ENT notes Flashcards
(103 cards)
1
Q
What is the thinnest part of the skull
A
Pterion
2
Q
Which bones make up the pterion
A
Temporal, Sphenoid, Frontal, Parietal
3
Q
Anterior cranial fossa bones
A
Frontal
Ethmoid
Sphenoid
4
Q
Middle cranial fossa bones
A
Sphenoid
Temporal
5
Q
Posterior cranial fossa bones
A
Temporal
Occipital
6
Q
Innervation of superior EAM
A
CN V3
7
Q
Innervation of inferior EAM
A
CN X
8
Q
How does the avascular elastic cartilage of the ear acquire nutrients
A
From skin
9
Q
Does the pars tensa sit inferiorly or superiorly
A
Posteroinferiorly
10
Q
What supplies the tympanic membrane (external and internal surfaces)
A
External - CN V3 (auriculotemporal branch)
Internal - CN IX
11
Q
What is the stapedius
A
Muscle which reduces stapes movement
Protects inner ear from excessive noise
12
Q
What type of tissue is present in the middle ear
A
Columnar-lined mucosa
13
Q
What type of tissue is present in the nasal vestibule
A
Squamous
14
Q
What is Schneiderian epithelium and where is it present
A
Pseudostratified ciliated columnar
(respiratory epithelium)
Nose & sinus
15
Q
Which cells in the salivary glands contain digestive amylase
A
Serous cells
16
Q
Which cells in the salivary glands are contractile
A
Peripheral myoepithelial cells
17
Q
How does a cholesteatoma usually arise
A
Chronic otitis media with a perforated tympanic membrane
18
Q
Which gene is mutated in NF type 2 and which protein does it code for
A
NF 2 gene
Merlin protein
19
Q
What should you include in your Ddx if a young person has nasal polyps
A
Cystic Fibrosis
20
Q
Which GI disease can cause a contact ulcer in the throat
A
GORD
21
Q
What is paramyxovirus of the salivary glands
A
Mumps + Bilateral parotitis
With associated orchitis
22
Q
What is the most common salivary gland tumour and how does it present
A
Pleomorphic adenoma
Usually in females over 60 in the parotid gland
23
Q
What is the 2nd most common salivary gland tumour(associated with smoking) and how does it present
A
Warthin’s tumour
usually in males over 50 (bilateral and multicentric)
24
Q
What is the most common malignant tumour of the salivary glands in the UK and the world
A
Adenoid Cystic Carcinoma - UK
Mucoepidermoid carcinoma - World
25
Which amino acid in particular triggers an umami/meaty/savoury taste
Glutamate
26
What kind of deficiency can cause Dysguesia (altered taste)
Zinc deficiency
27
Which cell type in the olfactory mucosa secrete mucus
Basal cells
28
Which brain surface are the olfactory bulbs on
Inferior brain surface
29
Name the 4 components of the Centor score
Tonsillar exudate
Fever
Tender anterior cervical lymphadenopathy
The absence of a cough
30
What is the most common cause of bacterial tonsilitis
Strep. Pyogenes
31
What are 2 late complications of bacterial tonsilitis
Rheumatic fever
| Glomerulonephritis
32
What antibiotic is first line for the treatment of otitis media
Amoxicillin
| Clarithromycin if allergic (2nd line - erythromycin)
33
What antibiotic is first line for the treatment of bacterial sinusitis
Penicillin V
| Doxycycline if allergic (not in children)
34
Name 4 complications of Infectious Mononucleosis
Splenic rupture
Increased risk of lymphoma
Airway obstruction
Anaemia
35
Where does necrosis in the brain occur, with regards to untreated herpes simplex encephalitis
Temporal lobe necrosis
36
What is the range of human hearing
20- 20,000Hz
37
What is the ratio and pressure gain between the tympanic membrane and oval window
18: 1
| Pressure gain of x22
38
What are the 4 inputs to regulate balance
Visual
Proprioceptive
Cardiovascular
Vestibular
39
What are the 5 key vestibular end-organs
```
Macula of Utricle
Macula of Saccule
Ampulla of Lateral Semi-Circular Canal
Ampulla of Superior Semi-Circular Canal
Ampulla of Posterior Semi-Circular Canal
```
40
What is the name of the special calcium carbonate crystals on the ends of the stereocilia in the otolith organs
Otoconia
41
Which salivary gland secretes 90% of the saliva
Parotid
42
Which major artery is the lingual artery a branch of
External carotid
43
Name the 5 muscles of the soft palate
```
Tensor Veli Palatini
Levator Veli Palatini
Palatoglossus
Palatopharyngeus
Musculus Uvulae
```
44
What is the medical term for the Adam's apple
The laryngeal prominence of the thyroid cartilage
45
What are the attachments of the true vocal cords
Vocal process of arytenoid to thyroid cartilage
46
What are the attachments of the false vocal cords
Arytenoid cartilage to the epiglottis
47
What does the quadrangular membrane connect
Vestibular ligament & epiglottis
48
What does the vocal ligament connect
Vocal process & thyroid
49
What does the conus elasticus connect
Cricoid and vocal ligament
50
What is the Hippocratic method and what is it used for
The position adopted for epistaxis
| Squeeze nose low and lean forward
51
What is pinna haematoma
Sub-perichondral haematoma
52
What does a 'proper' penetrating neck injury mean
An injury which penetrates the Platysma muscle
53
How many Hz is the tuning fork used in Rinne's and Weber test
512Hz
54
How can you differentiate between CSF and other discharge from the ear
Glucose testing strip
55
What is the name of the classification system used for retraction of the tympanic membrane
