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Copy > CCP 221 ENT Emergencies 👂👃 > Flashcards

CCP 221 ENT Emergencies 👂👃 Flashcards

1
Q

cranial nerves associated with extra ocular movement

A

III, IV, VI (3,4,6)

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2
Q

“S.H.O.R.T” acronym for predictors of difficult cricothyrotomy

A 
S - Surgery (recent/prev neck surgery)
H - Hematoma (zone 2 hematoma)
O - Obese (lots of fatty tissue)
R - Radiation distortion (thick, fibrous tissue)
T - Tumor (zone 2 space occupying mass)
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3
Q

peripheral vertigo (define, describe, differentiate from central vertigo)

💵💵💵💵 MONEY SLIDE 💵💵💵💵

A

describes vertigo caused by lesions affecting the inner ear and cranial nerve VIII (vestibulocochlear nerve)

sudden onset, intermittent/fluctuating, more severe symptoms
affected by head position/movement
motor function/gait typically intact

CAUSES:

benign paroxysmal positional vertigo (BPPV)
vestibular neuritis
Meniere's disease
acoustic neuroma
aminoglycoside toxicity
semicircular canal dehiscence syndrome
perilymphatic fistula
herpes zoster oticus (Ramsay Hunt syndrome)
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4
Q

central vertigo (define, describe, differentiate from peripheral vertigo)

💵💵💵💵 MONEY SLIDE 💵💵💵💵

A

vertigo caused by lesions affecting the brainstem and cerebellum

gradual onset, constant, more mild symptoms
unaffected by head position/movement
motor function/gait unstable

CAUSES:

vestibular migraine
brainstem stroke
multiple sclerosis
ischemic or hemorrhagic damage to the cerebellum
cerebral edema
high altitude cerebral edema
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5
Q

The four cranial nerves involved in vision and movement of the eyes

A

CN II optic nerve (sensory)
CN III oculomotor (motor)
CN IV trochlear (motor)
CN VI abducen (motor)

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6
Q

What 3 cranial nerves directly control the eye muscles?

A

CN III oculomotor (motor)
CN IV trochlear (motor)
CN VI abducen (motor)

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7
Q

cranial nerves controlling the position of the eyeballs

A

CN III oculomotor (motor)
CN IV trochlear (motor)
CN VI abducen (motor)

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8
Q

what cranial nerve influences the position of the eyelids and the size of the pupils

A

oculomotor (III)

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9
Q

3 zones of the neck

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A

Zone 3 - Angle of mandible to base of skull (UPPER ZONE)
Zone 2 - Cricoid to angle of mandible (MIDDLE ZONE)
Zone 1 - Clavicle to cricoid cartilage (LOWER ZONE)

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10
Q

5 eye vital signs

🔥🔥🔥MEGA PEARL🔥🔥🔥

A

1) Visual acuity (Snellen chart)
2) IOP (Tonometer)
3) Pupils (pupil exam)
4) Extraoccular movement (H-test)
5) Visual Fields (visual field exam)

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11
Q

hyphema (describe + define)

A

Blood pooling in the anterior chamber of the eye

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12
Q

iridocyclitis (describe + define)

A

Inflammation of the iris

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13
Q

iridodialysis (describe + define)

A

Tearing the iris root from the ciliary body causing a double pupil

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14
Q

what ophthalmic condition is characterized by a patient complaint of seeing “flashes and floaters”

A

Vitreous hemorrhage

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15
Q

what cranial nerve has been impacted to elicit a “down and out” pupil presentation?

A

CN III (oculomotor)

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16
Q

what cranial nerve has been impacted to elicit a “medially deviated” pupil presentation?

A

CN IV (abducens)

17
Q

Ludwig’s angina (describe + define)

A

Bilateral infection of the submandibular space in the deep neck that begins as a cellulitis in the floor of the mouth

18
Q

LeFort fracture definition

💵💵💵💵 MONEY SLIDE 💵💵💵💵

A

fractures of the midface, which collectively involve separation of all or a portion of the midface from the skull base

19
Q

Le Fort type I

A

Le Fort type I - horizontal maxillary fracture, separating the teeth from the upper face

Le Fort I is a floating palate (horizontal)

20
Q

Le Fort type 2

A

Le Fort type II - pyramidal fracture, with the teeth at the pyramid base, and nasofrontal suture at its apex

Le Fort II is a floating maxilla (pyramidal)

21
Q

Le Fort type 3

A

Le Fort type III - craniofacial disjunction

Le Fort III is a floating face (transverse)

