ENT 4 Flashcards
(50 cards)
The complications of tonsillitis:
Quinsy:
- Trismus
- Fever
- Muffled voice
Para- pharyngeal abscess
- Swelling of the anterior and posterior SCM muscle
- fever
- Rupture of the internal carotid
Lemierre syndrome
- thrombophlebitis of the internal jugular with septic emboli to the lungs
Scarlet fever
- sandpaper rash across chest
- strawberry tongue
Post - Step glomerulonephritis
What is your management for Bell’s palsy?
Eye protection
- dark glasses
- artificial tears
- Taped closed
Prednisolone 60mg if in the first 72 hours
What is the name of the operation called to fix a perforated ear drum?
Myringoplasty
What kind of drainage is needed following a thyroidectomy?
Suction
- this is because of the rapid complications of airway compromise
What is ludwig’s angina?
This is also a submandibular abscess between the mylohyoid muscle and floor of the mouth
- history of dental pain
- floor of mouth oedema and pain
- tongue pushed posteriorly with airway compromise
Due to:
- usually from dental sepsis
- typically caused by S. Pneumonia
Treatment:
- IV antibiotics
- Needle aspiration
What does a positive test in Rinne’s mean?
It means that air conduction is louder than bone conduction
- a normal examination
What two examinations can be done to test the vestibular spinal reflexes?
Romberg’s test
- patient stands with eyes closed and arm by side
- patient will fall to side of an uncompensated lesion
Unterberger’s test
- a patient marches on the spot with arms outstretched
and eyes closed for 30 secs.
*abnormal is inward rotation of 30 degrees.
What is the underlying is the underlying pathology of presbycusis?
Reduction in the number of inner and outer hair cells
Why must pinna haematomas be drained?
The blood build up can lead to restriction of blood to the cartilage causing deformation
- cauliflower ear
What is the main bony prominence seen on otoscopy?
Head of the malleus
What is histological difference between the pars tensa and pars flacida?
Organisation of the fibrous tissue.
Pars tensa is organised fibrous tissue with peripheral thickening creating the annulus that is around the tympanic membrane.
The pars flaccida is poorly organised fibrous tissue
Physiologically how much do the ossicles increase sound vibrations?
1:21
in practice it is 1:14 usually
What are the most common causative agents to middle ear infections? What is the typically management?
S. Pneumona
H. Influenza
Management:
- Amoxicillin PO
What is it called when there is chronic otitis media and discharge? and where does the perforation usually occur? How is it treated?
Chronic Mucosal discharge
- called mucosal because the epithelial cells within the middle ear undergo change into mucus producing cells
usually occurs in the pars tensa
Management:
- aural toileting
- topical steroids
- Tympanoplasty
What are the signs of glue ear?
Conductive hearing loss
Otalgia
Cracking sensation
- retraction of ear drum (due to air reabsorption)
- loss of light reflex
Investigations: - otoscopy - pure tone audiometry - tympanogram (adults ENT referral, flexible nasoscopy)
Treatment:
- Grommet insertion
- adenoidectomy may be indicated as well
What other procedure should a child with recurrent glue ear be considered for out with grommet insertion?
Adenoidectomy
What advice should be given to a child with a grommet insertion?
Avoid getting soapy water in the ear
What type of operation(s) are used to treat cholestomas?
Atticotomy
or
Radical mastoidectomy
Complications:
- facial nerve injury
- CSF leak
- Vertigo
What type of epithelium line the nasal passages?
Columnar ciliated
When is a nasal fracture realigned?
2 weeks after the initial injury
What is the surgery for nasal polyps?
Functional endoscopic nasal surgery
What are some malignant tumours that can occur in the nasal cavity?
Squamous cell carcinomas (smoking risk factor)
Anaplastic
Lymphomas
Adenocarcinomas
What are the symptoms of a paraphyaryngeal abscess?
Peristonilar abscess
- trismus
- paalate oedema
- throat swelling
Swelling behind the upper posterior mastoid
Complications:
- carotid artery rupture
- jugular vein thrombosis
What is the difference between radical neck dissection and modified neck dissection?
modified retains:
- jugular veins
- sternocleidomastoid
- accessory nerve
