ENT Flashcards
(86 cards)
1
Q
which is more common syndromic or non syndromic hearing loss
A
non syndromic is 70% of congenital hearing loss cases. Its due to genetic mutations of connexin genes found on ch13 (SNHL)
2
Q
timing of hearing loss
A
antenatal, perinatal, postnatal
3
Q
is congenital hearing loss more genetic or not
A
genetic
4
Q
syndromic HL is associated with 5 syndromes
A
- usher syndrome (+retinitis pigmentosa)
- pendred syndrome (+goiter)
- alport syndrome (+nephropathy/keratoconus)
- treacher collins (+misformed features)
- jervell and lange neilson syndrome (+cardiac arrythmia-long QT)
5
Q
speaking ages
A
- preverbal (<1yr)
- periverbal (1-3yr)
- postverbal (>3yr)
6
Q
SNHL is related to what genes
A
AR-CONNEXIN 26 (GJB2)
GJB6-CONNEXIN 30
AD-CONNEXIN 31
7
Q
severe HL and deep HL
A
severe>75-95 dB
deep >95 dB
8
Q
when do adenoids start to decrease in size
A
beyond 7 years
9
Q
TM athelectasis is
A
retraction of TM
10
Q
complications of AOM
A
mastoiditis, meningitis, petrositis, VII defect, cerebral abscess, sigmoid sinus thrombosis
11
Q
contrast viral and bacterial acute pharyngotonsillitis
A
viral (65% of cases): tonsil inflammation+low fever(<38) for a few days+non productive cough
bacterial (30% of cases): tonsil inflammation+high fever for >4 days+exudate+uvulitis+no cough
12
Q
symptoms of rhinosinusitis
A
chronic cough for more than 4 weeks+rhinorrhea+nasal congestion+post nasal drip+facial pain
13
Q
otoacoustic emission tests for
A
cochlear functioning
14
Q
when does the E tube acquire adult conformation
A
after 7 years old
15
Q
frontal and sphenoidal sinuses achieve pneumatization when?
A
9-13 years old
16
Q
conductive hearing loss levels
A
30-40 dB
17
Q
bugs causing AOM
A
m. catarrhalis
S. pneumonia
H.influenza
S. pyogenes
18
Q
treatment of pharyngotonsillitis
A
first symptomatic treatment. If fever lasts more then 4 dyas start antibiotics (amoxicillin)
19
Q
neck masses in kids
A
- HL or NHL
- branchial cyst infection
- thyroglossal duct cysts
- ectopic thyroid
- plunging ranula
20
Q
otohematoma is
A
cauliflower ear
21
Q
ramsay hunt syndrome
A
reactivation of herpes zoster oticus along VII/VIII near geniculate ganglion.
22
Q
exostosis
A
bilateral multiple bony growths in EAC. can be due to periostitis due to cold water
23
Q
osteoma
A
benign unilateral neoplasm of bony EAC. Has narrow base of implant
24
Q
differentiate a transverse from a medial temporal fracture
A
medial (longitudinal) has secretion in EAC.
transverse can affect TMJ and mastoid
25
furunculosis is? Therapy is?
a localised pustular folliculitis due to staph aureus. Treat with antibiotics
26
otomycosis is most often due to
aspergillus and candida
27
external ear imaging
CT no contrast
| MRI contrast
28
EAC bony vs fibrocartilagenous. E. tube bony vs cartilage?
EAC: cartilage 1/3+bony 2/3
| E tube: cartilage 2/3+bony 1/3
29
cough reflex
stimulation of auricular branch of vagus
30
cholesteatoma is
s an abnormal skin growth that can develop in the middle ear. It usually begins as a collection of dead skin cells and develops into a cyst-like pocket behind the eardrum. It can significantly impair a person’s hearing and balance, as well as the function of their facial muscles.
31
the middle ear is divided into 3 parts
epitympanim, mesotympanum, hypotympanum
32
jacobson nerve
is in hypotympanum, is IX, eventually enters otic ganglion
33
bullous myringitis
small fluid filled blisters form on the eardrum. Are painful
34
stages of AOM
hyperemia, exudation, suppuration, resolution
35
COM can be
cholestetomatous (rarely)(is keratinizing squamous epithelial growths. Presents as recurrent otorrhea, hypoacusia, VII palsy, vertigo))
non-cholesteatomatous (can be active suppuration or dry NO PAIN)
36
what is meningoencephalic herniation
bone defect or erosion that results in herniation of meningeal wall and so encephalic tissue (a pulsating mass) goes into middle ear
37
glomus tympanicus tumors
vascular mass of epitheliod cells in jugular bulb. Pulsating reddish blue mass present in low TM. Treat with surgery
38
sound greater than x dB damages the cochlea
85 dB
39
pure tone vs speech audiometry
pure tone is beeps, speech is words
40
tympanometry does what
measures pressure at middle ear with varying acoustic impedence (tests mobility of eardrum and conduction of ossicles - NOT A HEARING TEST)
41
define presbyacusis
age related loss of hair cells in inner ear
42
treatment of sudden SNHL
steroids, antivirals, neurotrophic agents (VB), anticoagulants, hyperbaric O2 therapy
43
duct of parotid gland. What does the parotid house?
