ENT

Question 1

What is the function of the eustachian tube?

Answer 1

Connects the middle ear and the nasopharynx
Equalises pressure between the middle ear and the atmosphere
Also drains mucus from the middle ear

Question 2

Which cranial nerve supplies the tongue with the majority of motor function?

Answer 2

Hypoglossal nerve (CN12, XII)

Question 3

What supplies motor function to the palatoglossus?

Answer 3

Vagus nerve (CN10, X)

Question 4

What is the main role of palatoglossus?

Answer 4

Initiating swallowing

Also elevates the posterior tongue

Question 5

Which cranial nerve supplies taste and sensation to the posterior 1/3 of the tongue?

Answer 5

Glossopharyngeal (CN9, IX)

Question 6

Which cranial nerve supplies taste to the anterior 2/3 of the tongue?

Answer 6

Chorda tympani branch of the facial nerve (CN7, VII)

Question 7

Which cranial nerve supplies sensation to the anterior 2/3 of the tongue?

Answer 7

Lingual branch of the trigeminal nerve (CN5, V)

Question 8

Which direction does the cone of light point when looking at the tympanic membrane?

Answer 8

Anteroinferiorly

Question 9

Absence of the light reflex in the ear could be a sign of?

Answer 9

Could be normal

Or increased pressure within the inner ear (e.g. otitis media)

Question 10

Which cranial nerve innervates the tensor tympani?

Answer 10

Trigeminal nerve (CN5, V)
Remember TTT
(Medial pterygoid, branch of mandibular nerve, V₃)

Question 11

What is a cholesteatoma?

Answer 11

Accumulation of keratinising squamous epithelial cells

Question 12

What makes up the lateral 1/3 of the external ear canal?

Answer 12

Skin and cartilage, contains sebaceous and ceruminous glands (produces wax) and hairs

Question 13

What makes up the medial 2/3 of the external ear?

Answer 13

Skin and bone, no hairs and no wax

Question 14

Where does skin of the external ear canal grow from?

Answer 14

The umbo of the tympanic membrane, outwards

Question 15

What are the 3 layers of the tympanic membrane?

Answer 15

Outer, continuous with skin of the EAC
Middle, fibrous layer
Inner, respiratory epithelium (ciliated columnar epithelium with goblet cells)

Question 16

What conducts sound waves from the tympanic membrane to the inner ear?

Answer 16

Ossicles, much more important in sound conduction than the tympanic membrane

Question 17

What three bones make up the ossicles?

Answer 17

Malleus
Incus
Stapes

Question 18

What lines the middle ear?

Answer 18

Same continuous respiratory epithelium that forms the inner layer of the tympanic membrane

Question 19

What does the facial nerve supply?

Answer 19

Motor to muscles of facial expression

Taste to anterior 2/3 of the tongue (via chorda tympani)

Question 20

What complications can arise from cholesteatoma?

Answer 20

They grow and are destructive. Can cause damage to the bony ossicles

Question 21

What are the semicircular canals responsible for?

Answer 21

Detecting head rotation

Question 22

What is the saccule responsible for?

Answer 22

Detecting linear acceleration in the vertical plane

Question 23

What is the utricle responsible for?

Answer 23

Detecting linear acceleration in the horizontal plane

Question 24

What can cause otitis media with effusion?

Answer 24

Chronic dysfunction of the eustachian tube, relative negative pressure in the middle ear and retraction of the tympanic membrane

Question 25

What two tuning fork tests are there?

Answer 25

Weber's - tests lateralisation | Rinnie - compares air/bone conduction

Question 26

What are the different types of audiometry?

Answer 26

``` Pure tone audiometry Visual reinforcement audiometry (6mth-3yrs) Play audiometry (3-6yrs) ```

Question 27

What is presbycusis?

Answer 27

Most common type of Sensorineural Hearing Loss Natural aging Occurs gradually and starts with loss of higher frequencies

Question 28

What is tympanometry?

Answer 28

Air forced into the air canal to make the eardrum move Measures the mobility of the eardrum Can help detect fluid, perforation or blockage

Question 29

Management of hearing loss?

Answer 29

Sound amplification Direct stimulus of cochlear nerve cells Surgery of outer and middle ear

Question 30

What types of hearing aid are there?

Answer 30

``` Open fit Bone anchored (BAHA) ```

Question 31

What conditions of the inner ear can affect balance?

Answer 31

Benign paroxysmal positional vertigo Vestibular neuritis Meniere's disease

Question 32

What common clinical condition can also affect balance?

Answer 32

Migraine

Question 33

How can you treat otitis media with effusion (glue ear)?

Answer 33

Hearing aids or grommets | Most improve within 3 months on their own

Question 34

Why are children more prone to ear infections than adults?

Answer 34

Eustachian tube is flat in children, easier for bacteria to get into the ear 45 degree angle in adults. Also adenoidal hypertrophy

Question 35

What can cause painful/discharging ears?

Answer 35

Otitis externa Acute otitis media Chronic otitis media Cholesteatoma

Question 36

How would you treat otitis externa?

Answer 36

Topical antibiotics | Water precautions

Question 37

How would you treat otitis media?

Answer 37

Antibiotics (co-amoxiclav) | Grommets and adenoidectomy if chronic

Question 38

When would you suspect cholesteatoma?

Answer 38

Hearing loss despite grommets | Chronic discharging ear

Question 39

What counts as a normal number of URTI episodes in children?

Answer 39

8 episodes per year up to 15 days

Question 40

What is epistaxis?

Answer 40

Nosebleed

Question 41

Epistaxis management?

Answer 41

First aid, pinch top of nose and tilt head forwards | Cauterisation if chronic

Question 42

Tonsillitis?

Answer 42

Bacterial or viral Risk of glomerulonephritis, peritonsillar abscess Treat with antibiotics if bacterial

Question 43

History of a child with airway problems?

Answer 43

``` Emergency History of foreign body Recent illness Feeding problems Stridor ```