General ENT Flashcards by Jack Kilpatrick

Sensory nerve supply to the ext. auditory canal

Auriculotemporal
Greater auricular Branches of the facial nerve

Arnold’s nerve (cough reflex) - branch of the vagus

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What is otosclerosis?

Fixation of the stapes footplate leading to conductive hearing loss

Autosomal dominant
Can be precipiated by pregnancy in those who are genetically predisposed

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What are responsible for detecting head rotation?

Semicircular canals

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What are responsible for head tilting and linear acceleration?

Utricle (horizontal plane)

Saccule (vertical plane)

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Region responsible for detecting linear acceleration

Macula (within utricle and saccule)

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Where does the facial nerve exit the skull?

Stylomastoid foramen

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Functions of the nose

Olfaction
Humidify/ Warms inspired air
Filtration of particulate matter
Mucus production
Pheremone detection via the organ of Jacobsen
alveolar collapse prevention via nasal cycle

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Blood supply of the nose

Superior labial artery (E)
Greater palatine artery (E)
Sphenopalatine artery (E)
Posterior ethmoidal (I)
Anterior ethmoidal (I)

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Innervation of the anterior 2/3 of tongue

SENSORY = Mandibular division of V via the lingual nerve

- TASTE = Chorda Tympani

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Innervation of the posterior 1/3 of the tongue

Superior laryngeal / glossopharyngeal

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Motor innervation of the tongue

All internal and external muscles innervated by hypoglossal

Excluding palatoglossus (pharyngeal plexus)

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Tongue deviation in hypoglossal nerve palsy

Towards the side of weakness

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What is Ludwig’s angina?

Abscess that form on the floor of the mouth due to a dental root infection

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Motor supply of the pharynx

Pharyngeal plexus

Stylopharyngeus - IX

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Site of Zenker’s diverticulum

Killian’s triangle - between thyropharyngeus and cricopharyngeus

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Complications of eustachian tube blockage

Middle ear effusion

Unilateral maybe caused by nasopharyngeal carcinoma (fossa of Rosenmuller)

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Parotid

Type of saliva, duct draiange

Serous saliva

Stenson’s duct

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Submandibular gland

Type of saliva, duct drainage

Mixed serous/mucus saliva
Wharton’s Duct

Forms majority of saliva production at rest

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Sublingual duct

Type of saliva, drainage

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Mucous saliva

submandibular duct and sublingual fold in the floor of the cavity

Level 1 lymph

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Submental and submandibular triangles

Bounded my midline, digastric and the mandible

Level 2 lymph

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Anterior triangle, inc SCM, from skull base to inferior border of hyoid

Level 3 lymph

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Anterior triangle, inc SCM, from inferior hyoid to inferior cricoid

Level 4 lymph

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Anterior triangle, inc SCM, inferior border of cricoid to superior border of clavicle

Level 5 lymph

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Posterior triangle`

Level 6 lymph

Paratracheal lymph nodes medial to the carotid

What does a Rinne's positive test mean?

AC > BC | Normal hearing / Sensorineural loss on opposite side

What does a Rinne's negative test mean?

BC > AC | Conductive hearing loss

Features of peritonsillar abscess (Quinsy)

``` Previous tonsillitis Sore throat Difficulty swallowing Trismus Uvula deviation ``` Requires IV Abx and drainage

What is chronic rhinosinusitis?

Inflammatory disorder of the paranasal sinuses and linings of the nasal passages that lasts 12 weeks or longer

Features of chronic rhinosinusitis?

facial pain: typically frontal pressure pain which is worse on bending forward nasal discharge: usually clear if allergic or vasomotor. Thicker, purulent discharge suggests secondary infection nasal obstruction: e.g. 'mouth breathing' post-nasal drip: may produce chronic cough

Most common site for SCC?

Oropharynx

Virus associated with Tonsillar SCC

HPV 16 & 18

HIV increases risk of which malignancies most commonly?

``` Kaposi sarcoma (HHV-8) Non-Hodgkin lymphoma ```

EBV associated head and neck malignancies

Nasopharyngeal in nature | Lymphoma

Treatment for poor response to Abx in otitis externa

Refer to ENT Gentle micro-suction of the ear Commence IV antibiotics Continue topical drops with insertion of an aural wick

Presentation of viral labyrinthitis

Sudden vertigo Nystagmus Hearing can be affected Viral infection often precedes its presentation

Treatment of spontaneous sensorineural hearing loss

High dose coticosteroids

When is myringoplasy performed?

Failed spontaneous healing of perforated tympanic membrane | Usually heals within 6-8 weeks

How do you differentiate between neuronitis ans labyrinthitis?

Neuronitis = unafected hhearing

Which drugs can cause gingival hyperplasia?

Phenytoin CCBs (Nifedipine) Cyclosporin

What is double sickening?

initial period of recovery followed by a sudden worsening of symptoms Thought to be caused by a secondary bacterial infection following viral rhinosinusitis Associated with bacterial sinusitis

Cranial nerves affected by acoustic neuroma

V: Absent corneal reflex VII: Facial palsy VIII: Vertigo, unilateral hearing loss and tinnitus

What is a cystic hygroma?

Congenital lymphatic lesion (lymphangioma) typically found in the neck, classically on the left side Most are evident at birth, around 90% present before 2 years of age

What is a branchial cyst?

An oval, mobile cystic mass Develops between the SCM and the pharynx Usually present in early adulthood Develop due to failure of obliteration of the second branchial cleft in embryonic development

Criteria for diagnosing chronic rhinosinusitis

Twelve weeks or longer of two or more of the following signs and symptoms: * mucopurulent drainage (anterior, posterior, or both), * nasal obstruction (congestion), * facial pain-pressure-fullness, or * decreased sense of smell AND inflammation is documented by one or more of the following findings: • purulent (not clear) mucus or edema in the middle meatus or anterior ethmoid region, • polyps in nasal cavity or the middle meatus, and/or • radiographic imaging showing inflammation of the paranasal sinuses

General ENT Flashcards

(45 cards)