Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Boies > Chapter 17: Diseases of the Nasopharynx and Oropharynx > Flashcards

Chapter 17: Diseases of the Nasopharynx and Oropharynx Flashcards

1
Q

Regions of pharynx

A
  1. Nasopharynx
  2. Oropharynx
  3. Laryngopharynx/hypopharynx
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Respiratory portion of the pharynx

Immobile except for the lower soft palate

A

Nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Extends from the inferior border of the soft palate to the lingual surface of the epiglottis
Includes the palatine tonsils with their pillars and the lingual tonsils located on the base of the tongue

A

Oropharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Represents the region of the separation of the upper airway from the upper digestive pathway

A

Laryngopharynx/hypopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Posterior wall extending toward the vault of the nasopharynx

A

Adenoid tissue

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Recessus pharyngeus

A

Rosennüller’s fossa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Reflection of pharyngeal mucosa over the rounded protrusions of the cartilaginous portion of the ET projects as a thumblike intrusion into the lateral wall of the nasopharynx just above the attachment of the soft palate

A

Torus tubarius

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Posterior choanae of the nasal cavity

A

Nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Close proximity and can be involved by extension of nasopharyngeal disease

A

Cranial foramina (jugular foramina)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Important vascular structures in the immediate in the nasopharynx

A
  1. Inferior petrosal sinus
  2. Internal jugular vein
  3. Meningeal branches from the occipital and ascending pharyngeal arteries
  4. Hypoglossal foramen
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Is in the proximity to the lateral portion of the roof of the nasophatynx

A
  1. Petrous portion of the temporal bone

2. Foramen lacerum

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Ostium of the sphenoid sinuses

A

Nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Permits direct visualization of the nasopharynx and torus tubarius

A

Nasopharyngoscope

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Circumferential ring of lymphoid tissue

A

Waldeyer’s ring

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Other parts of the ring

A
  1. Lymphoid tissue
  2. Palatine/faucial tonsils
  3. Lingual tonsils
  4. Lymphoid follicles on the posterior pharyngeal wall
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Has its lymphoid structures arranged in folds

A

Adenoid/pharyngeal tonsils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Has its lymphoid arrangement around cryptlike formations

A

Palatine tonsils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q
  1. Becomes diseased frequently than any of the other components of the ring
  2. More tortuous in the upper pole of the tonsils
  3. Become plugged with food particles, mucus, desquamated epithelial cells, leukocytes and bacteria
  4. Excellent place for the growth of pathogenic bacteria
A

Palatine tonsils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Have small crypts that are not particularly tortuous or branched

A

Lingual tonsils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Serves as a divider between the oropharynx and the hypopharynx

A

Epiglottis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q
  1. Includes the pyriform sinuses, posterior pharyngeal wall and post cricoid cartilage
  2. Funnel-shaped
A

Hypopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Results from the embryologic failure of the bucconasal membrane to rupture prior to birth

A

Congenital choanal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Results in the persistence of a bony plate (90%) or membrane (10%) obstructing the posterior nares

A

Congenital choanal atresia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Congenital choanal atresia

A

Unilateral: asymptomatic
Bilateral: emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Diagnostic for congenital choanal atresia

A

Inability to pass a soft catheter through the nose into the pharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Emergency treatment for congenital choanal atresia

A

Inserting a plastic oral airway into the infant’s mouth

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Alternative treatment for congenital choanal atresia

A

Tape a rubber baby bottle nipple (McGoven nipple) with a large opening on the tip into position in the infant’s mouth (permitting both breathing and feeding)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Blindly perforating the bony plate or membrane is prohibited because of the…

A

Narrow nasopharynx

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Atresia plate can be approached surgically by…

A
  1. Transnasal
  2. Transeptal
  3. Transpalatal (more definitive)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q
  1. Is a form of postnasal discharge that is produced by mucoid drainage from a pocket (pharyngeal bursa) in the uppermost part of the posterior pharyngeal wall
  2. Unusual cause of postnasal drainage
  3. Corrected by excision
A

