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AAA-ENT > APDN OF THE LARYNX 1.2 (AB) > Flashcards

APDN OF THE LARYNX 1.2 (AB) Flashcards

1
Q

What is the major function of the larynx?

A

Protection.

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2
Q

What mechanism prevents aspiration during swallowing?

A

Larynx moves up and forward. Epiglottis moves down and back. Closure of the laryngeal inlet.

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3
Q

What structures are involved in closure of the laryngeal inlet?

A

Aryepiglottic folds. True vocal folds. False vocal folds. Arytenoids.

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4
Q

What is the function of the cough reflex?

A

Force expiration against the larynx to clear foreign matter from the lower airway.

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5
Q

When does the Valsalva maneuver occur?

A

When the larynx closes tightly during heavy lifting. Defecation. Vomiting. Childbirth.

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6
Q

What happens to the glottis during inspiration?

A

It opens, becoming wider with deep breathing or panting.

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7
Q

What happens to the glottis during exhalation?

A

It gradually closes. Degree of closure determines rate of passive exhalation.

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8
Q

How is voice produced?

A

By vibration of vocal cords powered by exhaled air.

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9
Q

What are the three subsystems of voice production?

A

Air pressure system. Vibratory system. Resonating and modifying system.

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10
Q

What organs are involved in the air pressure system?

A

Lungs. Diaphragm. Abdominal muscle. Chest wall.

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11
Q

What organs are involved in the vibratory system?

A

Larynx. Vocal cords.

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12
Q

What organs are involved in the resonating and modifying system?

A

Oral cavity. Nasal cavity. Pharynx. Throat.

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13
Q

What organs are involved in articulation?

A

Lips. Tongue. Soft palate.

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14
Q

What are the three components of voice production?

A

Voice sound. Resonance. Articulation.

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15
Q

What is voice sound?

A

Buzzing sound from vocal cord vibration.

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16
Q

What is resonance in voice?

A

Voice sound filtered and amplified by vocal tract resonators.

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17
Q

What is articulation in voice?

A

Modification of voice sound into vowels and consonants by vocal tract articulators.

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18
Q

What affects voice intensity?

A

Air reservoir in lungs.

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19
Q

What affects voice pitch?

A

Voice generation.

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20
Q

What affects voice quality?

A

Voice resonation and articulation.

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21
Q

What are the requirements for normal phonation?

A

Appropriate vocal fold approximation. Adequate expiratory force. Control of length and tension. Intact layer structure of lamina propria. Adequate vocal fold bulk. Resonance of vocal tract.

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22
Q

What does the neuro-chronaxic theory suggest?

A

Vocal fold vibration from impulses by recurrent laryngeal nerves regulated by brain’s acoustic center.

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23
Q

Why is the neuro-chronaxic theory obsolete?

A

Muscle contractions too slow. Paralyzed folds can phonate. Passive phonation possible in excised larynges.

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24
Q

Who proposed the combined aerodynamic and myoelastic theory?

A

Jan Willem van den Berg in 1958.

