Laryngology Flashcards
(35 cards)
What is the only laryngeal aBductor?
Posterior cricoiarytenoid (PCA)
What muscle makes up the vocal FOLD body (vocalis)
Thyroarytenoid - deep to vocal ligament!
Vocal cord layers from superficial to deep?
Squamous epithelium, superficial lamina propria, vocal ligament (intermediate and deep lamina propria), thyroarytenoid
Components of stroboscopy grading (7)?
Mucosal wave, vibration, vertical phase, phase symmetry, regularity, adynamic segments, closure.
What is jitter and shimmer?
Jitter: Cycle to cycle variation in pitch/frequency
Shimmer: Cycle to cycle variatoin in amplitude
What are the components of the GRBAS scale?
Grade (overall severity)), Roughness, Breathiness, Asthenia, Strain
What hormone reduces LES pressure?
Glucagon
What is released by chief cells in the stomach and can cause refractory GERD?
Pepsin
What are the principle aDductors of the vocal cords?
Lateral cricoarytenoids (adduct and internally rotate arytenoid cartilage) and thyroarytenoid
What muscle is this and what is it innervated by?
Cricoarytenoid - External branch of superior laryngeal nerve
Which laser is preferred for respiratory papillomatosis?
-CO2 laser is main stay (and consider intralesional Cidofovir or Bevacizumab)
-BUT consider KTP laser for recurrent cases (less thermal damage to surrounding tissues)
Features of relapsing polychondritis?
Autoantibodies against type II collagen
Often have laryngeal dysfunction (cricoarytenoid joint especially affected) –> Hoarse, pain, cough, obstruction
Other sites: ears, nose, joints
Diagnosis: Clinical
TX: Steroids, immunomodulators
Site of:
Zenker’s Diverticulum
Killian-Jameson Diverticulum
Laimer Diverticulum?
Zenker: Between inferior constrictor and cricopharyngeas (Killian’s triangle)
Killian-Jameson: Between Oblique and Transverse cricopharyngeas fibers
Laimer: Between Cricopharyngeus and superior esophageal wall circular muscles
Esophageal Achalasia Features?
Degeneration of Aurbach’s plexus, failure of LES to relax
Bird’s beak on esophagram
TX: Botox or myotomy, can consider CCBs or nitrates to decrease LES pressure too.
CREST Syndrome (+ esophagram features)
Calcinosis, Raynaud’s, esophgeal dismotility, sclerodactyly, telangiectasia
Esophagram: dilated DISTAL esophagus, normal UES and LES
TX: Reflux regimen, CCBs (for Reynaud’s), can consider steroids
Diffuse esophageal spasm features?
Hih pressure non paristaltic contractions
Corkscrew esophaagus
Manometry: disorganized contractions
TX: Nitrates, Ca Channel Blockers
What histopath changes occur to vocal cords as they age?
INCREASE in collagen I and III,
DECREASE in Elastin
(i.e. VC stiffen with age)
What is laser an acronym for?
Light Amplification by Stimulated Emission of Radiation
Action of the cricothyroid muscle?
Increases length and tension of the vocal cord. Innervated by external branch of SLN.
Failure of what pharyngeal arch leads to a non recurrent RLN?
Failure of 4th pharyngeal ARCH (leads to a retroesophageal subclavian artery) –> non recurrent RLN
Sarcoidosis - what does it affect, histopath and TX?
Supraglottic thickening (i.. e. epiglottis), histopath shows NON necrotizing granulomas (non caseating) –> intralesional steroids
Other SX: Bilateral hilar lymphadenopathy, anterior uveitis, facial rash
AA women age 20-40
Wegener’s - what does it affect, hisopath and TX?
Subglottis, Necrotizing granulomas, Steroids…
ABductor spasmodic dysphonia:
Which muscle is affected?
How to diagnose?
TX?
-Posterior cricoarytenoid (only aBductor)
-Count 60-69 or “Harry’s Happy Hat” –> Breathiness (with consonents)
-Botox to PCA
ADductor spasmodic dysphonia:
Which muscle is affected?
How to diagnose?
TX?
-Thyroarytenoid or lateral cricoarytenoid
-Count 80-89 or “We eat eggs every easter) –> strain and breaks with vowels
-Botox to thyroarytenoid