Nasopharyngeal bursitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

Symptoms of nasopharyngeal tumor

A
  1. Posterior epistaxis
  2. Postnasal discharge
  3. Nasal obstruction
  4. Hearing loss
  5. Late sign: paralysis of CN 3, 6, 9, 10, 11
  6. Serous otitis media
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q
  1. Uncommon tumor occurs exclusively in adolescent boys
  2. Symptoms: epistaxis, nasal obstruction
  3. Can invade the surrounding vital structures with eventual invasion of the base of the skull
A

Juvenile nasopharyngeal angiofibroma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

Treatment modalities for juvenile nasopharyngeal angiofibroma

A
  1. Radiation ( for residual disease or when surgery is not possible)
  2. Surgery (preferred treatment when feasible)
  3. Hormonal therapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Evaluation of juvenile nasopharyngeal angiofibroma

A
  1. CT scan

2. Arteriography

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

Highly vascular tumors obtain their blood supply from

A
  1. Ascending pharyngeal artery or
  2. Internal maxillary artery
    Additional: branch of the internal carotid artery (tumor transcends into the anterior or middle cranial fossa)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

Diagnosis of juvenile nasopharyngeal angiofibroma

A
  1. History
  2. Exam
  3. CT
  4. Arteriogram
  5. Biopsy (not necessary and is hazardous)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

Most common presenting sign of nasopharyngeal carcinoma

A

Posterior high cervical lymph node

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

Virus that is associated with nasopharyngeal carcinoma

A

Epstein-Barr virus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

An accumulation of lymphoid tissue along the posterior wall of the nasopharynx above the level of the soft palate

A

Adenoids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

Adenoids

A

Hypertrophy: childhood (normal), greatest size in the preschool and early school-age years
Spontaneous resolution: 18-20 years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

Related to ET obstruction and resultant serous otitis media as well as recurrent and repeated episodes of acute otitis media

A

Adenoid hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

Can interfere with nasal breathing if theres obstruction

A

Adenoid hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

May lead to some changes in dental structure and malocclusion

A

Adenoid hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

Can interfere with the normal respiratory process—>cor pulmonale or sleep apnea-type syndromes

A

Adenoid hypertrophy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

Indications for adenoidectomy

A
  1. Chronic upper airway obstruction with resultant sleep disturbances, cor pulmonale or sleep apnea syndrome
  2. Chronic purulent nasopharyngitis despite adequate medical management
  3. Chronic adenoiditis or adenoid hypertrophy associated with production and persistence of middle ear effusion
  4. Recurrent acute suppurative otitis media that has not responded to medical management with prophylactic antibiotics
  5. Certain cases of chronic suppurative otitis media in children with associated adenoid hypertrophy
  6. Suspicion of nasopharyngeal malignancy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

Most common and preferred treatment for chronic serous otitis media that is refractory to medical management with antibiotics and other forms of conservative treatment

A

Insertion of ventilation tubes through the TM (may remain in place only 6-12 months)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Serves as a flag to warn of possible submucous palatal cleft

A

Bifid uvula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

Oropharyngeal disorder can be divided into those that cause…

A
  1. Acute sore throat

2. Chronic sore throat

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

Common organisms found in acute pharyngitis

A
  1. Streptococci
  2. Pneumococci
  3. Influenza bacillus
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

Stages of acute pharyngitis

A

Hyperemia—>edema—>increased secretion

Exudate at first is serous but becomes thicker or mucoid—>become dry and may adhere to the pharyngeal wall

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

Signs and symptoms of acute pharyngitis

A
  1. Dryness or scratchiness of the throat
  2. Malaise
  3. Headache
  4. Fever
  5. Exudate in the pharynx
  6. Hoarseness
  7. Dysphagia
  8. Cervical adenopathy and tenderness
  9. Pharyngeal wall is reddened
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

