ENT Flashcards
What is the top part of the tympanic membrane called?
Pars flaccida
What is the bottom part of the tympanic membrane called?
Pars tensa
Which bone can be seen clearly through the tympanic membrane?
Malleus
Describe the physiology of hearing
Vibrating column of air travel to tympanic membrane
This vibrates and transmits movement to ossicles
Move in a lever action to cause vibration of oval window
Cochlear converts oval window vibrations to electrical signals
CN VIII transmits impulse to cortex
Describe Weber’s test on a conductive ear
Weber’s sound lateralised to the ear with the conductive loss
What condition classically gives a flat tympanometry?
Otitis media with effusion
What is earwax made of?
Keratin and a viscous, oily secretion from the sebaceous glands
What are the most common bacteria to cause otitis externa?
Staph species
Pseudomonas species
What is a furunculosis?
Infection of hair follicle in external ear causing local swelling
Malignant otitis externa can lead to …
Progressive osteomyelitis of temporal bone
When do you suspect a cholesteatoma?
Perforated ear drum plus one of following: Persistent, smelly discharge No improvement with drops Severe hearing loss Dizziness Unexplained neurological signs
What is the definition of otitis media with effusion?
Persistence of fluid in the middle ear for >3 months
Define tinnitus
A noise in the ear or head in the absence of a sound stimulus
What is presbycusis?
Age related hearing loss
Define vertigo
Hallucination of movement produce by an underlying disorder of the vestibular system
What are the motor branches of the facial nerve?
Temporal Zygomatic Buccal Marginal mandibular Cervical
What are the most likely bacterial causes of acute rhinosinusitis?
Strep pneumoniae
H. Influenzae
Moraxella catarrhalis
Give complications of acute rhinosinusitis
Periorbital or orbital cellulitis Cavernous sinus thrombosis Abscess Meningitis Osteomyelitis
What factors can contribute chronic rhinosinusitis?
Allergy or atopy Other airway disease Fungal infection Persistent low grade infection Ciliary dysfunction Immune dysfunction
Describe the fever PAIN score
Used to assess whether the cause of tonsillitis could be bacterial Fever Purulent tonsils Acute hx <3 days Inflamed tonsils No cough
Which antibiotics should you avoid in pharyngeal infections?
Amoxicillin and ampicillin
If glandular fever is suspected avoid because it could lead to a florid rash
What are the long term complications of sleep apnoea?
Hypertension
Increased susceptibility to stroke and cardiac disease
Head and neck cancers are most commonly which type?
Squamous cell carcinoma
What are the risk factors for head and neck cancers?
Tobacco smoking Excess alcohol HPV Smokeless tobacco eg. Beetle nut chewing Poor diet
