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Oropharynx Flashcards

(63 cards)

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1
Q

What are the types of Acute tonsillitis?

A

Acute catarrhal/superficial tonsillitis
Acute follicular tonsillitis
Acute membranous tonsillitis
Acute parenchymatous tonsillitis

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2
Q

Acute tonsillitis is common in _____________ and is caused by ___________

A

school going children
hemolytic streptococcus

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3
Q

What are the symptoms of tonsillitis?

A

Sore throat
Ear ache
Difficulty in swallowing
Fever, malaise

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4
Q

What are the signs of tonsillitis?

A

Bad breath
Coasted tongue
Follicles
Hyperemia of the tonsils
A membrane that can be easily wiped
Tonsils that meet each other (parenchymatous)
Enlarged JD nodes

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5
Q

What is the treatment for tonsillitis

A

Fluids
Aspirin or paracetamol
Penicillin or erythromycin for 7-10 days

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6
Q

What are the complications of tonsillitis?

A

Chronic tonsillitis
Peritonsillar abscess
Parapharyngeal abscess
Cervical abscess
Rheumatic fever
Acute glomerulonephritis
Subacute bacterial endocarditis
Acute otitis media

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7
Q

Distinguishing features of Diphtheria

A

Slow onset
Membrane is dirty grey in color
Extends onto tonsils, soft palate
Removing it leaves a bleeding surface
Urine shows albumin

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8
Q

Distinguishing features of vincent angina

A

Removing the membrane will reveal irregular ulcers on tonsil

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9
Q

Distinguishing features of IMN

A

Young adults
Splenomegaly
Failure of the antibiotic treatment
Lymphocytes on CBC
Paul Bunnell test (mono test)

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10
Q

What is the Paul Bunnell test done for?

A

Infectious mononucleosis

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11
Q

What do we find in the Paul Bunnell test?

A

High titre of heterophil antibody

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12
Q

D/Ds of acute tonsillitis

A

Diphtheria
Vincent Angina
IMN
Agranulocytosis
Leukemia
Aphthous ulcer
Malignant tonsils
Traumatic ulcer
Candida

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13
Q

What are the types of chronic tonsillitis?

A

Chronic follicular
Chronic parenchymatous
Chronic fibroid

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14
Q

WHat type of chronic tonsillitis is associated with sleep apnea and risk of cor pulmonale?

A

Chronic parenchymatous

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15
Q

WHat type of chronic tonsillitis is associated with recurrent sore throat?

A

CHronic fibroid tonsillitis

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16
Q

Important sign of chronic tonsillits

A

Flushing of Anterior pillars

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17
Q

What are the indications of tonsillectomy

A

Speech
Deglutition
Respiration
Recurrent attacks

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18
Q

What are the complications of chronic tonsillitis?

A

Peritonsillar abscess
Parapharyngeal abscess
Intratonsillar abscess
Tonsilloliths
Tonsillar cyst
Other systematic infections

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19
Q

What is ludwig Angina

A

Infection of the submandibular space

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20
Q

Explain the anatomy of the submandibular space

A

Above the mylohyoid, we got the sublingual space
Below it, we have submaxillary and submental space

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21
Q

WHat are the causes of ludwigs angina

A

Dental infection
Submandibular sialadenitis
Injury to oral mucosa
Fractures of mandibule