Acute suppurative bacterial tonsilitis is most often caused by

A 
Beta-hemolytic Streptococcus group A
Others:
Pneumococci
Staphylococci
Hemophilus influenzae
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

General inflammation and swelling of the tonsil tissue with an accumulation of leukocytes, dead epithelial cells and pathogenic bacteria in the crypts

A

Acute suppurative bacterial tonsilitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

Pathologic phases: acute suppurative bacterial tonsilitis

A
  1. Simple inflammation of the tonsil area
  2. Formation of exudates
  3. Cellulitis of the tonsil and its surrounding area
  4. Formation of a peritonsillar abscess
  5. Tissue necrosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

Symptoms of acute suppurative bacterial tonsilitis

A
  1. Sorethroat
  2. Dysphagia
  3. Fever
  4. Otalgia
  5. Tender cervical lymphadenopathy
  6. Enlarged and inflamed tonsils with/out exudates
56
Q

Lukewarm gargling solution in acute suppurative bacterial tonsilitis

A

1st: warm

2nd and 3rd: even warmer

57
Q

Drug of choice for acute suppurative bacterial tonsilitis

A

Penicillin

58
Q

If group A beta-hemolytic streptococci are cultured, it is important to…

A

Maintain adequate antibiotic therapy for 10 days to reduce the possibility of nonsuppurative complications such as RHD and nephritis

59
Q
  1. Present in the tonsil is capable of producing beta-lactamase
  2. This may explain persistent positive cultures after apprpriate treatment
A

Branhamella catarrhalis

60
Q

Do not have the complex arrangement of the faucial tonsils nor are they as large

A

Lingual tonsils

61
Q

More common in tonsillectomized patients and in adults

A

Lingual tonsilitis

62
Q

Signs and symptoms of lingual tonsilitis

A
  1. Soreness on swallowing
  2. Sense of lump in the throat
  3. Malaise
  4. Slight fever
  5. Cervical adenopathy with tenderness
  6. Reddened, swollen lingual mass with whitish spots dotting the surface of the tonsils
63
Q

Membranous pharyngitis

A
  1. Vincent’s (or Plaut’s) angina

2. Diphtheria

64
Q

Caused by fusiform bacilli and spirochetes normally present in the oral cavity

A

Vincent’s infection or trench mouth

65
Q

Diagnosis of Vincent’s angina

A

Presence of numerous fusiform bacteria seen with Fontana stain

66
Q

Treatment of Vincent’s angina

A
  1. Supportive measures
  2. Sodium perborate or hydrogen peroxide mouthwash
  3. Specific penicillin therapy
67
Q

Remains the most common site for diphtheria

A

Pharynx

68
Q

Occurs more frequently in unimmunized or inadequately immunized individuals

A

Diphtheria

69
Q

Most common initial complaints of diphtheria

A

Sore throat

70
Q

Examination in patient with diphtheria

A
  1. Membrane present over the tonsillar area with spread to adjacent structures
  2. Membrane appears dirty and dark green and may even obstruct the view of the tonsils
  3. Bleeding occurs with elevation of the membrane
71
Q

Treatment of diphtheria

A
  1. Use of a specific antitoxin

2. Elimination of the organism from the oropharynx

72
Q
  1. Acute infectious disease characterized by fever, malaise, somnolence, lymph node enlargement (posterior cervical region)
  2. Lymphocytosis with appearance of abnormal lymphocytes
A

Infectious mononucleosis

73
Q

Lead to erroneous diagnosis of lymphoma

A

Biopsy of a cervical lymph node during an acute episode of infectious mononucleosis

74
Q

Complications of infectious mononucleosis

A
  1. Ruptured spleen
  2. Guillain-Barré ascending paralysis
  3. CN paralysis
75
Q
  1. Infections of the tonsils proceed to a diffuse cellulitis of the tonsillar area extending onto the soft palate
  2. Usually unilateral and is more common in older children and young adults
A

