HEENT pt. 2 Flashcards Preview

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Flashcards in HEENT pt. 2 Deck (42):
1

Radiopaque

describes density
prevents X-rays from passing through freely
Higher atomic numbers
white shadow

2

radiolucent

density
X-rays pass freely
small atomic numbers
dark shadow

3

mandibular series

PA view
lateral
towns
bilateral oblique

4

Panorex

one plane

5

PA view (posterior anterior)

entire mandible
symphysis is obscured by spine
condyles are superimposed against mastoid or occ. bones
BEAM SHOOTS POSTERIOR TO ANTERIOR

6

away from the film

less white

7

toward the film

more white

8

Towns view

bone overlap is common
used to evaluate condyles

9

Oblique views

mandibular groove best seen

10

waters view

occipitomental view

11

basal view

submentovertex view

12

considerations: 1st, 2nd, 3rd

1st: evaluate the adequacy if the films
2nd: trace all cortical margins and evaluate for discrepancy
3rd: if one fracture is present, look for more!
"ring bone rule"

13

if the condyles are injured or broken then what else could be?

symphysis

14

if the angle of the mandible is broken or injured then what else could be broken ?

contralateral body or condyle

15

Facial series

caldwell view - chin down
waters view - chin up
submental vertex (basal) - through sub mental area
lateral view - lateral

16

lines of dolan

if they are misaligned then it indicate a fracture
1 = base of orbit
2 = lateral part of orbit
3 = superior part of maxillary

17

what is the best view for imaging the nasal bones?

lateral

18

Direct signs of facial fracture

nonanatomic linear lucency's
cortical defect
bone fragments overlapping - more white
asymmetry of face

19

Indirect signs of facial fracture

soft tissue swelling
periorbital or intracranial air
fluid in a sinus - fracture of orbit bone

20

whats the most common fracture of the face?

nasal bone

21

Computed Tomography

uses a computer to reconstruct cross-sectional imaging

22

CT - IV contrast

enhances the density differences between lesions and surrounding parenchyma (tumor in the lung use contrast and abscess in throat)
Vascular anatomy

23

CT - Oral/Rectal contrast

given to opacify bowel
LOOKING FOR A PIECE OF SHITTT!
stones will light up on their own w/o contrast so using contrast could hide them

24

Ct is good for what parts of the afce?

sinuses and soft tissue

25

Xray sinus

waters view

26

Indications for CT of sinuses

persistent sinusitis
recurrent sinusitis
intraorbital or intracranial spread of infection

27

Indications for CT of facial bones and mandible

complex facial fractures
trauma
benign films

28

why is a CT the gold standard over an Xray for the face?

Xray miss a lot of facial fractures because of overlapping

29

Le Fort I

floating palate

30

Le Fort II

pyramidal

31

Le Fort III

craniofacial dysfunction

32

CT orbit is best seen when using?

CT (coronal view)
WithOUT contrast

33

Retropharyngeal abscess location?

anterior to C3, >3mm (increased in crying children)

34

Epiglottitis best seen with what view?

soft tissue lateral
(88-100% sensitive)
(96% specific)

35

what is it called when the epiglottis looks swollen and enlarged?

thumb print sign
(aryepiglottic folds are thickened and Vallecula is thickened)

36

Croup virus?

RSV

37

Croup will show what on the Xray?

distended hypo pharynx and laryngeal vesicle
HAZINESS OR NARROWING OF SUBGLOTTIC SPACE
NARROWING TRACHEA = STEEPLE SIGN
(93& sensitive)
(92% specific)

38

Narrowing of the airway (subglottic larynx)

Steeple Sign

39

Indications for CT of soft tissue neck

W/ contrast: mass, swelling, adenopathy
W/O contrast: no helpful
W/ & W/O contrast: salivary stones / ducts

40

what is the pre test for CT

creatinine if contrast is to be used cause the kidney does not like the contrast dye and can cause renal failure

41

Peritonsilar abscess (seen with CT of the neck)

W/ contrast - pus that lies between the tonsillar capsule and superior pharyngeal constrictor muscle
(75% specific)
(100% sensitive)
rim enhancing fluid collection within an enlarged and inflamed tonsil

42

what is the gold standard for visualizing a retropharyngeal abscess?

CT, W/ contrast
(90% sensitive)
fat planes obliterated
enhanced by ring