22
Q

pathophysiology of trismus in deep space neck infections

A

local inflammation of the muscles of mastication or the direct involvement of these muscles by the infection

23
Q

“Hard Signs” of neck trauma

💵💵💵💵 MONEY SLIDE 💵💵💵💵
🥼🥼🥼PIMP-ABLE TOPIC🥼🥼🥼

A
  1. Airway compromise
  2. Air bubbling wound
  3. Expanding or pulsatile hematoma
  4. Active Bleeding
  5. Shock, compromised radial pulse
  6. Hematemesis
  7. Neuro Deficit/Paralysis/Cerebral ischemia
  8. Absent or unequal radial pulse
24
Q

“Soft Signs” of neck trauma

💵💵💵💵 MONEY SLIDE 💵💵💵💵
🥼🥼🥼PIMP-ABLE TOPIC🥼🥼🥼

A
  1. Subcutaneous emphysema
  2. Dysphagia, dyspnea
  3. Non-pulsatile, non-expanding hematoma
  4. Venous oozing
  5. Chest tube air leak
  6. Minor hematemesis
  7. Paresthesias
25
Q

Zone III (upper neck) structures

🥼🥼🥼PIMP-ABLE TOPIC🥼🥼🥼

A 
Distal portion of the internal carotid arteries
Vertebral arteries
Jugular veins
Pharynx
Spinal cord
Cranial nerves IX, X, XI, XII
Sympathetic chain
Salivary and parotid glands
26
Q

Zone II (midneck) structures

🥼🥼🥼PIMP-ABLE TOPIC🥼🥼🥼

A 
Common carotid arteries
Internal and external branches of carotid arteries
Vertebral arteries
Jugular veins
Trachea
Esophagus
Larynx
Pharynx
Spinal cord
Vagus and recurrent laryngeal nerves
27
Q

Zone I (low neck) structures

🥼🥼🥼PIMP-ABLE TOPIC🥼🥼🥼

A 
Thoracic outlet vasculature (subclavian arteries and veins, internal jugular veins)
Proximal carotid arteries
Vertebral artery
Apices of the lungs
Trachea
Esophagus
Spinal cord
Thoracic duct
Thyroid gland
Jugular veins
Cranial nerve X (vagus nerve)
28
Q

differentiating central vs peripheral vertigo

🥼🥼🥼PIMP-ABLE TOPIC🥼🥼🥼

A

PERIPHERAL: think SUDDEN ONSET, SEVERE, inner ear and cranial nerve VIII (vestibulocochlear nerve) involvement

CENTRAL: think CHRONIC, GRADUAL ONSET, MORE MILD, brainstem involvement

29
Q

signs of impending airway failure in epiglottitis

A
  1. Drooling
  2. Muffled voice
  3. Stridor
  4. Hypoxia
  5. Sniffing position (sitting upright with neck extended)
30
Q

characteristic XR finding in epiglottitis

A
  1. Thumbprint sign of epiglottitis lateral neck XR

2. Presence of a “thumb-like” epiglottis on lateral soft tissue neck radiograph is concerning for epiglottitis

31
Q

pathophysiology of epiglottitis

A
  1. Inflammation of the epiglottis can lead to airway obstruction
  2. Epiglottitis was previously seen primarily in children as a result of Haemophilus influenzae type b infection
  3. Since the widespread adoption of vaccination against Haemophilus influenzae type B, the incidence of epiglottitis infections has decreased, and the mean age of patients with epiglottitis is now 45 years
  4. In the era following Haemophilus influenzae type B vaccination, Streptococcus and Staphylococcus are now the leading causes of epiglottitis
32
Q

Physical exam findings concerning for oropharyngeal infection

A
  1. Trismus (local inflammation of the muscles of mastication)
  2. Nuchal rigidity
  3. Uvular edema or deviation
  4. Submental edema or tongue elevation
33
Q

pathophysiology of Peritonsillar abscesses (quincy)

A
  1. Tonsillar inflammation and cellulitis can progress to PTA.
  2. PTA can also result from obstruction of Weber glands (salivary glands in the soft palate).
  3. Complications include abscess rupture and aspiration, erosion into the carotid sheath leading to hemorrhage, extension into the deep tissues of the neck and mediastinum, and airway obstruction
34
Q

pathophysiology of ludwig’s angina

A

Infection and edema of the submandibular space (sublingual and submaxillary spaces) can rapidly lead to airway obstruction.

classically results from the spread of odontogenic infection and is frequently polymicrobial.

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