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Year 4: Special Senses > Laryngology > Flashcards

Flashcards in Laryngology Deck (86)
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1

Name the medial, lateral and superior boundaries of the anterior triangle of the neck.

- Medial: Midline of the neck

- Lateral: Anterior border of sternocleidomastoid

- Superior: Lower border of the mandible

2

Name the medial, lateral and superior boundaries of the posterior triangle of the neck.

- Anterior: Posterior border of sternocleidomastoid

- Posterior: Anterior edge of trapezius

- Base: Middle third of clavicle

3

Describe the anatomical location of a retropharyngeal abscess.

Anterior to the prevertebral fascia, behind the pharynx.

This space extends from the base of the skull to the mediastinum.

4

Describe how a patient with a retropharyngeal abscess would present.

- Commonly in young children

- Commonly after an URTI

- Neck held rigid and upright with reluctance to move

- Systemically unwell

- Airway compromise

- Dysphagia/ Odynophagia

5

What investigation would you order if you suspected a patient has a retropharyngeal abscess?

- CT Neck (preferably)

- Widening of the retropharyngeal space on lateral X-Ray

6

Describe how you would manage a patient with a retropharyngeal abscess.

- Secure airway if any concerns

- IV antibiotics

- Surgery: Incision and drainage

7

What is ludwig’s angina?

Infection of the space between the floor of the mouth and mylohyoid.

8

What is ludwig’s angina most commonly associated with?

Dental infection

9

Describe how a patient with ludwig’s angina would present.

- Swelling of the floor of the mouth

- Painful mouth

- Protruding tongue

- Airway compromise

- Drooling

10

What investigation would you order if you suspected a patient had ludwig’s angina?

- CT neck

- OPG (Orthopantomogram is a scan that gives a panoramic view of your jaw and teeth)

11

Describe how you would manage a patient with ludwig’s angina.

- Secure airway if any concerns

- IV antibiotics

- Surgery to drain any collection

12

Where is the parapharyngeal space?

A potential space postero-lateral to the oropharynx and nasopharynx which is divided by the styloid process

13

Describe how a patient with a parapharyngeal abscesses would present.

- Febrile illness

- Odynophagia

- Trismus (reduced opening of the jaws)

- Reduced neck movement

- A swelling in the neck around the upper part of the sternocleidomastoid.

14

Describe how you would manage a patient with a parapharyngeal abscesses.

- Secure airway if any concerns

- IV Antibiotics

- Surgical drainage

15

Name the causative organism of epiglottitis.

Haemophylis influenza

(NOTE: Incidence has reduced with introduction of HIB vaccine)

16

Describe the demographics of patients commonly affected by epiglottitis.

Mainly seen in children aged 2 - 6

17

Is epiglottitis an emergency?

Yes

18

Describe how a patient with epiglottitis would present.

- Stridor

- Drooling

- Pyrexia

19

Describe how you would manage a patient with epiglottitis.

- Secure the airway

- Don't examine (this may precipitate airway obstruction)

- Calm child

- Intubated in theatre (preferable)

- IV antibitoitcs

20

How should neck masses (except
for pulsatile masses) be investigated?

Ultrasound guided fine needle aspiration

21

Name the 4 muscles of the pharynx.

Superior, middle, and inferior constrictors, and cricopharyngeus.

22

What is Killian’s dehiscence?

A pharyngeal pouch formation.

Between inferior constrictor and cricopharyngeus, there is an area deficient of muscle at which herniation may occur.

23

Describe how a patient with a pharyngeal touch would present.

- Dysphagia

- Delayed regurgitation of food

- Sometimes recurrent chest infections from aspirated food

24

Name the 3 pairs of muscles that cause elevation and depression of the pharynx.

1. Stylopharyngeus

2. Salpingopharyngeus

3. Palatopharyngeus

25

What is the commonest cause of obstructive sleep apnoea in children?

Adenotonsillar hypertrophy

26

What is the commonest cause of obstructive sleep apnoea in adults?

Obesity

27

Describe how you would manage obstructive sleep apnoea in children.

Adenotonsillectomy

28

Describe how you would manage obstructive sleep apnoea in adults.

- Advice and lifestyle changes including weight loss

- CPAP: Continuous Positive Airway Pressure

- Mandibular positioning devices in selected cases

29

Name 5 causative organisms of bacterial tonsillitis.

1. Beta-haemolytic Streptococci

2. Staphylococci

3. Streptococcus pneumoniae

4. Haemophilus influenzae

5. Escherischia coli

30

Name 4 causative organisms of viral tonsillitis.

1. Rhinovirus

2. Adenovirus

3. Enterovirus

4. Epstein-Barr virus (EBV)