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Flashcards in ENT Deck (22):

Ear anatomy

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Air conduction

depends on external, middle, and inner ear, CN 8, and central auditory pathways


Bone conduction

depends on inner ear, CN 8, and central auditory pathways


Weber test

Will lateralize OPPOSITE the side with SENSORINEURAL loss or TO the side with CONDUCTIVE hearing loss


Rinne test

Tests air conduction. Air should be louder than bone conduction; if not the test is positive. Will lateralize TO side with CONDUCTIVE hearing loss. In sensorineural hearing loss, both will be reduced equally, so the test will not be positive.


Conductive hearing loss

Due to lesion in either external meatus, tympanic membrane, or middle ear all the way up to oval window. Weber lateralizes TO affected ear; Rinne positive


Sensorineural hearing loss

Due to lesion in the inner ear, CN 8, or central auditory structures. Weber lateralizes AWAY; Rinne negative.


Epistaxis local causes

Trauma (nose picking), septal perf 2/2 cocaine, polyps, infection, angiofibroma of nasopharynx


Epistaxis systemic causes

Infection (malaria, scarlet fever, typhoid), vascular (hereditary hemorrhagic telangiectasia, aortic coarctation), bleeding disorders, overdose of anticoag/antiplatelet medications


Epistaxis initial management

Pinch nostrils against septum and flex head anteriorly. This will stop bleeding originating from Kiesselbach's plexus. If bleeding source is posterior to that, blood will pool up into nasopharynx and get coughed up


What is the only muscle of the pharynx not innervated by CN 10, vagus?

Stylopharyngeus is innervated by CN 12, glossopharyngeal


Possible complications of tonsillectomy

Bleeding is most common. Damage to glossopharyngeal nerve. Damage to internal carotid (runs lateral to the tonsil)


Tonsils picture

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Salivary glands picture

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Parotid tumors

Most common type of salivary gland tumor. Majority of parotid gland tumors are benign. Can affect facial nerve


Most common histologic type of parotid tumor

Pleomorphic adenoma: benign but recurs, rarely undergoes malignant transformation


Oropharyngeal cancer prognosis by location

Best: lips. Worst: hypopharynx


Oropharynx anatomy

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Nasopharyngeal carcinoma

Risk factors: tobacco, EBV association. Bimodal age distribution in teens and 45-55 yo. Radiation therapy is initial treatment for primary nasopharyngeal cancer


Oropharyngeal cancer treatment

Surgery and radiation


Hypopharyngeal cancer treatment

Surgery with postop radiation. Need radical neck dissection because LN mets are frequently not well controlled by radiation alone


Branchial cleft cysts

In children presents as painless lateral neck mass. In adults, more likely to present with infection of cyst. First fistula dissection can injure facial nerve. Second fistula dissection can injure hypoglossal nerve, also adjacent to carotid bifurcation. 

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