Peritonsillar abscess

76
Q

Symptoms of peritonsillar abscess

A
  1. Fever
  2. Sorethroat
  3. Trismus
  4. Cervical adenopathy
77
Q
  1. Suppurative infiltration of the peritonsillar tissue occurs most often in the supratonsillar fossa
  2. Causes edema of the soft palate on the involved side and displacement of the uvula across the midline
  3. Swelling extends to adjacent soft tissues, causing painful swallowing and trismus
A

Peritonsillar abscess

78
Q

Throat culture may be negative in presence of an abscess

A

Peeistonsillar abscess

79
Q

Bacterial recovered in peritonsillar abscess

A
  1. Primary: S. pyogenes

2. Less: S. aureus

80
Q

Peritonsillar abscess

A

Regardless of method preferred, ALL peritonsillar abscesses are drained

81
Q

History peritonsillar abscess or a history of repeated episodes of pharyngitis…

A

Tonsillectomy is performed either immediately or as inyerval tonsillectomy 6 weeks later

82
Q

Mucosa appears thin and glistening or glazed, with an absence of all but a few of the lymphoid collections that are seen in an average pharynx

A

Atrophic pharyngitis

83
Q
  1. Dryness is striking
  2. Mucous coating is gluelike in consistency
  3. Underlying mucous membrane has a dry, furrowed appearance
A

Atrophic pharyngitis/pharyngitis sicca

84
Q

Caused by the air not being sufficiently warmed and humidified by the nasal mucosa, as occur in chronic mouth breathing

A

Atrophic pharyngitis

85
Q

Symptoms of atrophic pharyngitis

A
  1. Sense of dryness
  2. Thickness in the upper pharynx
  3. Hoarseness
  4. Fetor
86
Q

Treatment of atrophic pharyngitis

A
  1. Mandl’s paint (stimulate secretion)
  2. Potassium iodide
  3. Breathing of warm moist air (20-30 minutes 2x a day)
87
Q
  1. Dry troublesome throat
  2. Mild soreness, difficulty with marked pharyngitis sicca
  3. Dry, shiny and hyperemic pharyngeal mucosa
  4. Management: complete avoidance of smoking
A

Pharyngitis associated with tobacco

88
Q

Most common of all recurring throat diseases

A

Chronic tonsilitis

89
Q

Category of chronic tonsilitis

A
  1. Tonsil is enlarged with evident hypertrophy and scarring. The crypts seem partially stenosed, but an exudate, often purulent. One or two crypts are enlarged and a considerable of cheesy or putty-like material can be expressed
  2. Small tonsils, usually recessed and often referred to as “buried” in which the margins are hyperemic and a small amount of thin, purulent secretion can be often expressed
90
Q

Does not necessarily correlate with severity of the problem

A

Size of the tonsils in chronic tonsilitis

91
Q

Treatment of chronic tonsilitis

A
  1. Removal of tonsils
  2. Prolonged courses of penicillin
  3. Daily throat oral irrigating device
92
Q

Has been performed frequently in an effort to control recurrent pharyngeal disease, upper airway obstruction and chronic otitis media

A

Tonsillectomy with or without adenoidectomy

93
Q

Commonly performed in young adults who have suffered repeated episodes of documented tonsilitis, peritonsillar cellulitis or perironsillar abscess

A

Tonsillectomy

94
Q

Absolute indications for tonsilectomy

A
  1. Development of cor pulmonale by chronic airway obstruction
  2. Tonsil or adenoid hypertrophy with sleep apnea syndrome
  3. Hypertrophy to the extent of causing dysphagia with associated weight loss
  4. Excisional biopsy for suspected malignancy (lymphoma)
  5. Recurrent peritonsillar abscess or abscess extending into adjacent tissue spaces
95
Q

