larynx Flashcards
1
Q
development of larynx starts and completes at
A
4wk to 3rd mnth of intrauterine life
2
Q
wrisberg cartilage is ??
A
cuneiform cartilage
3
Q
cartilage of santorini is ??
A
corniculate cartilage
4
Q
angle bw lamina of thyroid is ?
A
male 90
female 120
5
Q
oblique line over thyroid lamina gives attachment to ??
A
thryohyoid
sternohyoid
inferior constrictor
6
Q
largest laryngeal cartilage
A
thyroid cartilage
7
Q
only complete cartilaginous ring is ??
A
cricoid cartilage
8
Q
wht is pachydermia laryngitis
A
due to faulty production of vocal process of arytenoid rub against each other leads to an area of heaped up mucosa on one vocal process which fits into ulcer like depression on side
9
Q
which part of vocal fold is affected by pacydrermia laryngitis
A
posterior 1/3
10
Q
is contact ulcer malignant ??
A
no they r not malignant
11
Q
cause of contact ulcers is ??
A
vocal abuse
12
Q
TB affects which part of vocal cord
A
posterior
13
Q
first sign of laryngeal tb is ??
A
hyperemia and ulceration of unilateral vocal cord with impairment of abduction
14
Q
mouse nibbled appearence is seen in ??
A
tubercular laryngits
15
Q
turban epiglottis is ??
A
pseudoedema of epiglottis seen in laryngeal tb
16
Q
lupus of larynx is seen in which part of larynx
A
anterior
17
Q
syphilis effects which part of larynx
A
anterior
18
Q
leprosy effects which part of larynx
A
anterior
19
Q
lesions of leprosy r ?
A
dull in color of epiglottis is destroyed and gives appearance of hook over a buttonhole
20
Q
wht is reinke edema
A
b/l symmetrical swelling of
vocal cord giving appearance of hook over a button hole
21
Q
kind of voice in reinke s edema
A
pt uses false cords therefore voice is low pitched and rough
22
Q
b/w which layers of vocalcord
lies the reinke edema
A
b/w superficial lamina propria and intermediate lamina propria
23
Q
dysphonia plica ventricularis is ??
A
voice production by false cord
24
Q
treatment of dysphonia plica ventricularis is ??
A
psychological counselling if functional cause
25
key hole appearence of glottis is seen in ??
phonosthenia
26
cause of keyhole appearance
elliptical space bw the cords is due to paralysis of thyroartenoid and triangular gap is due to weakness of interarytenoid
27
cause of rhinolalia clausa
nasal allergy
polyp
adenoids nasopharyngeal mass
28
cause of rhinolalia aperta
velopharyngeal insufficiecy
29
gutzman test is positive in ?
puberphonia
| thyroid prominece is pressed backwards and downwards
30
muscle responsible for falsetto voice of puberphonia
cricothyroid main tensor
| there is hyperkinetic function and spasm of this muscle
31
intubation granuloma is most commonly found on??
posterior third of vocal cord
32
glottic cancer is found where
free edge and upper surface of ant 1/3 of true vocal cord
33
wht is mogiphonia
phonic spasm occurs in professional voice users
| initially voice is normal but soon vocal cords get adducted and person cannot speak
34
lesions of leprosy are ?
dull grey in color
| epiglottis idestrgives
35
most common site affected in pacydermia laryngis
arytenoid cartilage
36
```
true abt reinke edema is ?
1usually unilateral
2 common in smoker
3 corticosteroids is mainstay of treatment
4 patient has low pitch voice
5 involves membrnous part of vocal cord
```
ans
common in smoker
involves whole vocal cord
pt has low pitched voice
37
wht is functional aphonia
seen in emotionally labile females in age grp 16-30 yrs
laryngoscopy shows vocal cords in abducted position and fails to adduct on phonation however adduction is seen on coughing
indiacting normal adductor function
38
treatment of functional aphonia
reassurances and psychotherapy
39
wht is typ1 thyroplasty
medialisation of vocal cord
40
wht is type 2 thyroplasty
lateralisation of vocal cord
| indications spasmodic dysphonia
41
type 3 thyroplasty
relaxation of vocal cord or shortening of vocal cord
| as in puberphonia to lower pitch
42
type 4 thyroplasty
lengthening of vocal cord
| ie in androphonia to elevate the pitch
43
muscle responsible for change of pitch of voice
cricothyroid
44
ortners syndrome is ??
cardiomegaly + paralysis of RLN
45
distance bw vocal cords in full abduction
19 mm
46
distance bw vocal cord as glottic chink
7 mm ie 3.5 mm from midline
47
which side of vagus is more prone to injury
left as it has longer
48
features of unilateral SLN paralysis
voice is not severly effected but pitch of voice cannot be raised
iosilateral cord is bowed and floppy,,increased in length,cords sag down in inspiration and bulge up during expiration
unilateral anaesthesia above the cord
49
treatment of unilateral
| SLN paralysis
no treatment
50
bilateral SLN PARALYSIS
voice is breathy and weak also there is high chances of aspiration as there is bilateral anaesthesia of supraglottic part
51
treatment of bilateral SLN paralysis
tracheostomy may be required
| epiglottopexy is close laryngeal inlet is done to protect from aspiration
52
features of unilateral RLN paralysis
ie unilateral abductor paralysis affected cord is in paramedian position does not move laterally on inspiration
slight hoarseness which improves over days
voice tires on repeated use
53
treatment of unilateral RLN paralysis
speech therapy
54
features of bilateral RLN paralysis
both cords lie in median ot paramedian position due to unopposed action of cricothyroid muscle
voice is gud
dyspnea stridor may be present
55
treatment for bilateral RLN
emergency tracheostomy or lateralise the cord
56
position of cord i both RLN AND SLN paralysis
adductor paralysis causes vocal cord to be in cadaveric position
57
muscular voice in female is treated by ?