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25
How is sound produced according to the combined aerodynamic and myoelastic theory?
Subglottic blast of air opens vocal cords. Passive vibration produces sound.
26
What helps close the vocal cords in the combined theory?
Muscle tension and Bernoulli's effect.
27
What makes the vocal cords vibrate in the combined theory?
Subglottic air blast and passive cord vibration.
28
What are key history elements in evaluating a dysphonic patient?
URTI. fever. cough. voice. tobacco or alcohol abuse. dysphagia. aspiration. breathing difficulty. weight loss. GERD. trauma. previous surgery.
29
What are methods used in the examination of a dysphonic patient?
Indirect laryngoscope. direct laryngoscope. fiberoptic flexible scope. stroboscopy. high speed video. objective voice measures. QOL questionnaires.
30
What are voice-specific questions to ask a dysphonic patient?
Onset of hoarseness. constancy of hoarseness. post-URTI voice changes. pain or effort during talking. voice fatigue. difficulty getting loud. pitch or range changes. running out of air. voice cracking. prior intubation or surgery. recent medication use. occupational voice needs. smoking. throat dryness. radiation history. neurologic or arthritic problems. prior trauma.
31
What is the most common cause of stridor in neonates and infants?
Laryngomalacia.
32
What is the pathophysiology of laryngomalacia?
Immaturity of the larynx as if fetal development has persisted.
33
What are the symptoms and treatment options for laryngomalacia?
Intermittent inspiratory stridor improved in prone position. treatment is observation or acid suppression. epiglottoplasty. tracheostomy.
34
What are the features of subglottic stenosis?
Incomplete recanalization. small cricoid ring. membranous. cartilaginous. or mixed types.
35
What are the grades of subglottic stenosis?
Grade I: 0-50%. Grade II: 51-70%. Grade III: 71-99%. Grade IV: complete obstruction.
36
What is the management for subglottic stenosis?
Grade I-II: endoscopic CO2 or excision with dilation. Grade III-IV: anterior cricoid split or laryngotracheal reconstruction.
37
What are the features of a laryngeal web?
Incomplete recanalization. can be supraglottic. glottic. or subglottic. weak or hoarse cry. variable respiratory obstruction.
38
What is the treatment for a laryngeal web?
No treatment. LASER excision. or open procedure with tracheostomy.
39
What are the types and features of subglottic hemangioma?
Capillary (resolves) or cavernous. 50% associated with cutaneous involvement. biphasic stridor.
40
What is the treatment for subglottic hemangioma?
Observation. corticosteroids. propranolol. LASER excision. open procedure with tracheostomy.
41
What is a laryngocele and its types?
Air-filled dilated sac in ventricle. types: internal. external. mixed.
42
What causes a laryngocele?
Increased intrapharyngeal pressure. idiopathic. seen in glass blowers and wind instrument players.
43
What is the treatment of a laryngocele?
Endoscopic marsupialization or excision. open procedures.
44
What are the causes of traumatic laryngeal injury?
Blunt trauma. penetration. burns. inhalation of foreign bodies.
45
What are causes of intubation injuries?
Prolonged or blind intubation. too large tube. most common laryngeal injury.
46
What are the symptoms and treatment of intubation injuries?
Hoarseness. dyspnea. treated with voice rest. endoscopic removal. open procedures. tracheostomy.
47
What are features of vocal nodules?
Bilateral. common in singers. located at anterior 1/3 and mid 1/3 junction.
48
What is the mainstay treatment of vocal nodules?
Voice therapy.
49
What are features of vocal fold polyp?
Unilateral. located at middle to anterior 1/3. mucoid or hemorrhagic.
50
What is the treatment for vocal fold polyp?
Surgical excision and voice therapy.
51
What are types of vocal fold cysts?
Congenital dermoid. mucus retention cysts.
52
What is the treatment for vocal fold cysts?
Surgical excision and voice therapy.
53
What are causes of vocal cord paralysis in adults and children?
Neoplastic. iatrogenic. idiopathic. trauma. neurologic. infectious. systemic. toxins. in children: Arnold Chiari malformation. birth trauma.
54
What are symptoms of vocal cord paralysis?
Dysphonia. choking. aspiration. stridor. asymptomatic.
55
What are treatment options for unilateral vocal fold paralysis?
Voice therapy. gelfoam. fat or collagen injection. teflon. medialization laryngoplasty. arytenoid adduction.
56
What are treatment options for bilateral vocal fold paralysis?
Cordotomy. arytenoidectomy. arytenoid abduction. lateralization laryngoplasty. tracheotomy.
57
What is the most common cause of acute laryngitis?
Viral infection.
58
What are symptoms of acute laryngitis?
Sudden dysphonia. fever. cough. globus sensation.
59
How is acute laryngitis treated?
Vocal hygiene. hydration. symptom relief.
60
What organism causes acute epiglottitis?
Haemophilus influenzae B.
61
What are classic symptoms of acute epiglottitis?
Fever. dysphagia. drooling. dyspnea. tripod position. no cough. hot potato voice.
62
What is the treatment for acute epiglottitis?
Avoid oral exam. intubation in OR. IV antibiotics. corticosteroids.
63
What virus causes croup?
Parainfluenza 1-3.
64
What are symptoms and treatment for croup?
Biphasic stridor. brassy cough. hoarseness. no dysphagia. treat with humidified oxygen. racemic epinephrine. steroid.
65
What causes fungal laryngitis?
Candidiasis. aspergillosis.
66
What are symptoms of fungal laryngitis?
Dysphonia. cough. odynophagia.
67
What is treatment for fungal laryngitis?
Antifungal regimen. biopsy if persistent.
68
What virus causes recurrent respiratory papillomatosis?
HPV types 6 and 11.
69
What are features of recurrent respiratory papillomatosis?
Hoarseness. stridor. wart-like lesions. juvenile or adult types.
70
What is the treatment for recurrent respiratory papillomatosis?
Laser excision. microdebrider. cidofovir. interferon.
71
What is the most common histologic type of laryngeal cancer?
Squamous cell carcinoma.
72
What are risk factors for laryngeal cancer?
Smoking. alcohol. radiation exposure.
73
What are symptoms of laryngeal cancer?
Hoarseness. aspiration. dysphagia. stridor. weight loss. hemoptysis. globus sensation.
74
How is laryngeal cancer classified?
Supraglottic: 30-40 percent. Glottic: 50-75 percent. Subglottic: rare.
75
What is the treatment for laryngeal cancer?
Radiotherapy. partial laryngectomy. total laryngectomy with neck dissection.

AAA-ENT (25 decks)

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