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Otorhinolaryngology > Anatomy, Physiology, & Histology > Flashcards

Anatomy, Physiology, & Histology Flashcards

1
Q

acoustic antenna; transmits sound waves to middle ear structures.

A

External ear

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2
Q

impedance matching or transferring incoming vibrations from large low impedance tympanic membrane to smaller but high impedance oval window

A

Middle ear

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3
Q

impedance matching or transferring incoming vibrations from large low impedance tympanic membrane to smaller but high impedance oval window

A

Middle ear

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4
Q

site for acoustic vibrations from mid ear transmitted to perilymph; this set in motion the nerve endings and transform vibration to electric impulse of hair cells for hearing

A

Inner ear

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5
Q

The reason why during PE, to visualize the tympanic membrane using an otoscope, you should

A

“S” shaped, to protect against injury “S” shaped, to protect against injury

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6
Q

Seen as deficiency or a fracture line in the cartilaginous part

Clinical significance: gateway for disease to pass from external auditory canal to the periparotid and neck spaces

Infections from the parotid and superficial mastoid can enter the canal and vice versa

A

Fissure of Santorini

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7
Q

Route of communication between the external ear and infratemporal fossa

Route for tumors and infection to spread

A

Foramen of Huschke

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8
Q

Supplies lateral surface thru the anterior auricular branches

A

Superficial temporal artery

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9
Q

Supplies the medial surface thru the auricular branches

A

Posterior auricular artery

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10
Q

Supplies medial surface thru the auricular branches

A

Occipital artery

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11
Q

labyrinthine artery or internal acoustic artery from basilar artery

A

Internal Ear

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12
Q

Alderman or Arnolds nerve -> cough reflex when EAC is stimulated

Jacobsons nerve

A

CN X and CN IX

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13
Q

Normal findings of a Tympanic membrane

A

semi-translucent, pearl white oval, presenting obliquely 55 degrees with canal floor

1.0cm2, superoinferiorly, 8mm anteroposteriorly

Umbo-center of TM

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14
Q

Triangular part above the anterior and posterior malleolar folds, common site of retraction points

A

Pars Flaccida (Shrapnell’s membrane)

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15
Q

Portion below the malleolar fold tensed by the manubrium of the malleus

A

Pars tensa

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16
Q

Fibrocartilaginous ring which supports the tympanic membrane; deficient superiorly at the notch of Rivinus

A

Annulus fibrosus

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17
Q

Ear ossicle definition

A

First bones to be fully ossified during development and are essentially mature at birth

Covered with the mucous membrane lining the tympanic cavity; they lack a surrounding layer of osteogenic periosteum

Muscles associated (both dampen or resist movements of the auditory ossicles

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18
Q

Eustachian Tube anatomy and physiology

A

Lined with mucous membrane; connects middle ear to back of the throat (nasopharynx)

Upper 1/3 near middle ear à bony about 12 mm • Second part of the ET near nasopharynx is cartilaginous

Equalizes air pressure

Normally closed except during yawning or swallowing

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19
Q

Inner Ear (Labyrinth): Bony Division

A

Semi-circular canals (SCC) à three canals that lie at the right angle to one another and about 2/3 of a circle

Lateral or horizontal: not really horizontal but 30 degrees to the horizontal; nonampullated end opens to posterior wall of vestibule

Superior joins free posterior at the crus communis before entering the vestibule in the middle of the posterior wall

Posterior

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20
Q

Inner Ear (Labyrinth): Vestibule divison

A

Ovoid chamber that measures 5 mm long, 5 mm high and 3 mm deep; central area which receives several openings

Anteriorly: scala vestibule of cochlea

Posteriorly: five openings of the semicircular canals

Lateral wall: opening of the oval (fenestra vestibule) and round (fenestra cochlearis) windows

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21
Q

Inner Ear : Oval Window and Round Window

A

Oval Window: Located at the footplate of the stapes
When the footplate vibrates, the cochlear fluid is set into motion

Round Window: Functions as the pressure relied port for the fluid set into motion initially by the movement of stapes in the oval window

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22
Q

5 Bones of the Nose

A

o Maxilla
o Frontal bone
o Nasal bone
o Vomer
o Ethmoid

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23
Q

External nose: Bony Vault

A

Bony vault ->immobile; most superior

Frontal process of maxilla
Paired nasal bones
Nasal spine of frontal bone
Perpendicular plate of nasal bone

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24
Q

External nose: Bony Vault

A

Bony vault ->immobile; most superior

Frontal process of maxilla
Paired nasal bones
Nasal spine of frontal bone
Perpendicular plate of nasal bone

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25
Q

External nose: Cartilaginous

A

Slightly movable and made up of:

Paired upper lateral nasal cartilage
Paired lower nasal cartilage (greater alar cartilage)
Lesser alar cartilage § Accessory alar cartilage (sesamoid cartilage)
Septal cartilage

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26
Q

Help regulate respiration

A

Nasal valve of Mink

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27
Q

Internal Nose: Roof

A

o Nasal bone
o Under nasal spine of frontal bone
o Cribiform plate of ethmoid
o Undersurface of sphenoid bone

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28
Q

What are the sinuses opening of the middle meatus

A

Anterior ethmoidal cells
Middle ethmoidal cells
Maxillary sinuses
Bulla ethmoidalis

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29
Q

Anterior ethmoidal cellls and the frontal sinuses openins in the?