thyroplasty type 4 used to lengthen the vocal cord and elevate the pitch
58
voice in bilateral abductor paralysis
normal
59
position of vocal cords in cadaver
intermediate
60
most common cause of vocal cord palsy is
total thyroidectomy
61
rht siided vocal cord pasy is seen in
rht RLN arises from vagus at the level of subclavian artery and hooks around it
it is seemin laryngeal carcinoma
62
course of left RLN
arise from vagus in the mediastinum at level of arch of aorta loops around it and then ascends into neck
63
treatmemt of unilateral vocal cord palsy
type 1 thryoplasty ie medialisation of vocal cord
64
most common cause of vocal cord palsy
surgical due to surgery of thyroid , parathyroid carotid
65
most common malignancy causing vocal cord palsy
bronchial 》esophagus 》nasopharyngeal 》thyroid
66
most common cause of benign tumor
squamous papillomas
67
cause of juvenile papillomatosis
HPV types 6,11
68
treatment of infant hemangiona
involute spontaneously treated by CO2 laser
69
treatment of adult hemangioma
most are cavernous
| can be treated by steroids and radiation therapy
70
mc type of laryngeal cancer
squamous cell carcinoma
71
supraglottis and infraglottis drains inti
upper deep cervical
72
vocal cord lymphatic drainage
no lymphatics
73
mc site for laryngeal cancer
glottis
74
worst prognosis of which laryngeal can er
subglottic
75
best prognosis for which laryngeal cancer
glottic
76
ackerman tumor treated by ??
verrucus carcinoma is Ackermantumor
| treatment is always surgery
77
structures removed in radical neck dissection
```
lymph nodes 1-V
+
spinal accessory nerve
+
int jugular vein
+
sternocleidomastoid
```
78
modified radical neck dissection
```
type 1 spinal accessory preserved
type2
spinal accessory nerve +internal jugular vein
type3
spinal accessory nerve +int jugular vein
```
79
levels of neck nodes
```
level 1 submental
1b submandibular 2
upper jugular
3
middle jugular
4
lower jugular
5
posterior triangle
6
central
7
sup mediastinal
```
80
premalignant conditions for laryngeal cancer
leukoplakia papillomas
| chronic laryngitis
81
which is more aggressive hpv 6 and 11
hpv 11
82
mode of acquiring papillomas in a child
vertical transmissions at time of parturition
83
most common initial symptoms of supraglottis cancer
pain on swallowing
84
most common first sign
| of supraglottis cancer
mass in neck
85
treatment of choice for all stage 1 laryngeal cancer which neither impair mobility or invade cartilage or cervical nodes
radiotherapy
86
TOC FOR stage T1 glottic carcinoma
radiotherapy
87
treatment for stage T2 of glottic carcinoma with mobile vocal cords
radiotherapy
| external bean radiation
88
treatment of choice for vocal cords with impaired vocal cord mobility
laryngectomy
89
laser used for laryngeal cancer
CO2 laser
90
TOC in perichondritis larynx
total laryngectomy
91
IOC in upper airway obstruction
fiberoptic endoscopies
92
most definative managemet for upper airway obstruction
tracheostomy
93
immediate methods for upper airway obstruction
heimlich and jaw thrust
94
minitracheostomy is ?
cricothyrotomy
95
site for tracheostomy is ??
2nd,3rd,4th tracheal ring which lie under isthmus of thyroid gland
96
high tracheostomy disadv
perichondritis of cricoid cartilage can lead to subglottic stenosis
97
low tracheostomy disadv
injuries to great vessel of neck and ap
98
prefered material for tracheostomy tube in children
silicon as it is flexible and causes less trauma
99
should we use cuffed tracheostomy tubes in child
no as it causes subglottic stenosis
100
mc foreign body
vegetable foreign body
101
site of impaction of foreign body in upper digestive tract
cricopharynx
102
treatment for foreign body in larynx
heimlich maneuver
| cricothyrotomy
103
killian incision is for
smr
104
weber freguson incision
total maxillectomy
105
freers incision
septoplasty
106
moures incision
lateral rhinotomy
107
Which anaesthetic should be avoided in middle ear surgery
N2O as it can cause expansion of ear cavity
108
High tracheostomy is indicated for ??
Carcinoma
109
LAM is
Laser assisted myrigotomy
110
What is brewer luckhardt reflex
Inspiratory closure of Glottis and tracheal adduction of vocal cords which is unresponsive to airways. Manoeuvres
111
Commonest indication for myringostomy
Serious otitis media
112
Most common indication for tracheostomy is
Foreign body aspiration
113
Frequency of cuff deflation
Cuff should be deflated every 2 hrs for 5 min
114
Structures which can be damaged by emergency tracheostomy
Ishtmus of thyroid and thyroidima artery
| Inf thyroid vein
115
Most common complications of tracheostomy
Hemorrage
116
Commonest cause of bleeding during tracheostomy
Ant jugular vein
117
Mc cause of laryngeal stenosis
Endotracheal incubation followed by tracheostomy
118
Commonest site of aspiration of foreign body
Rht side
If pt is supine 》post segment of upper lobe
Or superior segment of lower lobe
If patient is upright and sitting
》basilar segment of lower lobe
119
kashim operation is done for ?
cordotomy
120
Gold std for OSA
Polysomnography
121
Can we pt of osa will benefit from the surgery
Yes by Muller maneuver
122
larynx cartilages r hyaline or elastic
thyroid cartilage
| cricoid cartilage basal part of arytenoid are hyaline cartilage rest all are elastic cartilage