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22
Q

What afre the bacteria involved in ludwigs angina

A

Mixed
Streptococci
Staphylococci
Bacteroides

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23
Q

Features of ludwig angina

A

Odonyphagia
Trismus
Tongue pushed up
Woody hard feel
Laryngeal edema

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24
Q

Complications of LA

A

SPread of infection
Airway obstruction
Septicemia
Aspiration pneumonia

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25
Treatment of LA
Systemic antibiotics I/D intraoral if sublingual I/D external if submaxillary Tracheostomy
26
What is peritonsillar abscess
Collection of pus in the space between capsule of tonsils and superior constrictor muscle
27
What is the cause of peritonsillar abscess
Acute tonsillits De novo
28
Features of Peritonsillar abscess
Constitutional symptoms Odonyphagia is so severe that it causes dehydration Hot potato voice Foul breath Earache Trismus
29
Peritonsillar abscess mostly affects ________ and is _________ (unilateral/bilateral)
adults unilateral
30
WHat are the signs of peritonsillar abscess
Uvula bulged to opposite site Torticollis to the side of abscess
31
Tx of Peritonsillar abscess
Hospitalization IVF A/A I/D Interval tonsillectomy Abscess or hot tonsillectomy
32
Complications of Peritonsillar Abscess
Parapharyngeal abscess Laryngeal Edema Septicemia Pneumonia Jugular Vein thrombosis SPontanoeus hemorrhage
33
Explain retropharyngeal space
The space between bucopharyngeal fascia (covering the pharyngeal constrictors) and prevertebral fascia
34
Explain prevertebral space
Space between the prevertebral fascia and the vertebral bodies
35
Acute retropharyngeal abscess is in _____________
Retropharyngeal space
36
Chronic Retropharyngeal abscess is in _______________
prevertebral space
37
Etiology of Acute RP Abscess
Secondary infections of surrounding structures in children Injury in adults
38
Dx of Acute RP abscess
Stridor Croupy cough Torticollis Dysphagia Bulge in the posterior pharyngeal abscess Widening of prevertebral shadow and presence of gas
39
Chronic RP Abscess is caused by _____________
tuberculosis (on one side of the midline) caries of the cervical spine (centrally)
40
Quinsy is AKA as _____________
Peritonsillar Abscess
41
Explain the parapharyngeal space anatomy
The space lateral to the pharynx. It is divided into Anterior compartment and posterior compartment
42
What are the important structures that pass through the posterior compartment of parapharyngeal space?
Carotid artery Jugular Vein 9, 10, 11 and 12 CN Sympathetic trunk Deep cervical nodes
43
What are the features of Anterior compartment infection of the parapharyngeal space?
prolapse of tonsil and fossa trismus swelling behind the angle of the jaw
44
What are the features of posterior compartment infection of the parapharyngeal space?
Bulge of pharynx behind the posterior pillar Paralysis of CNs and sympathetic chain Swelling of the parotid region
45
Complications of Parapharyngeal abscess
Edema of larynx Thrombophlebitis Spread of infection Mycotic aneurysm of carotid artery Carotid blow
46
Pleomorphic adenoma is most commonly found on _____________
hard or soft palate
47
Mucus cyst is usually seen in _________
vallecula
48
Common sites of malignant tumors in the oropharynx
Posterior 1/3 or base of the tongue Tonsils and fossa Faucial palatine arch Posterior and lateral pharyngeal wall
49
Hot potato voice is seen in ___________ and _____________
Peritonsillar abscess Base of the tongue CA
50
____________ CA is the most common in oropharynx
Squamous cell carcinoma
51
What is styalgia?
Pain in tonsillar fossa Aggravated on swallowing Dx - Palpation of styloid process and Xray lateral or open mouth
52
Styalgia is AKA ___________
Eagle Syndrome (elongation of styloid process or calcification of stylohyoid ligament)
53
Sleep Apnea means ___________
No breathing during sleep
54
Types of sleep apnea
Obstructive sleep apnea Central Sleep Apnea Mixed
55
Pathophysiology of sleep apnea
Hypoxia - CO2 retention - pulmonary vasoconstriction - CHF, ↓ HR, MI leaft heart failure, cardiac arrhythmias and sudden death
56
Symptoms of sleep apnea
Sleep fragmentation Day time sleepiness Snoring Gasping and choking Morning headaches Memory loss Impotency
57
Excessive daytime sleepiness is measured by ______________
Epworth sleepiness scale
58
The collar size should not exceed ____ cm in males and ____ cm in females
>42 cm in males >37.5 cm in females
59
Muller maneuver is used for __________
sleep apnea
60
Examination of patients with sleep apnea include
BMI Collar size Head and neck examination Muller Maneuver Systemic examination Cephalometric radiographs Polysomnography Split-night polysomnography
61
What is the gold standard test for sleep apnea?
Polysomnography
62
Nonsurgical treatment of sleep apnea
Positional therapy (sleep on his/her side) Intraoral devices (Mandible advancement device; MAD or Tongue retaining device TRD) CPAP (continuous positive airway pressure)
63
Surgical treatment of sleep apnea
Permanent tracheostomy is the gold standard Tonsillectomy/ Adenoidectomy Nasal surgery Oropharyngeal surgery Advancement genioplasty with hyoid suspension Tongue base radiofrequency Maxillomandibular advancement osteotomy

ENT (12 decks)

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