A

Anterior part of the meatus

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30
Q

Middle ethmoidal cells opening

A

Above the bulla ethmoidalis or hiatus semulinaris

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31
Q

Maxillary sinuses opening

A

Posterior part of the hiatus semilunaris

32
Q

Osteometal Complex: Anatomy and Physiology

A

Area in the lateral nasal wall where ostia or opening of paranasal sinus except for sphenoid sinus (mid meatus)

(+) free airflow and mucicilliary drainage

33
Q

Osteomeatal Comlex composed of?

A

o Uncinated process
o Semilunar hiatus
o Frontal recess
o Ethmoid bulla
o Ethmoid infundibulum
o Maxillary sinus ostium

34
Q

Nasal Septum: Bony parts of the septum are formed by the?

A

o Posteroinferiorly by the vomer
o Posterosuperiorly by the perpendicular plate of ethmoid
o Nasal spine of frontal bone joins ethmoid plate
o Rostrum of sphenoid between the vomer and ethmoidal plate
o Nasal crest of the two maxillae and palatine process

35
Q

Nasal Septum: Cartilaginous Part

A

• Formed by quadrilateral cartilage
• Attached to a perpendicular plate of ethmoid bone posterosuperiorly
• Anterior border of vomer
• Internasal crest superiorly
• Nasal crest of maxilla and anterior nasal spine inferiorly
• Upper nasal cartilage attached to anterosuperior border of septal cartilage

36
Q

Mucosa of the nose: Anterior Vestibular region lined by?

A

Stratified squamous epithelium; end at mucocutaneous junction

37
Q

Respiratory portion of nasal mucosa lined by?

A

Pseudostratified columnar ciliated

Mucosa is firmly adherent to perichondrium and periosteum

38
Q

Olfactory mucosa of the nose

A

Occupies olfactory region on nose -> extends over upper part of septum and adjacent to lateral wall to superior turbinates

Yellowish color

39
Q

main supply; branch from internal maxillary artery and Divides to lateral nasal and long septal branch

A

Sphenopalatine artery

40
Q

Branch of ophthalmic artery and Supply upper part of lateral wall and upper part of septum

A

Anterior and Posterior ethmoidal artery

41
Q

Enter thru the inclusive canal to the nose and supplies the anteroinferior part of the septum and adjacent areas of the floor and lateral wall

A

Greater palatine artery

42
Q

Supplies the septim and nasal alae

A

Superior labial branch of the facial artery

43
Q

Arterial blood supply form anastomosis at the anteriorinferior portion of the septum also called as little’s area frequent site of bleeding

A

Keissel-Bach’s Plexus

44
Q

Anterior Epistaxis comes from?

A

• Greater palatine
• Anterior ethmoid
• Sphenopalatine
• Superior labial

GAAS

45
Q

Woodroofs plexus (Posterior epistaxis) comes from?

A

o Internal maxillary veins
o Sphenopalatine (from maxillary artery)
o Ascending pharyngeal (from external carotid)

ISA

46
Q

Paranasal sinuses parts

A

They are hollow within several facial bones and named:
o Maxillary
o Sphenoid
o Frontal
o Ethmoid

47
Q

Paranasal sinuses definition

A

•Humans have 12 cavities along roof and lateral aspect of air space varying in number, size, shape, and symmetry
• All paranasal sinuses are lined with modified respiratory epithelium that produces mucous and having cilia
• Essential sinuses are air filled
• Only Maxillary sinus are present at birth – the rest appear in early childhood

48
Q

Maxillary Sinus or Anthrum of Highmore

A

• Pyramidal cavity in maxilla
• Divided into small spaces by bony septa
• Roof from floor of orbit
• Floor below level of nasal cavity and from alveolar process of maxilla
• Contains anterosuperior dental vessels and nerves
• Roots of premolar and molar teeth may project to sinus cavity

49
Q

MAXILLARY SINUS OR ANTRUM OF HIGHMORE Medial wall and Posterior wall

A

Medial Wall:
o Nasal surface of maxilla
o Perpendicular plate of palatine bone
o Maxillary process of inferior turbinate
o Uncinated process of ethmoid

Posterior Wall:
o Posterior surface of maxilla

50
Q

MAXILLARY SINUS OR ANTRUM OF HIGHMORE Opening and Capacity

A

• Opening of maxillary sinus is posterior part of hiatus semilunar between bulla ethmoidis
• Capacity of sinus varies: 15 – 30 mL