Most widely accepted indications for tonsillectomy in children

A
  1. Documented recurrent bouts of tonsilitis (despite adequate medical management)
  2. Tonsilitis associated with persistent and pathogenic streptococcal cultures (carrier state)
  3. Tonsil hyperplasia with functional obstruction
  4. Hyperplasia and obstruction remaining 6 months after infectious mononucleosis
  5. Rheumatic fever history with heart damage associated with chronic recurrent tonsilitis and poor antibiotic control
  6. Persistent chronic tonsil inflammation that does not respond to medical management
  7. Tonsil and adenoid hypertrophy associated with orofacial or dental abnormalities that narrow the upper airway
  8. Recurrent or chronic tonsilitis associated with persistent cervical adenopathy
96
Q

Contraindications for tonsillectomy

A
  1. Repeated URTI
  2. Systemic or chronic infection
  3. FUO
  4. Enlarged tonsils without obstructive symptoms
  5. Allergic rhinitis
  6. Asthma
  7. Blood dyscrasias
  8. General inability or failure to thrive
  9. Poor musculat tone
  10. Sinusitis
97
Q

Tonsillectomy can be performed in individuals who have a cleft palate deformity. However…

A

There should be extenuating circumstances to indicate this operative procedure and the patient must be informed of the possible effect on voice quality of the operative procedure

98
Q

Structure of 2 pillars

A
  1. Palatoglossus muscle (anterior pillar)

2. Palatopharyngeus muscle (posterior pilla)

99
Q

Lateral boundary of the tonsillar fossa

A

Superior constrictor muscle

100
Q

Blood supply of tonsils

A
  1. Dorsalis linguae from the lingual artery
  2. Ascending palatine from the external maxillary
  3. Tonsillar from the external maxillary
  4. Ascending pharyngeal from the external carotid
  5. Descending palatine from the internal maxillary
101
Q

Main lymphatic drainage from the palatine tonsils…

A

Leaves the fibrous trabeculae of the tonsil to pass through the capsule to the superior constrictor muscle of the pharynx

102
Q

Post operative bleeding (tonsillectomy)

A
  1. Immediate

2. Delayed

103
Q

Generally handled by reanesthetizing the patient and controlling by ligature or suction electrocautery

A

Immediate persistent postoperative bleeding

104
Q
  1. May be handled in an outpatient situation, particularly if the youngster or adult is cooperative
  2. Occur up to the 10th postoperative day
A

Later bleeding of significance

105
Q

Sources of deep neck infections

A
  1. Dental
  2. Pharyngeal
  3. Trauma
106
Q

Pharyngeal space infection

A
  1. Dental
  2. Oral cavity
  3. Tonsils
  4. Parotid gland
  5. Traumatic
  6. Mastoid
107
Q

Funnel-shaped, with its base located at the base of the skull on each side to the jugular foramen and its apex at the great horn of the hyoid bone

A

Pharyngomaxillary (parapharyngeal) space

108
Q

Inner boundary of pharyngomaxillary space

A

Ascending ramus of the mandible and its attached medial prerygoid muscle and the posterior portion of the parotid gland

109
Q

Dorsal boundary of pharyngomaxillary space

A

Prevertebral muscle

110
Q

Each fossa is divided into unequal compartments

A
  1. Anterior (prestyloid) compartment

2. Posterior compartment

111
Q
  1. Larger
  2. May become involved in a suppurative process as a result of infected tonsils, some form of mastoiditis or pertrositis, dental caries and surgery
A

Anterior (prestyloid) compartment

112
Q
  1. Smaller

2. Contains the internal carotid artery, jugular vein, vagus and sympathetic nerve

A

Posterior compartment

113
Q

When infection extends from the pharynx into pharyngomaxillary space, patient will develop…

A

Marked trismus

114
Q

Pharyngomaxillary space abscess should be drained through a…

A

Cervical incision (transverse incision)
2 fingerbreadths below the mandible, gives access to the anterior border of the SCM
Submaxillary gland is identified as well as the posterior belly of the digastric muscle

