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DOHNS OSCE Flashcards

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1
Q

Arteries supplying nasal septum

A

SPA
Greater palatine artery
(Both above from maxillary artery from ECA)
Ant ethmoidal (from ophthalmic artery from ICA)
Branches of facial artery (from ECA)

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2
Q

MEN 1

A

3 Ps:
- Pituitary adenoma
- Parathyroid hyperplasia
- Pancreas

MENIN gene - chromosome 11

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3
Q

MEN 2a

A

2Ps + 1M:
- Parathyroid
- Phaeochromocytoma
- Medullary thyroid ca.

RET oncogene - chromosome 10

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4
Q

Men 2b

A

1P + 2Ms:
- Phaeochromocytoma
- Medullar thyroid ca.
- Marfanoid habitus / mucosal neuroma

RET oncogene - chromosome 10

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5
Q

Which nerve related to origin of middle meningeal artery?

A

Auriculotemporal nerve - supplies sensation to the external ear and outermost part of the tympanic membrane

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6
Q

Level of hyoid/epiglottis?

A

C3

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7
Q

Level of thyroid cartilage notch?

A

C4

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8
Q

Level of cricoid?

A

C6

Also;
Junction of larynx with trachea
Junction of pharynx with oesophagus
Level at which the inferior thyroid artery enters the thyroid gland
The level at which the vertebral artery enters the transverse foramen in the 6th cervical vertebra
Level at which the superior belly of omohyoid crosses the carotid sheath
The level of the middle cervical sympathetic ganglion
The level at which the carotid artery can be compressed against the transverse process of C6 (carotid tubercle).

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9
Q

Papillary thyroid ca. route of spread?

A

Lymphatic

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10
Q

Follicular thyroid ca. route of spread?

A

Haematogenous

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11
Q

Branches of external carotid artery?

A

Some angry lady figured out PMS

Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal

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12
Q

Structures passing through foramen ovale?

A

O - otic ganglion
V3 - mandibular
A - accessory meningeal artery
L - lesser petrosal nerve
E - emissary veins

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13
Q

Nerves passing through supraorbital fissure?

A

Live Frankly To See Absolutely No Insult

Lacrimal
Frontal
Trochlear
Superior division of oculomotor
Abducens
Nasociliary
Inferior division of oculomotor

3,4, 5-1, 6

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14
Q

Which foramina does trigeminal nerve exit?

A

Standing Room Only

V1 - superior orbital fissure
V2 - rotundum
V3 - ovale

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15
Q

Cranial nerve exits?

A

2244

2 cerebrum (I, II)
2 midbrain (III, IV)
4 pons (V, VI, VII, VIII)
4 medulla (IX, X, XI, XII)

Cerebellopontine angle mass affects VII and VIII (7 and 8)

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16
Q

Most common parotid malignancy?

A

Mucoepidermoid, followed by adenoid cystic (latter characterised by perineurial invasion)

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17
Q

Branches of ICA?

A

Ophthalmic
Posterior communicating
Choroidal
Anterior cerebral
Middle cerebral

Only Press Carotid Arteries Momentarily

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18
Q

Parasympathetics CNs?

A

1973

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19
Q

Most common thyroid ca.?

A

Papillary
Lymphatic spread predominates

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20
Q

Second most common thyroid ca.?

A

Follicular
Vascular spread predominates

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21
Q

Thy1?

A

Non-diagnostic

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22
Q

Thy2?

A

Non-neoplastic

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23
Q

Thy3?

A

Neoplasm possible

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24
Q

Thy4?

A

Suspicious for malignancy

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25
Thy5?
Malignant
26
U1?
Normal
27
U2?
Benign
28
U3?
Indeterminate
29
U4?
Suspicious
30
U5?
Malignant
31
ECV in children?
0.4 - 1.0 ml
32
ECV in adults?
0.6 - 1.5 ml
33
Constrictions of oesophagus?
- Cricopharyngeus - C6 (14-16cm from incisors) - Aortic arch (25-27cm from incisors) - GOJ (36-68cm from incisors) 70-20-10: percentage of impaction at each level, respectively
34
LASER acronym?
Light Amplification by Stimulated Emission of Radiation
35
Classification system for nasal polyps?
Meltzer staging system 1 - No polyps 2 - Polyps restricted to middle meatus 3 - Polyps extending below middle turbinate 4 - Massive polyposis, occluding entire nasal cavity
36
Embryology of external ear?
Forms from 1st pharyngeal groove (between 1st and 2nd pharyngeal arch)
37
Boundaries of Prussak's space?
Superior - lateral mallear ligament fold Inferior - lateral process of malleus Lateral - TM (pars flaccida) Medial - neck of malleus
38
Tensor tympani innervation?
Trigeminal nerve - V3 (mandibular) (via medial pterygoid)
39
Stapedius innervation?
Facial nerve (via branch in stylomastoid canal)
40
Tensor tympani inserts....
...handle of malleus
41
Stapedius inserts....
...neck of stapes
42
Mastoiditis organisms?
Strep. pneumoniae H. influenzae Group A strep progenes Pseudomonas auriginosa S. aureus
43
Sofradex contains?
Framycetin, gramicidin, dex
44
What are the zoster zones?
Ear (herpes auricularis) Face (herpes facialis) Posterior neck (herpes occipito-collairs)
45
Other cranial neuropathies in Ramsay-Hunt (beside facial n.)?
VIII, IX, V and VI in this order of frequency
46
Vocal cord layers?
Stratified squamous epithelium Reinke's space (lamina propria) Vocal ligament Thyroartyenoid muscle (vocalis)
47
Bloods supply to larynx?
Superior laryngeal a. from ECA Inferior laryngeal a. from thyrocervical trunk of subclavian
48
Tonsillitis organisms?
Step pyogenes aka group A beta-haemolytic strep. EBV
49
Contents of superior orbital fissure?
Oculomotor Abducens Trochlear Frontal Lacrimal Nasocillary
50
Contents of inferior orbital fissure?
Infraorbital nerve Infraorbital artery Zygomatic nerve
51
Contents of jugular foramen?
IJV CN 9 (glossopharyngeal) CN 10 (vagus) CN 11 (spinal accessory) Emissary veins and inf. petrosal sinus Meningeal branches of occipital and ascending pharyngeal arteries
52
Structures passing through foramen magnum?
CN 11 Vertebral arteries Spinal arteries Spinal cord/medulla
53
Muscles attaching to styloid process?
Styloglossus Stylohyoid Stylopharyngeus Stylohyoid ligament Stylomandibular ligament
54
Muscles attaching to mastoid process?
Sternocleidomastoid Post belly digastric Splenius capitis Longissimus capitis
55
Attachment to pharyngeal tubercle?
Pharyngeal raphe Superior pharyngeal constrictor
56
Contents of foramen spinousum?
Middle meningeal artery
57
Contents of foramen lacerum?
Greater petrosal nerve
58
Contents of stylomastoid foramen?
Facial nerve Stylomastoid artery
59
Contents of IAM?
Facial nerve Vestibulocochlear nerve Vestibular ganglion Labyrinthine artery
60
Attachment to pharyngeal tubercle?
Pharyngeal raphe Superior pharyngeal constrictor
61
Contents of carotid canal?
ICA Sympathetic nerve fibres of the eye
62
Non-random association with choanal atresia?
CHARGE Coloboma of the iris. Heart defect (e.g. atrial septal defect). Atresia of the choanae (100%). Retarded growth and development. Genitourinary abnormalities (e.g. cryptorchidism, hydronephrosis). Ear defects (e.g. deafness).
63
Nose block nerves?
Infratrochlear Infraorbital External nasal Nasopalatine
64
Adduction of VCs?
Lateral cricoarytenoid muscles
65
Abduction of VCs?
Posterior cricoarytenoid muscle
66
Tensing of VCs?
Cricothyroid muscle
67
Systemic causes of septal perforation?
Wegener's Sarcoidosis SLE TB Syphillis Polyarteritis nodosa
68
Bat ears?
Underdevelopment of anti-helical fold Overdevelopment of cochal wall
69
Helicotrema?
Scala vestibular and tympani meet here (at apex)
70
Inferior parathyroid gland origin?
3rd pharyngeal pouch
71
Superior parathyroid gland origin?
4th pharyngeal pouch
72
Glue ear surgical intervention in children timing (NICE)?
Children with persistent bilateral OME documented over a period of 3 months with a hearing level in the better ear of 25–30 dBHL

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