The Sade classification
56
What is the immediate management of Otitis Externa to provide symptomatic relief
Suction Cleaning
57
Compare the biochemistry of the Perilymph and the Endolymph in terms of Na & K concentrations, and explain why this is
Endolymph has low [Na] and high [K]
| These concentrations drive the vibrations and allow depolarisation via Na influx
58
What is the name of the special membrane which covers the organ of Corti
Basilar Membrane
59
How do you test the vestibulo-ocular reflex
VNG
| Videonystagmography
60
How do you differentiate between BPPV & Vertebrobasilar insufficiency
Vertebrobasilar insufficiency presents with other symptoms apart from vertigo e.g visual disturbances, weakness, numbness
61
Name 3 treatments for BPPV
Epley Manoeuvre (main one)
Semont Manoeuvre
Brandt- Daroff exercises
62
What can Buccal Prochlorperazine be given for and why
Vestibular neuronitis
Labyrinthitis
(given to decrease vertigo
63
Which disease out of vestibular neuronitis and labyrinthitis has associated tinnitus & hearing loss
Labyrinthitis
64
What is phonophobia
Fear of loud sounds
65
Which head and neck cancer is hardwood associated with
Sinus cancer
66
What structures does the recurrent laryngeal nerve wrap around on the right and left
Right - right subclavian artery
| Left - arch of aorta
67
What is the difference between dysphagia and odynophagia
Dysphagia - difficulty swallow
| Odynophagia - pain on swallowing
68
What are gabapentin and pregabalin normally used for
Anit-Convulsants
69
What 2 pro-inflammatory molecules do mast cells release when activated
Histamine
| Leukotrienes
70
Name a nasal decongestant drug
Pseudoephedrine
71
Name an anti-histamine drug
Cetirizine
72
According to the ARIA classification, how is intermittent rhinitis defined
Symptoms < 4 days/week
| OR symptoms < 4 weeks
73
According to the ARIA classification, how is persistent rhinitis defined
Symptoms > 4 days/week
| AND symptoms > 4 weeks duration
74
What is the treatment ladder for allergic rhinitis (including the background continuous management)
Anti-histamine
Topical steroid
Anti-histamine + Topical steroid
(Allergen avoidance constant)
75
What is Samter's triad
Asthma, Nasal Polyps, Aspirin sensitivity
76
What is the purpose of giving a topical cholinergic drug in non-infective rhinitis
Supresses rhinorrhoea
77
What are the differentials from a presentation of unilateral nasal discharge and what is the next step
Foreign Body or Neoplasia
| Refer urgently
78
Which tonsils make up Waldeyer's ring of lymphoid tissue
Palatine tonsils
Adenoid tonsils
Lingual tonsils
79
Which tonsils have a transitional layer and what is the function of it
Adenoid tonsils
| Antigen processing layer
80
Which tonsils have stratified squamous epithelium on its luminal surface
Palatine tonsils
81
What kind of epithelium is present on the surface of the adenoid tonsils
Ciliated pseudostratified columnar
82
What two things will be seen in the blood which could aid in the diagnosis of Infectious Mononucleosis
Low CRP
| Atypical lymphocytes
83
When should you refer otitis media with effusion
Persistent >3 months
Bilateral
Speech/ language problems
Developmental delay
84
What would a mass found in the tail of the parotid gland make you think of
Pleomorphic adenoma
85
How can a cholesteatoma cause hearing loss and vertigo
A large enough one can invade the otic capsule
86
Which systemic autoimmune disease could cause bilateral parotid gland swelling and facial nerve palsies
Sarcoidosis
87
What would halitosis + a painless neck mass make you think of
Pharyngeal pouch
88
Which abnormality is fixed using the Sistrunk procedure
Thyroglossal cyst
89
Which growth has a typically biphasic growth on histology and why is this
Pleomorphic adenoma
| due to stromal & epithelial elements
90
What is a side effect of using topical decongestants for a prolonged period
Tachyphylaxis
| Greater doses are needed to produce the same effect
91
What should you do on the first presentation of a perforated eardrum
Watch and wait for 6 weeks
92
What can be given for acute attacks of Meniere's
Buccal or IM Prochlorperazine
93
What can be given for prevention of Meniere's
Betahistine
94
What test will be positive for Meniere's and BPPV respectively
Meniere's --> Romberg
| BPPV --> Dix-Hallpike
95
What are crista galli
A special feature of cribriform plate of ethmoid
96
What makes up the nasal septum
Perpendicular plate of ethmoid
97
Which bones make up the medial wall of the nasal septum
Ethmoid and Vomer
98
What are vibrissae and where are they found
Small hairs found in the stratified keratinised epithelium in the nasal vestibule
Filter the air we breathe in
99
What is a microscopic feature of vestibular schwannomas
Verocay bodies
100
Describe the 2 ends of an olfactory neurone
Thick short dendrite and expanded olfactory rod
101
What causes oral thrush and what is the treatment
Candida Albicans
| Topical Nystatin suspension
102
What is the causative organism of herpangina
Coxsackie
103
What is thought to be the pathology of Meniere's
Membrane separating perilymph and endolymph tears, resulting in mixing of the two fluids
