Path II test 2 Flashcards
What are signs of pancoast tumor?
Tumor in the apex of the lung infiltrates brachial plexus.
Sx: pain numbness and weakness of affected arm (TOS)
Also may be involved with adjacent vertebrae and ribs
Horners syndrome
Tumor extension of pancoast tumor Involves cervical and thoracic nerves -ipsilateral miosis -ptosis -facial anhidrosis
Superior Vena Cava Syndrome
Tumor extension of pancoast tumor Obstruction of venus drainage -dilation of neck veins -neck and facial edema -redness -
Potential complications of OM
Rupture TM Mastoiditis Infx to cochlea Infxn to CNS and meninges hearing loss delayed/abnormal speech acquisition Bullous myringitis Cholesteatoma
Meniere’s disease:
Triad?
Causes?
Who?
“Endolympyhatic Hydrops”
- Vertigo
- Tinnitus
- SNSL
Caused by pressure and volume changes in endolymph of vest. appararatus
Idiopathic
20-50 yo;
Acoustic Neuroma
Progressive Unilateral hearing loss
Benign tumor CN 8
Invasion/compression of internal auditory meatus, cerebellum. brain stem
-tinnitus, dizziness, otalgia, trigem neur, hemiparesis/paralysis of CN 7
What is Choleastoma/where is it
Epidermoid cyst lined with keratinizing squamous or columnar epithelium (mucous producing) and filled with amorphous debris and sometimes cholesterol
Arises in middle ear, tympanic membrane or adjacent struct., mastoid
What does progressive enlargement of choleastoma do?
What is sequlae?
Causes erosion into soft tissues and bones: ossicles labyrinth, adjacent bone, surronging soft tissue
Sequlae:
grow into ossicle/labyrinth = deafness
Facial paralysis
Infection and intercranial abscess
How do you get choleastoma ?
cpngenital or acquired
Often from chronic OM
Maybe TM perforation or chronic retraction
What is otitis Externa?
How might it present?
Risks to get it?
“swimmers ear” infx external ear canal
- local furuncle: S aureous
- diffuse generalized infxn: bacterial
Risks:
Allergies, eczema, psoriasis seb. derm; decreased canal acidity, injury, chemical irritants
Malingnant Otitis Externa: what/where
who?
Appearance?
SSX
Osteomylitis of temporal bone
P. aueroginosa…often beginning with otitis externa
Elderly, diabetic, immunocompromised
Granulation tissue in external canal/jxn of bony margin of temporal bone with cartilage portion of pinna
Foul smelling, purulent otorrhea and severe otalgia
Scleritis vs conjunctivitis
scleritis vessels do not constrict with phenylephrine, vessels are not displaced by cotton swab.
More dangerous than conjunctivitis, can be from systemic dz like RA.
Not normally infection agent, unlike conjunctivitis
Maybe uvea infxn
Conjuntivitis
has rich distribution of lymphatic channels
May heal without incident
Maybe allergic, infectious, granulatomous
What is glaucoma
Optic nerve issues
collection of conditions leading to change in visual fiesld and optic cup
Elevated intraocular pressure
Lack of drainage of aqueous humor from ant. chamber
Optic nerve:
diffuse loss of ganglion cells
thinning of retinal nerve fiber layer
cupping and atrophy
Open angle glaucoma
Canals of schlemm/trabecular netwrks are open/accessible
resistance to aq. humor drainage in open angle: fluid pressure up
What glaucoma is more common and what causes it?
population?
what happens?
Primary…idiopathic…associated with MYOC gene sometimes.
eyes with shallow anterior: hyperopia
drainage blocked by narrow canal…iris bulges forward
Iris bombe/shadow/cresent shadow
lens epithelium maybe damaged: slit-lamp exam
corneal edema/bullous keratopathy
