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PE midterm > Ear nose and mouth > Flashcards

Ear nose and mouth Flashcards

(115 cards)

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1
Q

What makes up the external ear?

A

pinna/auricle + ear canal

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2
Q

Be able to identify the helix, antihelix, tragus, lobule, and EAM

A

OK

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3
Q

What are mastoid air cells?

A

part of the external ear that can become infected and lead to mastoiditis which is a surgical emergency and requires drainage

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4
Q

What are the ossicles of the ear?

A

malleus, incus, stapes

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5
Q

What are the components of the middle ear?

A

the ossicles and TM

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6
Q

What are the components of the inner ear?

A

cochlea, eustachian tube

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7
Q

When is the light reflex of the TM obliterated?

A

infection

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8
Q

What is the anatomy of the TM?

A

anterior folds, posterior folds, light reflex, umbo, handle of malleus

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9
Q

What are the different parts of the otoscope?

A

speculum, viewing window, sometimes inflation device to push air against TM

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10
Q

What are the possible reactions of the TM to the inflation device?

A

positive or negative movement with positive and negative pressure, infected ear TM won’t move

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11
Q

What should be palpated on the ear exam?

A

auricle, tragus, mastoid process

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12
Q

How shold pediatric patients be held during ear exam? Why?

A

Cuddle hold, TM can become erythematous after crying

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13
Q

What does a normal TM look like?

A

pearly grey, non-injected, non-erythematous, intact, light reflex

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14
Q

Where does a light reflex show up in the left and right ears?

A

Left: left, right: right

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15
Q

What are bony exostoses?

A

normal variants of the ear caused by repeated exposures to cold water (surfers/divers)

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16
Q

What is cerumen impaction?

A

normal variant, ear wax impaction - abnormal variant can cause tinnitus, pain and conductive hearing loss

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17
Q

What is the most common cause of conductive hearing loss?

A

cerumen impaction

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18
Q

What is the difference in appearance of ear wax that is soft and solid?

A

soft: light-colored, solid: dar brown, black

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19
Q

What is tympanosclerosis?

A

normal variant: due to recurrent infections

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20
Q

What are the physical exam findings of acute otitis media?

A

erythema, no light relfex, no umbo, injection

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21
Q

What is serous otitis media?

A

Result of viral URI or seasonal allergies - a change in pressure leads to fluid accumulation behind the ear. Can cause conductive hearing loss, appreciate fluid bubbles on exam behind TM, landmarks are preserved, light reflex present

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22
Q

What can cause chronic otitis media? What do these pts require?

A

eustachian tube dysfunction, require myringotomy tube (tympanotomy tube)

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23
Q

What happens to myringotomy tubes with age?

A

they fall out

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24
Q

What are the positions the TM can be perforated?

A

central or marginal

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25
How is TM perforation treated?
often heal on own, intervene if there is hearing loss
26
What can cause TM perforation?
extremely loud noise, pressure, otitis media
27
What are the sxs of TM perforation?
pain that goes from bad to worse (10/10) then relief with ruptire and discharge
28
What is swimmer's ear AKA?
otitis externa
29
What are the sxs of otits externa?
pain with palpation anywhere on the external ear
30
What is the most common cause of otitis externa?
pseudomonas infection of the EAM causing rupture
31
How can you treat swimmer's ear?
ear wick with drops of Rx
32
Who is most likely to develop fungal otitis externa?
pts with DM or immunocompromised
33
What is BCC?
common cause of skin cancer - benign, rarely metastasizes
34
What is found of physical exam of BCC on the ear?
a mass with telangiectasia, pearly appearance, necrosis and ulceration - very slow growing
35
What are keloids?
hypertrophic scars that grow outside the bounds of the wound - common in AA, not painful, common on sternum
36
What is chondrodermatitis helices?
chronic inflammatory lesion of the helix/antihelix - Bx to rule out BCC
37
How is sound conducted when you cover your ears?
bone conduction
38
What are the causes of conductive hearing loss?
breach in air conduction in the external/middle ear: cerumen, foreign body, infection, tumor
39
Which cranial nerve is reponsible for hearing?
VIII
40
What is presbycusis?
high frequency hearing loss with age, normal, senescent, miss consonants
41
What is sensorineural hearing loss?
disorder of the inner ear, brain, or CN VIII
42
What can cause damage to the inner ear?
tumor, high decibel sound, infection
43
What is a normal result of the rinne test?
air conduction greater than bone conduction (same for sensorineural hearing)
44
With obstruction, what is the result of the Rinne test?
AC\
45
Why is it difficult to demostrate sensorineural hearing loss
both bone and air conduction are similar sounding
46
What is a normal result of the weber test?
no lateralization of sounds
47
What happens to results of the weber test with conductive hearing loss?
lateralizes to the blocked ear
48
What happens to results of webers test when there is CN VIII impairment?
lateralizes to the good ear
49
What are the functions of the nasal mucosa?
cleanse, humidify, control the temperature of inspired air
50
What are the sinus ostia?
maxillary sinuses - drain into the middle meatus
51
Which plexus is responsible for posterior nosebleeds?
woodruff's
52
Which type of nosebleed is an emergency?
posterior - can compromise the airway, pt has trouble breathing
53
Which nasal plexus is responsible for anterior nosebleeds?
Kiesselbach's plexus
54
What are common causes of anterior nosebleeds?
dry, irritated, infected mucosa, coagulopathy, trauma
55
When can nasal speculum be used to identify the source of epistaxis?
anterior nosebleeds
56
What is a common cause of septal perforation?
drug use - cocain, methamphetamine
57
What are common causes of septal deviation?
trauma, congenital
58
What are sxs of deviated nasal septum?
anosmia, sleep apnea, infection, bleeds
59
is it necessary to treat a nondisplaced nasal fx?
no
60
How do you test for nasal obstruction?
have pt close one nostril and inhale in each
61
What do normal turbinates look like?
pink, moist
62
What does allergic rhinitis present with on PE?
pale, blue/purple turbinates, stringy mucous
63
What causes nasal polyps?
allergies
64
What do pts with nasal polyps also likely have?
allergy to ASA, allergic triad, cystic fibrosis
65
What is the allergic triad?
eczema, asthma, allergic rhinitis
66
What is rhinophyma?
lumps on nose as a result of severe/untreated rosacea
67
What are the names of the types of teeth?
incisors, (1st medial, 2nd lateral), canines, premolars, molars
68
what is the crown of the tooth?
the part of the tooth exposed above the gums
69
What are the 3 layes of the tooth from outside to inside?
enamel, dentin, pulp (contains vasculature)
70
What helps cement the tooth into the jaw
peridontal membrane
71
Where do the tonsils reside?
between the palatoglossal and palatopharyngeal arches
72
What are vallate papillae?
the larger bumps on the back of the tongue
73
What are fungiform papillae?
taste buds
74
What are the anterior and posterior pillars?
Anterior: palatoglossal arch, posterior: palatopharyngeal arches
75
What is the lingual frenulum?
the midline of the ventral side of the tongue
76
What is the buldge at the bottom of the lingual frenulum?
the papilla
77
what is the difference between the alveolar mucosa and the gingiva?
the gingiva is around the teeth, the alveolar mucosa is below that
78
what is the inside of the lip called?
labial mucosa
79
What is malloclussion?
over/underbite
80
Which nerve is responsible for tongue movement?
XII
81
What do crackled lips denote?
dehydration
82
What is torus palatinus?
benign midline lump that is hard, not tender and bony
83
What CN mediates the symmatrical rise of the soft palate on "ah"?
XII
84
What are normal variants of the uvula?
pointy, bifurcated, none at all
85
What are the signs of SCC on the tongue?
painless ulcer on the tongue
86
What are normal variants of the tongue?
fissured/geographic tongue/hairy tongue
87
What can cause hairy tongue?
tobacco use, hx of trush, poor hygeine, abx use, coffee, overuse of bismuth
88
are sublingual varices normal variants?
yes, normal with age, veins on ventral side of tongue are varicosed
89
What are mandibular tori?
growths on the bottom of the mouth, pink, normal, bony, non-tender
90
What is the most common cause of herpes outbreak on the mouth?
HSV1
91
What does herpes look like on the mouth?
vesicular on erythematous base - "dew drops on a rose petal"
92
What is the normal progression of herpes mouth lesions?
vesicles --\> ulcer (contagious) --\> crusting = healing
93
What is angioedema?
deep tissue inflammation due to hypersensitivity reaction (ACEi)
94
What is leukoplakia?
SCC precursor what is fixed and painless on the buccal mucosa/tongue
95
Who gets hairy leukoplakia?
HIV pts
96
What does hairy leukoplakia look like?
feathery, corrugated, well demarcated
97
How is trush distinguished from leukoplakia?
painful, scrapes off with an erythematous base, bleeds after scraping
98
Who gets thrush?
babies, people using advair (rinse mouth), prednisone, immunocompromised, abx use
99
What is periapical abscess?
odontogenic infection that is tender, nodular, fluctuant (smooshy) found at the apex of the tooth
100
What 3 conditions cause gingival hyperplasia?
leukemia (if there is bleeding), chronic dilatin use, pregnancy
101
What is a common presentation of gum recession?
you can see dentin, pts don't normally floss, associated with heart disease
102
What is a common cause of gum recession?
chronic periodontal disease
103
Who develops pyogenic granulomas?
pregnant women (1-5%)
104
What does dyptheria present as?
grey/white membrane on posterior pharynx which can lead to respiratory obstruction
105
What causes kaposi sarcoma?
HHV-8
106
What does kaposi sarcoma look like?
vascular tumor, purple, can occur in multiple organs
107
What is a common finding of oral exam in pts with bullemia?
yellow teeth with caries
108
What does HAND stand for?
used for bullemia: Halitosis, abrasions onf knuckles, negative gag reflex, dentition in ill repair
109
What are common signs of bullemia?
maintain body weight, cuts on the back of the throat from forks to wretch
110
What do pts with ANUG present with?
fever, malaise, LAN, halitosis, found in AIDs pts
111
What do petechiae on the hard palate represent?
mono, HIV, trauma, coagulopathy (ITP)
112
When you see eshar necrosis, what do you think of?
black necrosis of the mouth - sign of oral CA, painless, yellow slough
113
When should tongue lacerations be sewed?
if laceration is all the way through the tongue
114
What is actinic cheilitis?
thickening whitish discoloration of the lip at the border of the lip and skin, loss of vermillion border
115
What is angular cheilitis?
inflammation of one or more corners of the mouth

PE midterm (10 decks)

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