • Hand/foot weakness
  • Altered/absent sensation in hands/feet
  • Priapism
  • History of past spinal problems
  • High-risk for cervical spine injury
  • If patient is unable to actively rotate their neck
  • If it was not known how the patient fell/ended up on the floor
121
Q

What is priapism?

A

Prolonged erection of the penis or erection not caused by sexual arousal. It is the hallmark for irreversible spinal cord injury.

122
Q

What is a flexion injury of the spine?

A

They occur following a fall in the bent position or an object falling on the bent back.

123
Q

What is a common cause of a hyperextension spinal injury?

A

Whiplash

124
Q

What is a distraction spinal injury?

A

They occur due to distractive forces causing disruption of the posterior and middle spinal columns e.g. hanging

125
Q

What are the two steps in in-line spinal immobilisation?

A

1) Cervical collar

2) Log roll to keep the head, neck and pelvis in line

FStCP 2 (2 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions