EENT

Question 1

Define exophthalmos. Who typically experiences this disorder?

Answer 1

increased axial projection (eye protrusion)

Common finding in. thyroid eye disease and found in about 60% of patients

Question 2

Define ptosis and causes

Answer 2

Drooping of the upper eyelid.

Causes: senescence (deterioration with age), myasthenia gravis, or damage to the oculomotor nerve (CNIII)

Question 3

What condition is this?

More common in elderly population

Inward turning of the lid margin. The lower lashes irritate the conjunctiva and lower cornea. Lower lashes may be invisible when turned inward

Answer 3

Entropion

Question 4

What condition is this?

Lower lid margin turns outward, exposing the palpebral conjunctiva. When this occurs the eye no longer drains well

More common in older adults

Answer 4

Ectropion

Question 5

What condition is related to elevated intracranial pressure that causes intra-axonal edema along the optic nerve, leading to engorgement and swelling of the optic disc?

Answer 5

papilledema

Question 6

what sinuses are typically affected when patients present with sinus pressure or sinus infection?

Answer 6

Maxillary sinus (near the cheeks) and ethmoid sinus (near the bridge of the nose)

Question 7

at what age does the frontal sinus develop. Describe their location

Answer 7

7 years old; near the forehead

Question 8

What are causes of rhinorrhea

Answer 8

Viral infections. allergic rhinitis (hay fever), and vasomotor rhinitis (itching favors allergic cause)

Question 9

What term defines unequal pupils

Answer 9

aniscoria

Question 10

movement of the auricle and tragus is painful in _____ but not painful in _____.

Answer 10

acute otitis externa (inflammation of the ear canal)

not painful in otitis media (inflammation of the middle ear)

Question 11

What are causes of sensorineural hearing loss

Answer 11

loud noise exposure, inner ear infections, trauma, acoustic neuroma, congenital and familial disorders, and aging

Question 12

What are the effects of sensorineural hearing loss

Answer 12

Higher registers are lost, so sound may be distorted

Hearing worsens in noisy environment

Voice may be loud because hearing is difficult (due to cochlear nerve and neuronal impulse transmission to the brain is affected)

Question 13

What are the causes of conductive hearing loss

Answer 13

foreign body, otitis media, perforated eardrum, and otosclerosis of ossicles

Question 14

What are the effects of conductive hearing loss

Answer 14

little effect on sound

Hearing seems to improve in noisy environment

Voice remains soft because inner ear and cochlear nerve are intact

Question 15

Acute otitis media with purulent effusion is commonly caused by what bacteria

Answer 15

S. pneumoniae or H. influenzae

Question 16

xerostomia

Answer 16

dry mouth

Question 17

white, cottage cheese‐like lesions that can be easily removed with swab is called what?

What is it treated with

Answer 17

Thrush (candida - fungal); treated with anti-fungal

Question 18

recurrent single or multiple shallow, painful ulcers, that are scattered or grouped are called what?

What is treatment?

Answer 18

Aphthous ulcers

Symptomatic treatment with “Magic Mouthwash”

Question 19

Multiple ulcers on tonsils, soft palate, uvula (May also
have lesions on hands and soles of feet).

What population does this primarily affect?

Answer 19

Herpangina (Coxsackie virus)

Seen more in kids

Question 20

painless punched out ulceration on lip, tonsil or palate is called what?

What is treatment?

Answer 20

Syphillis chancre

Treated with PCN.

Question 21

painful, similar in appearance to aphthous ulcers, but only on mucosa attached to bony
structures is descriptive of what condition?

What is treatment?

Answer 21

Herpes

Treated with anti‐virals.

Question 22

halitosis

Answer 22

malodorous breath

Question 23

what structures are part of the oropharynx

Answer 23

uvula, soft palate, palatine tonsils, and posterior wall of the oropharynx

Question 24

A hump in the middle of the nose is called what?

Answer 24

dorsum convexity

Question 25

Saddling of the middle of the nose is called what?

Answer 25

dorsum concavity

Question 26

asymmetric protrusion of the tongue suggests a lesion of what cranial nerve? What way would the tongue turn if there is a lesion?

Answer 26

CN XII tongue points toward the side of the lesion

Question 27

what are common causes of otitis media?

Answer 27

- edema and congestion in Eustachian tube - refulux of bacteria from the nasopharynx - accumulation of secretions in middle ear increase pathogen growth

Question 28

Name the structures of the middle ear

Answer 28

malleus, incus, stapes, tympanic membrane (eardrum), tympanic cavity, semicircular canals

Question 29

Name the structures of the inner ear

Answer 29

cochlea, vestibular nerve, cochlear nerve, estachian tube

Question 30

Name the structures of the outer ear

Answer 30

auricular lobule (earlobe) Concha antihelix tringular fossa scapha helix temporal muscle temporal bone external acoustic meatus (ear canal)

Question 31

Extraocular muscles: What movement does the superior rectus muscle control? What cranial nerve moves it

Answer 31

Moves the eye upward (elevation) CN III

Question 32

Extraocular muscle: What movement does the inferior rectus control What cranial nerve moves it

Answer 32

Moves the eye downward (depression) CN III

Question 33

Extraocular muscle: What movement does the Medial rectus control What cranial nerve is associated

Answer 33

Moves the eye inward toward the nose (adduction) CN III

Question 34

Extraocular muscle: What movement does the lateral rectus muscles control What cranial nerve is associated

Answer 34

Moves the eye outward away from the nose (abduction) CN VI

Question 35

Extraocular muscles: What movement does the superior oblique control What CN is associated

Answer 35

Rotates the top of the eye toward the nose around the long axis (torsion) and downward CN VI

Question 36

Extraocular muscles: What movement does the inferior oblique muscle control What CN is associated

Answer 36

Rotates the top of the eye away from the nose around the long axis (extorsion) and moves the eye upward (elevation) CN III

Question 37

Name the cranial nerves: CN VI CN IV CN III

Answer 37

CN VI: abducens nerve CN IV: trochlear nerve CN III: oculomotor nerve

Question 38

What cranial nerve control facial expressions and facial muscles? What movements activate the cranial nerve

Answer 38

Cranial nerve VII (the facial nerve) Ask person to smile, frown, close eyes tightly, lift eyebrows, show teeth

Question 39

Describe location of the submental lymph nodes and their direction of lymphatic drainage

Answer 39

in the midline a few centimeters behind the tip of the mandible external and internal lymphatic drainage (from the mouth and throat)

Question 40

Describe the location of the submandibular lymph node group and their direction of drainage.

Answer 40

Midway between the angle and the tip of the mandible. External and internal lymphatic (from the mouth and throat)

Question 41

Describe the location of the preauricular lymph node group and their direction of lymph drainage

Answer 41

in front of the ear external lymphatic drainage

Question 42

Describe the location of the posterior auricular lymph node group and their direction of lymph drainage

Answer 42

superficial to the mastoid process external lymphatic drainage

Question 43

Describe the location of the tonsillar (jugulodigastric) lymph node group and their direction of lymph drainage

Answer 43

at the angle of the mandible internal lymphatic drainage (from the mouth and throat)

Question 44

Describe the location of the occipital lymph node group and their direction of lymph drainage

Answer 44

at the base of the skull posteriorly external lymphatic drainage

Question 45

Describe the location of the anterior superficial cervical lymph node group and their direction of drainage

Answer 45

superficial to the SCM muscle external lymph drainage

Question 46

Describe the location of the posterior cervical lymph node group and the direction of drainage

Answer 46

along the anterior edge of the trapezius external lymph drainage

Question 47

Describe the location of the deep cervical chain lymph node group and the direction of drainage

Answer 47

Deep to the SCM muscle and often inaccessible to examination no direction of drainage

Question 48

Describe the location of the supraclavicular lymph node group and the direction of drainage

Answer 48

deep in the angle formed by the clavicle and the SCM muscle external lymph drain

Question 49

Enlarged tender lymph nodes commonly accompany what condition

Answer 49

pharyngitis

Question 50

Describe symptoms of hypothyroidism

Answer 50

intolerance to cold, weight gain, dry skin, and slowed heart rate

Question 51

Describe symptoms of hyperthyroidism

Answer 51

intolerance to heat, weight loss, moist velvety skin, and palpitations

Question 52

redness and scaling on the scalp may indicate what condition

Answer 52

Seborrheic dermatitis

Question 53

What are the characteristics of lymph nodes during acute infections

Answer 53

nodes are bilateral, enlarged, warm, tender, and firm but freely movable

Question 54

What are the characteristics of lymph nodes with chronic inflammation, such as tuberculosis

Answer 54

the nodes are clumped

Question 55

What are the characteristics of cancerous lymph nodes

Answer 55

hard, unilateral, nontender, and fixed

Question 56

What are the characteristics of lymph nodes with HIV infection

Answer 56

enlarged, firm, non-tender, and mobile

Question 57

What are the characteristics of lymph nodes when neoplasm in thorax or abdomen is present

Answer 57

single, enlarged, non-tender, hard, left, supraclavicular node (Virchow's node)

Question 58

What are the characteristics of lymph nodes when Hodgkin's lymphoma is present

Answer 58

painless, rubbery, discrete nodes that gradually appear

Question 59

A tracheal shift pushed to the unaffected side could indicate what conditions?

Answer 59

Aortic aneurysm, tumor, unilateral thyroid lobe enlargement, and pneumothorax

Question 60

A tracheal shift with the trachea puled toward the affected side could indicate what conditions?

Answer 60

large atelectasis, pleural adhesions, or fibrosis

Question 61

Lymph nodes greater than how many cm is considered enlargement

Answer 61

>1 cm

Question 62

Test muscle strength and status of cranial nerve XI by what movement

Answer 62

trying to resist person's movements with your hands as person shrugs shoulders and turns head to each side

Question 63

the internal carotid supplies what area

Answer 63

runs upward to supply the brain

Question 64

The external carotid supplies what area

Answer 64

the face, salivary glands, and superficial temporal area

Question 65

What part of the ear mediates conductive hearing

Answer 65

outer and middle ear

Question 66

What part of the ear mediates sensorineural hearing

Answer 66

the inner ear

Question 67

What are the 3 pairs of salivary glands and where are they located

Answer 67

Parotid glands: in the cheeks over the mandible anterior to and below the ear Submandibular glands: beneath the mandible at angle of the jaw Sublingual glands: in the floor of the mouth

Question 68

What is the function of the lymphatic system

Answer 68

filter lymph and engulf pathogens, preventing potentially harmful substances from entering the circulation

Question 69

What do the posterior auricular nodes drain

Answer 69

ear canal, posterior neck and upper ear

Question 70

What do the superficial cervical nodes drain and what are possible differentials

Answer 70

drains tongue, larynx, oropharynx Differential: mono, upper respiratory infection, dental disease

Question 71

What do the supraclavicular lymph nodes drain? What are the differentials

Answer 71

Drains GI/GU tract and pulmonary Can be a sign of abdominal cancers that metastasize by the lymph system like gastric cancer

Question 72

What do the submandibular drain and what are the differentials associated

Answer 72

oral cavity Same as superficial cervical; Differential: mono, upper respiratory infection, dental disease

Question 73

Where do the epitrochlear lymph nodes drain and what are the differentials associated

Answer 73

Drains the last 2-3 fingers Differential: lymphoma or melanoma or upper limb infection

Question 74

What nodes are known as tumor draining nodes

Answer 74

epitrochlear and axillary nodes

Question 75

Where is lice more likely to be located

Answer 75

at the nape (base of the neck)

Question 76

What is the light reflex test assessing and what might you be concerned about

Answer 76

assessing brain stem function; might be concerned of possible lesion or tumor at the brain stem

Question 77

What drug class can cause an abnormal light reflex

Answer 77

barbituates