51
Q

FRONTAL SINUS Anatomy

A

• 2 in number; unequal size
• Develop in frontal bone
• Average capacity of sinus: 7 mL (adults)
• Supplied by supraorbital nerve and vessels

52
Q

FRONTAL SINUS Pathophysiology Colleration

A

• Anterior wall and floor of sinus have marrow containing bone; osteomyelitis can develop at any age
• Floor of sinus forms part of roof of the orbit; posterior wall forms anterior boundary of anterior cranial fossa -> infection of sinus can drain via frontonasal duct which opens in middle meatus

53
Q

SPHENOID SINUS Anatomy

A

• 2 sinuses unequally divided by septum
• Develop in the body of sphenoid bone
• Superiorly related to frontal lobe and olfactory tracts
• Above and posteriorly lies the pituitary gland
• Laterally related to optic nerve and cavernous sinus
• Opens in anterior wall in sphenoethmoidal recess

54
Q

Larynx: Location and Main Function

A

• Located at level C4 or C5 to C7
• Main function: separate aerodigestive tract to 2 distinct parts
• Voice box

55
Q

Suprahyoid muscle group

A

• Stylohyoid, digastric, genohyoid, stylopharyngeus (elevates larynx)
• Intrinsic muscles
• Cricothyroid: only muscle outside larynx
• Post-cricoarytenoid: only abductor of vocal cord (safety muscle)

56
Q

Branch of superior thyroid artery from external carotid artery

A

Superior laryngeal artery

57
Q

From inferior thyroid artery from subclavian artery

A

Inferior laryngeal artery

58
Q

Laryngeal lymphatics

A

o Supraglottic area: drain to deep cervical node in carotid bifurcation
o Subglottic area: drains to LN at upper trachea to deep cervical and superior mediastinal node
o Glottic area: devoid of lymphatics

59
Q

Child has diminished hearing on R ear thru out the day which started 2 weeks PTC; no other SSX and improves by swallowing Impacted cerumen

A

Impacted cerumen

60
Q

A 40 y/o female px complains of vertigo, hearing loss and tinnitus

A

Meniere’s Disease

61
Q

Px complains of fever, pain and nasal discharge

A

Acute Otitis Media

62
Q

A px complains of chronic, foul-smelling ear discharge

A

Chronic Suppurative Otitis Media

63
Q

A 23 y/o px complains of watery ear discharge, ear pain on R ear; 5 days PTC fever, 4 days PTC clear nose discharge and stuffy nose; 2 days ptc pain

A

Viral in etiology (AOM)

64
Q

Unilateral foul-smelling, sudden loss of hearing

A

Foreign Bodies

65
Q

Arteries that comprise the Woodruff’s plexus (located posterior to the middle turbinate)

A

• Sphenopalatine artery (branch of maxillary)
• Ascending pharyngeal artery (branch of ECA)
• Internal maxillary veins
• Posterior septal arteries

66
Q

Dysfunction in sense of smell (you smell an object differently)

A

Parosmia

67
Q

Battle Sign of ear signifies

A

Hematoma

68
Q

A test to diagnose mastoiditis and needs Xray to confirm

A

Three-Finger Test:

(Index, middle and thumb)
Index- over mastoid
Middle-over ear concha
Thumb- apply pressure over mastoid process

69
Q

Question about Rinne and Weber Test

A

CHL:
• Rinne BC>AC
• Weber: lateralizes to impaired ear

SHL:
• Rinne: AC>BC (transduction and sound conduction are both affected)
• Weber: lateralized to the normal ear

70
Q

Brodzky score

A

Grade 0: tonsils in fossa or removed
1+: <25% oropharynx occupied
2+: 25-50%
3+: 50-75%
4+: >75%

71
Q

Mallampati Score

A

Class 1: soft palate, entire uvula, faucial pillars
Class 2:soft palate, entire uvula
Class 3: soft palate, base of uvula only
Class 4: only hard palate visible

72
Q

Function of cochlea

A

Transduction – convert sound waves into mechanical vibrations of eardrum and ossicles then these vibrations get sensed by crista hair cells and turned into action potential

73
Q

Function of cochlea

A

Transduction – convert sound waves into mechanical vibrations of eardrum and ossicles then these vibrations get sensed by crista hair cells and turned into action potential

74
Q

Blood supply of external ear

A

• Posterior auricular
• Superficial temporal
• Occipital artery
• Maxillary artery (deep auricular branch)

*all are branches of ECA

75
Q

Branch of CN X; Cough reflex; supplies skin of external acoustic meatus

A

Arnold’s Nerve

76
Q

Branch of CN IX, caused referred pain (pain from an abnormality in throat or nasopharynx is referred to the ear

A

Jacobson’s nerve

77
Q

Layers of tympanic membrane

A

• Outer epidermal layer
• Middle fibrous layer
• Inner mucosal layer

Otorhinolaryngology (6 decks)

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