Flashcards in Outcome 2 ENT Deck (125):
Acute inflammatory process affecting the mucus membrane that lines the upper respiratory tract
common cold/upper respiratory tract infection (URI/URTI)
Caused by almost 200 different viruses that are part of normal body flora
Group of viruses responsible for 1/2 of the 200 viruses that cause the common cold
Controversial treatment for colds
When do ordinary colds and bacterial colds usually resolve?
ordinary cold: 4-5 days
bacterial: 7-10 days
SInusitis is the acute or chronic inflammation of the mucous membranes of the ______
Sinusitis is caused by ___, ___ and ___ that travel to the sinuses from the nose; often occurs after the patient has been infected by the common cold
virus, fungus, bacteria
What is another cause of sinusitis?
Any condition that blocks sinus drainage and ventilation
Treatment: saline nasal sprays and corticosteroid nasal sprays
What are the 2 types of sinusitis?
1. acute: 3 to 4 week resolution
2. chronic: surgical treatment
Type of sinusitis requiring surgery
Which paranasal sinuses are affected most in sinusitis?
maxillary paranasal sinuses
Acute or chronic inflammation or infection of the pharynx
What is the informal term for pharyngitis
What are 3 types of pharyngitis?
Type of pharyngitis that may be secondary to systemic viral infections such as chickenpox and measles
Type of pharyngitis that occurs when an infection spreads to the pharynx and remains, such as syphilis and tuberculosis
Type of pharyngitis resulting from oral-genital sexual activity
How is streptococcal pharyngitis treated?
7-10 day course of antibiotics
What are the two conditions that must be ruled out before diagnosing pharyngitis?
2. Ludwig's angina: cellulitis of the floor of the mouth
Head and neck cancer that arises in the area of the pharynx unique in that it is not linked to tobacco use
Nasopharyngeal carcinoma arise in the area of the pharynx that opens into the ____ anteriorly and the ___ inferiorly
nasal cavity, oropharynx
Cancer often linked to dietary intake or Epstein-Barr Virus infection
What are three main symptoms of nasopharyngeal carcinoma?
1. neck mass
3. serous otitis media
5 risk factors for nasopharyngeal carcinoma:
1. salted fish in regular diet
2. high levels of nitrates
3. chinese herbs
4. infection with EBV
5. first degree relative with nasopharyngeal carcinoma
How are early stage and advanced stage nasopharyngeal carcinoma treated?
early stage: radiation therapy
advanced stage: chemoradiotherapy
Inflammation of the larynx including the vocal cords; main symptoms is hoarseness
List 5 causes of laryngitis.
1. infection: bacterial or viral
3. reflux laryngitis: repeated attacks of acid reflux
4. excessive use of voice
5. benign or malignant lesion of the larynx
Treatment: voice rest, bed rest, fluid intake, lozenges and cough syrup
Chronic laryngitis is treated based on elimination of _____
the causative factor
Crooked nasal septum
deviated septum (DNS)
What are the two causes of DNS?
1. congenital anomaly
Treatment is unnecessary unless air passage is compromised; if so, treated surgically
Benign growth that form as a consequence of swollen mucous membranes protruding into the nasal cavity
If polyps grow large enough, they can cause ____ and ____
breathing problems and anosmia (loss of smell)
Nasal polyps are caused by the _____ in the cells of the mucous membrane: also allergic rhinitis
overproduction of fluid
How are nasal polyps treated?
1. surgical removal
2. injection of a steroid directly into the polyps
Impairment or loss of the sense of smell
The _____ form of anosmia can be caused by nasal polyps and allergic rhinitis
List 3 other causes of anosmia.
2. damage of the olfactory nerves
3. intranasal swelling
Phobia of a certain smell
Can cause temporary anosmia
T or F. Damaged nerves can't be repaired in regards to anosmia
Hemorrhage from the nose
What is the informal term for epistaxis
List 3 causes of epistaxis.
1. cold/infections that cause crusting which damages the mucous membrane and ruptures vessels
2. direct trauma to the nose
3. systemic disorders
What are 2 common topical cauterization agents used to treat moderate epistaxis?
1. silver nitrate (AgNO3)
What are 5 risk factors for epistaxis?
1. vitamin k deficiency
3. aspirin ingestion
4. high altitude
5. anticoagulant therapy
Treated with local application of epinephrine followed by cauterization, nasal packing, surgical ligation of a bleeding artery if severe
____ lasting longer than 2 weeks is usually the inly symptom of a tumor of the larynx
dysphonia or difficulty speaking
What are the 2 types of benign tumors of the larynx?
Type of larynx tumor that causes intermittent dysphonia
Type of larynx tumor that causes continuous, gradually worsening dysphonia
How is laryngeal cancer treated once it has metastasized?
Neoplasm of the larynx
What is the most common site for head and neck tumors?
Laryngeal cancers are mostly _____ carcinomas
squamous cell carcinomas
T or F. Laryngeal cancers have peak incidence in the fifth and sixth decades of life
F. Sixth and seventh
What are the two major factors for laryngeal cancer, particularly when both occur?
2. alcohol abuse
How are laryngeal cancers treated?
surgery and/or radiation therapy
What are the 4 requirements for hearing?
1. vibratory or sound STIMULUS
2. RELAY of sound/vibration to the inner ear
3. STIMULATION of tiny hairs in cochlea
4. CONDUCTION of nerve impulses to the brain
What are the two main types of hearing loss?
Conductive hearing loss is related to impairment of the ____ or ____
eardrum or middle ear ossicles
Sensorineural hearing loss is caused by impairment of the ____ or _____
cochlea or the auditory nerve
Abnormal accumulation of ear wax in the canal of the outer ear, preventing sound waves from reaching the _____
impacted cerumen, tympanic membrane
What are 3 main causes for impacted cerumen?
1. dryness and scaling of skin
2. excessive hair in ear canal
3. abnormally narrow ear canal
Treatment: softened with oily drops or hydrogen peroxide and irrigated with water
Inflammation of the external ear canal
infective otitis externa
Infective otitis externa is caused by a buildup of ____ mixed with ___ which is a good place for bacteria or fungi
cerumen mixed with water
What are 2 conditions that can cause infective otitis externa?
T or F. Infective otitis externa tends to recur and can become chronic
Inflammation and resulting infection of the outer ear canal after water has been trapped during swimming
Swimmer's ear is caused by a buildup of ___ mixed with ___ in the ear canal
cerumen mixed with water, exactly like infective otitis externa
How are infective otitis externa and swimmer's ear different?
Swimmer's ear infection is caused by swimming; IOE is caused by an already existing infectious process
Inflammation of the normally air-filled middle ear with the accumulation of fluid behind the tympanic membrane; can occur unilaterally or bilaterally
otitis media (OM)
What are the two types of otitis media?
1. serous or nonsuppurative
Type of OM with relatively clear and sterile fluid
serous or nonsuppurative
What are two types of serous otitis media?
Acute serous otitis media is caused by a URI virus that has spread through the ____ into the ___
eustachian tube into the middle ear
Chronic serous otitis media develops from an acute attack, _____ of the adenoids, or ____ infection
hypertrophy of the adenoids or chronic sinus infection
Type of OM caused by bacteria
Treated with decongestants to promote drainage and antibiotics for suppurative cases
How is severe OM treated?
surgical evacuation of the fluid or myringotomy
T or F. Myringotomy tubes may need to be inserted after OM is treated to keep the middle ear filled with air and prevent fluid accumulation
Abnormal bone growth in the middle ear, primarily affecting the stapes
T or F. Otosclerosis causes conductive hearing loss
What is the key symptom of otosclerosis?
In otosclerosis, the movement of the ____ is impaired, causing reduced conduction of sound waves
What is the only cure for otosclerosis?
stapedectomy in which the bone is replaced with a prosthesis
If surgery is not an option for a patient with otosclerosis, how does he or she manage the condition?
Chronic disease of the inner ear affecting the labyrinth
What are the 4 core symptoms of Ménière's disease?
3. progressive hearing loss
4. sensation of aural fullness
Ménière's disease involves the destruction of the ____ inside the cochlea
tiny hair cells
List some predisposing factors for Ménière's disease.
1. middle ear infection
2. head trauma
3. dysfunction in the autonomic nervous system
4. noise pollution
5. premenstrual edema
Treated by adopting a salt-free diet, restricted fluid intake, avoiding stressful situations
Ménière's disease can also be treated with surgical destruction of the affected labyrinth by ____
Vestibular system disorder stimulated by head movement
benign paroxysmal positional vertigo (BPPV)
BPPV is caused by balance or equilibrium disorders where the ___ and ___ are not functioning properly
brainstem and cerebellum
What are the 3 drugs prescribed for BPPV?
Treated by repeatedly turning the head side to side
What is the specific diagnostic test for BPPV?
Inflammation or infection of the labyrinth
BPPV vs Ménière's disease vs labyrinthitis?
BPPV: vertigo stimulated by head movement; vestibular system
Labyrinthitis: constant vertigo not in relation to head movement
Labyrinthitis is caused by a virus or bacterial infection that has spread from the _____
Type of labyrinthitis that can cause permanent hearing deficiency and/or balance problems
Any tear or injury to the eardrum that causes a breach in the integrity of the membrane
ruptured tympanic membrane
Ruptured tympanic membrane is the result of which 3 main factors?
2. force or insult from outside
3. increased pressure within the middle ear
Examples: nearby explosion, fractured skull, severe ear infection, sharp object, etc
Treated with patch applied to the eardrum or tympanoplasty
ruptured tympanic membrane
Pocket of skin cells located in the middle ear collects into a cyst-like mass and becomes infected
In cholesteatoma, the bone lining the ____, rods, and ossicles become damaged
middle ear cavity
How does cholesteatoma develop?
1. in infancy
2. chronic ear infection
In cholesteatoma, the ____ fails to open or becomes blocked (OM)
A pocket in the eardrum is formed because the normally air-filled chamber develops a weak ____ causing the eardrum to become retracted
The early stage of cholesteatoma is treated with thorough cleaning of the ____ and inflation of the ___
middle ear cavity, eustachian tube
THe advanced stage of cholesteatoma is treated with surgical reconstruction of the ____
What are some complications that can arise when surgically reconstructing the middle ear?
deafness, vertigo or erosion of a facial nerve
Inflammation of the mastoid bone or mastoid process
What are the 2 types of mastoiditis?
Acute mastoiditis is the result of neglected, untreated, or poorly treated ______
acute otitis media
Chronic mastoiditis is associated with _____
Chronic mastoiditis may be treated with what surgical procedure?
Occupational hearing loss where sound waves reach the inner ear but are not perceived
sensorineural hearing loss
In sensorineural hearing loss, ____ are not transmitted to the brain
List some causes of sensorineural hearing loss
1. nerve failure
2. damage to the cochlea or auditory nerve VIII
4. loud noises
5. side effects of medication
6. physical trauma with fracture of the temporal bone