115
Q

Most serious complications of the phatyngomaxillary space infection involve the…

A

Surrounding vasculature

  1. Septic thrombophlebitis of the jugular vein
  2. Sudden massive hemorrhage from erosion of the internal carotid artery
116
Q

If hemorrhage occurs when the abscess is drained…

A

Immediate ligation of the internal carotid artery or common carotid artery can be performed

117
Q

Is a cellulitis of phlegmonous inflammation of the superior compartment of the suprahyoid space

A

Ludwig’s angina

118
Q

Potential space exists between the muscles attaching the tongue to the hyoid bone and the mylohyoid muscle

A

Suprahyoid space

119
Q

Causes extreme firmness in the tissue of the floor of the mouth and forces the tongue upward and posteriorly and thus can potentially obstruct the airway

A

Ludwig’s angina

120
Q

Treatment of Ludwig’s angina

A

Surgical incision through midline, thus interrupting the tightness that has formed in the floor of the mouth

121
Q

Preparation before incision and drainage of Ludwig’s angina

A

Possible tracheostomy

122
Q

Potential space is in close proximity to the pharyngomaxillary space

A

Masticator abscess

123
Q

Includes the internal pterygoid muscle, masseter muscle and ramus of the mandible

A

Masticator space

124
Q

Most frequently involved secondary to infection of dental origin

A

Masticator space

125
Q

Swelling and tenderness occur over the ramus of the mandible as well as firmness developing along the lateral floor of the mouth

A

Masticator abscess

126
Q

Management of masticator abscess

A
  1. Antibiotics
  2. Drainage ( transverse cervical incision, 2 fingerbreadths below the mandible and carried down to the mandibular periosteum)
127
Q
  1. Occurs primarily in infants or small children under the age of 2
  2. Older children/adults: secondary to spread from a paraphryngeal space abscess or traumatic interruption of the posterior pharyngeal wall lining by trauma from a foreign object or during instrumentation or intubation
A

Retropharyngeal abscess

128
Q

In children there is an accumulation of pus between the posterior pharyngeal wall and prevertebral fascia which results from a suppuration and breaking down of lymph nodes in the retropharyngeal tissue

A

Retropharyngeal abscess

129
Q

Symptoms of retropharyngeal abscess

A 
Infant/child
1. Unexplained fever
2. Loss of appetite
3. Change in speech
4. Difficulty swallowing
5. Stridor (abscess becomes larger or edema extends downward to involve the larynx)
Adults
1. Dysphagia
2. Pain on swallowing
130
Q

Safe intubation is required to avoid rupture of the abscess

A

Retropharyngeal abscess

131
Q

Diagnosis of retropharyngeal abscess

A

Lateral soft tissue xray: reveal a marked increase in the soft tissue shadow between the pharyngeal airway and the bodies of the cervical vertebrae
Larynx and trachea: forward position

132
Q

Treatment of retropharyngeal abscess

A
  1. Drainage: head is lowered so that escaping pus will not be aspirated, and a small, pointed scalpel blade is used to make a short vertical incision at the point of greatest swelling
133
Q

Complications of retropharyngeal abscess

A
  1. Asphyxia
  2. Hemorrhage (profuse: ligation of internal carotid artery)

Can extend to mediatinum—>mediatinitis

134
Q

Results from the efforts of the heart and lungs to compensate for long-term chronic obstruction

A

Cardiopulmonary syndrome

135
Q

Other findings associated with sleep apnea syndrome

A
  1. Systemic hypertension
  2. Polycythemia
  3. Cardiac arrhythmia (bradycardia and ventricular tachycardia)
136
Q

More common in patients with associated obstructive lung disease and daytime hypoxia

A

Right heart failure

137
Q

Associated with an increased risk of sleep disordered breathing

A
  1. Obesity

2. Increasing age

Boies (27 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions