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Head and Neck > Clinical Head and Neck > Flashcards

Clinical Head and Neck Flashcards

1
Q

dysphonia

A

hoarseness

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2
Q

head and neck general investigations

A
  • FNAC
  • CT/MRI/PET
  • US scan
  • plain x-ray
  • contrast swallow
  • endoscopy
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3
Q

what does it suggest if swallowing solids is difficult?

A

suggests narrowing

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4
Q

what does it suggest if swallowing liquids is difficult?

A

neuromuscular/ neurological problems because liquids are more difficult to move down the oesophagus

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5
Q

characteristics of a non-malignant neck node

A
  • round
  • firm
  • irregular
  • fixed
  • non-tender
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6
Q

potential consequence biphasic breathing

A

it is exhausting, so you will slow down your breathing and ultimately suffocate

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7
Q

where would you put in a tracheostomy

A

between cricoid and thyroid cartilage

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8
Q

symptoms:

  • pus covered tonsils
  • neck nodes
  • fever
  • no cough
A

bacterial tonsilitis

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9
Q

sign guidelines for offering tonsilectomy

A
  • bacterial tonsilitis
  • 6-7 attack/ 1 year
  • 5attacks/year over 2yrs
  • 3 attack/ year over 3yrs
  • disrupting daily activity
  • more than 1 quinsy
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10
Q

quinsy

A

pus in the space between tonsils and wall of pharynx

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11
Q

Quinsy

A

Potentially serious complication tonsillitis
When abscess develops between tonsil and wall of mouth
All symptoms would be expected from abscess + mass @ back of mouth

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12
Q

Glandular fever

A
  • tired/ ill for months
  • fever, very sore throat, lymphadenopathy, fatigue, malaise, aches, chills, sweats, anorexia
  • grey coating of tonsils
  • blood test for EBV
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13
Q

Pharyngeal pouch

A

Bulge/ pocket that develops in roof of oesophagus

Dysphasia, feeling limp in throat, regurgitation, pouch on barium swallow

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14
Q

Auricular haematoma

A

Shearing forced to anterior auricle and tearing of some blood vessels

Incision and drainage
Pressure dressing
ABs

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15
Q

Foreign body in ear

A

Pain, infection, conductive hearing loss

Remove - batteries urgent

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16
Q

Otitis externa

A

Inflammation external auditory meats
Risks: allergies, asthma, water in ear regularly
Otorrhoea
Usually one ear
Antibiotics, steroid ear drops - no water or cotton buds

17
Q

Malignant otitis externa

A

Osteomyelitis of the temporal bone
Not a cancer, but rather an aggressive infection
Pain, discharge, conductive and sensorineural hearing loss, vertigo, fever, loss of voice +/- cranial nerve palsies

Pseudomonas aerugniso

Antibiotics for ageeees

18
Q

Otitis media with effusion

A

Glue ear - sterile fluid in middle ear
Eustachian tube dis function
Hearing loss, speech delay, loss of balance
Non- buldging tympanic membrane
Usually self limiting, grommet after 3 months

19
Q

Acute suppuratice otitis media

A

Pus in middle ear. Otalgia, otorrhoea, fever
Buldging tympanic membrane
Observation, amoxicillin

20
Q

Chronic suppurative ottitis media

A 
Chronic inflammation of middle ear and mastoid cavity 
Perforated tympanic membrane 
Conductive hearing loss 
Hole/ thickening of membrane 
Topical antibiotics
Suction 
Steroids
21
Q

Cholesteatoma

A

Abnormal collection of skin in middle ear/ mastoid bone
Can be due to Eustachian tube malfunction
Persistent offensive otorrhoea
Gradual loss of hearing in effected war
Facial palsy

Mastoidectomy

22
Q

Tempanosclerosis

A

Calcification of tympanic membrane +/- middle ear
White patches in ear drum
Usually asymptotic

23
Q

Otosclerosis

A 
Fixation of stapes by extra bone 
Progressive hearing loss
Find it easier to hear when there’s background noise
Tinnitus 
Conductive hearing loss
Hearing aid/ stapedectomy
24
Q

What condition makes it easier to hear when there’s background noise?

A

Otosclerosis

Fixation of stapes by extra bone

25
Q

Conductive hearing loss

A

Issue with conduction through ear e.g. blockage etc.

26
Q

Sensorineural hearing loss

A

Problems with nerves of the ear. Air>bone (rinnes test positive)(Webber’s lateralised to good ear)

27
Q

Tinnitus

A

Any perception of sound
Ringing, buzzing, whooshing, humming, throbbing, hissing, singing
Unilateral

Treat underlying cause (if possible)
Sounds enrichment - having sound in the environment 
Stress management 
CBT
Counselling
28
Q

Benign paroxysmal positional vertigo

A

Where specific head movements cause vertigo
Otoconia in semicircular canals. They move and until they come to rest @the bottom of then canals they make you feel dizzy.

Dix-hallpike test

Epley manouvre

29
Q

What is dix-hallpike test used to test for?

A

Benign paroxysmal positional vertigo

30
Q

Vestibular neuritis

A

Inflammation of the vestibulocochlear nerve @ inner ear
Disrupts balance
Dizzy for days
Bed rest, antibiotics and benzodiazepine

31
Q

Migraine

A 
Usually a moderate or severe headache felt as throbbing 
Spontaneous vertigo 
Aura
Precipitated by migraine triggers
Past history of migraines
32
Q

Facial nerve palsy

A

Lower motor neurone - forehead involved

33
Q

Labyrinthitis

A

Vestibular neuritis, usually follows a viral infection which can spread to inner ear causing headaches, hearing loss, otlagia, otorrhoea, tinnitus
Nystagmus horizontally towards affected ear

34
Q

What would a fast horizontal twitching of the eye towards the left ear suggest?

A

Labrynthitis in that ear

35
Q

Allergic rhinitis

A

Inflammation of the inside of the nose caused by an allergen

Allergen testing
Nasal cytology

Allergen avoidance, antihistamines, immunotherapy

36
Q

Epitaxis

A

Nose bleed

Pinch end of nose and lean forward slightly
Silver nitrate
Ligation
Ablation of nasal arteries

37
Q

Laryngomalacia

A

Laryngeal cartilage is floppy
Can’t breath on back
Difficulty breathing
Strider

Should settle when they get older, but if breathing problems operate

38
Q

Acute sinusitis

A

Sinuses inflamed and swollen; this interferes with drainage and causes mucous to build up

Head and Neck (3 decks)

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