stensons (2nd maxillary molar). The retromandibular vein, ECA, VII CN
44
submandibular duct is
whartons duct (sublingual caruncle position)
45
PNS to all salivary glands is via
VII and V2/V3
46
Parotid gets PNS via
IX and V3
47
all salivary glands above oral fissure (parotid) are innervated by
greater petrosal nerve from VII
48
all salivary glands below the oral fissure are innervated by
chorda tympani
49
chronic sialadenitis is
chronic inflammation of salivary glands
50
what is the most common salivary tumor
pleomorphic adenoma of the parotid
51
warthins tumors is
monomorphic adenoma of parotid gland
52
where does the thyroid originate from
foramen cecum
53
elevated serum calcitonin means you should suspect
thyroid medullary carcinoma
54
halsted and evans anastomosis is for
parathyroid gland. its from superior and inferior thyroid arteries
55
in what 3 cases would you perform a thyroidectomy
- pathology not contolled by medication
- airway obstruction
- malignancy
56
explain thyroid vascularization
arteries: ECA--> SUP. THYROID A--> ANT GLANDULAR A & POST GLANDULAR A.
SUBCLAVIAN a--> THYROCERVICAL TRUNK--> INF THYROID A & ASCENDING CERVICAL A
venous: SUP & MID & INF THYROID VEINS
57
tirage
sign of bronchial obstruction showing at inspiration on soft chest walls
58
cornage
loud laryngotracheal murmur heard during inspiration
59
in what scenarios would you consider doing a tracheotomy
- upper airway obstruction
- pulmonary secretion
- mechanical ventilation
- prevent glottic stenosis/complications
60
what is ludwigs angina? How do you treat?
Ludwig 's angina , also known as submandibular space infection , is an infection that leads to the rapid death of cells under the mouth. Doesn't usually happen nowadays thanks to antibiotics, but if it did perform tracheotomy
61
superfical/deep neck abscesses are most commonly due to
dental infections
62
bells palsy, most associated to VII peripheral palsy presents as
- drooping eyelid
- cannot wrinkle forehead
- paralysis of lower face (more for central VII palsy)
63
nose cartilages
are hyaline; septum, ala (sesamoid complex), lateral cartilages
64
vasculature of the nose, innervation of nose
A: supratrochlear A from occipital A from ICA
V: angular V to Sup labial V to facial V
N: VII (temporal/zygomatic/buccal)
V1 (supratrochlear) V2 (infraorbital)
65
nasal turbinate comes from which bone
ethmoid
66
roof of the nose
olfactory cleft, ethmoid bone (cribiform plate), orbital part of frontal bone
67
modern therapy for paranasal sinus drainage?
enlarge natural ostea
68
boundaries of maxillary sinus
floor of orbital cavity
- post: ITF
- inf: PPF
69
frontal sinus boundaries
is connected to the nose via ethmoid bone
70
borders of sphenoid sinus
-sup: anterior cranial fossa
-post: sella turcica/middle cranial fossa/post cranial fossa through clivus.
THE OPTIC NERVE/PITUITARY (MEDIAL)/INTERNAL CAROTID (LATERAL) PASS HERE
71
tell me about the vidian nerve and what structure its for
```
VII--> great petrosal N
+
Sympathetic chain--> deep petrosal N
= vidian nerve goes to PPG
for autonomic control of nose
```
72
anterior paranasal sinuses are
frontal, maxillary, anterior ethmoid (drain into nose via osteom to middle meatus)
73
posterior paranasal sinuses are
sphenoid, posterior ethmoid (drain into nose via sphenoethmoid recess)
74
kiesselbach plexus is for
the nose arteries
75
fungal RHS types and subtypes
fungal can be invasive (acute(IC)/chronic(IC)/granulomatous) or non invasive (saphrophytic colonization/fungal ball/eosinophilic related)
76
complications of RHS
orbital (cellulitis)
bony (poffy tumor)
intracranial (meningitis)
mucoceles (epithelium lined sac fills the paranasal space and causes remodling. if bacteriainfects it it become mucopyocele. often in fronto ethmoid region)
77
what is osteoma? where is it most often? Imaging finding?
- benign osteoblastic growth
- in frontal sinus
- ivory (hard bone)--> mixed--> spongiosum (mature)
78
inverted papilloma is ? Most often in?
benign tumor of skin. Shows as focal hyperostosis (bony strut) can be with SCC
most common in maxilary/nasoethmoid/frontal/sphenoid sinus
79
juvenile angiofibroma? D.d with what?
occurs in teen males. blood supply from internal maxillary and sphenopalatine. Point of origin is PPF.
D.D. with lobular capillary hemangioma: kids/teen males. due to injury/hormones.
D.D. with hemangiopericytoma: in old females. site of origin is nasal cavity
80
wood and leather dust lead to? Nikel and radium lead to?
- ADC
| - SCC
81
trismus is
lock jaw
82
most common midline lesions
- cocaine induced
- granulomatous with polyangitis (wegener)
- eosinophilic with polyangitis (churgg strauss)
- NK/T lymphoma
83
what is affected most often with CIML
inferior turbinate
84
3 phases of churgg strauss
- prodromic: allergic rhinitis/polyps/asthma/cutaneous lesions
- eosinophilic: gastroenteritis
- vasculitic: multiorgan involvement LOOK AT PHOTO OF TABLE FOR ANCA/MPO
85
Most common site of oral cancer
tongue
86
does PPv have hearing loss?
no
