DOHNS OSCE Flashcards
Arteries supplying nasal septum
SPA
Greater palatine artery
(Both above from maxillary artery from ECA)
Ant ethmoidal (from ophthalmic artery from ICA)
Branches of facial artery (from ECA)
MEN 1
3 Ps:
- Pituitary adenoma
- Parathyroid hyperplasia
- Pancreas
MENIN gene - chromosome 11
MEN 2a
2Ps + 1M:
- Parathyroid
- Phaeochromocytoma
- Medullary thyroid ca.
RET oncogene - chromosome 10
Men 2b
1P + 2Ms:
- Phaeochromocytoma
- Medullar thyroid ca.
- Marfanoid habitus / mucosal neuroma
RET oncogene - chromosome 10
Which nerve related to origin of middle meningeal artery?
Auriculotemporal nerve - supplies sensation to the external ear and outermost part of the tympanic membrane
Level of hyoid/epiglottis?
C3
Level of thyroid cartilage notch?
C4
Level of cricoid?
C6
Also;
Junction of larynx with trachea
Junction of pharynx with oesophagus
Level at which the inferior thyroid artery enters the thyroid gland
The level at which the vertebral artery enters the transverse foramen in the 6th cervical vertebra
Level at which the superior belly of omohyoid crosses the carotid sheath
The level of the middle cervical sympathetic ganglion
The level at which the carotid artery can be compressed against the transverse process of C6 (carotid tubercle).
Papillary thyroid ca. route of spread?
Lymphatic
Follicular thyroid ca. route of spread?
Haematogenous
Branches of external carotid artery?
Some angry lady figured out PMS
Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal
Structures passing through foramen ovale?
O - otic ganglion
V3 - mandibular
A - accessory meningeal artery
L - lesser petrosal nerve
E - emissary veins
Nerves passing through supraorbital fissure?
Live Frankly To See Absolutely No Insult
Lacrimal
Frontal
Trochlear
Superior division of oculomotor
Abducens
Nasociliary
Inferior division of oculomotor
3,4, 5-1, 6
Which foramina does trigeminal nerve exit?
Standing Room Only
V1 - superior orbital fissure
V2 - rotundum
V3 - ovale
Cranial nerve exits?
2244
2 cerebrum (I, II)
2 midbrain (III, IV)
4 pons (V, VI, VII, VIII)
4 medulla (IX, X, XI, XII)
Cerebellopontine angle mass affects VII and VIII (7 and 8)
Most common parotid malignancy?
Mucoepidermoid, followed by adenoid cystic (latter characterised by perineurial invasion)
Branches of ICA?
Ophthalmic
Posterior communicating
Choroidal
Anterior cerebral
Middle cerebral
Only Press Carotid Arteries Momentarily
Parasympathetics CNs?
1973
Most common thyroid ca.?
Papillary
Lymphatic spread predominates
Second most common thyroid ca.?
Follicular
Vascular spread predominates
Thy1?
Non-diagnostic
Thy2?
Non-neoplastic
Thy3?
Neoplasm possible
Thy4?
Suspicious for malignancy
Thy5?
Malignant
U1?
Normal
U2?
Benign
U3?
Indeterminate
U4?
Suspicious
U5?
Malignant
ECV in children?
0.4 - 1.0 ml
ECV in adults?
0.6 - 1.5 ml
Constrictions of oesophagus?
- Cricopharyngeus - C6 (14-16cm from incisors)
- Aortic arch (25-27cm from incisors)
- GOJ (36-68cm from incisors)
70-20-10: percentage of impaction at each level, respectively
LASER acronym?
Light Amplification by Stimulated Emission of Radiation
Classification system for nasal polyps?
Meltzer staging system
1 - No polyps
2 - Polyps restricted to middle meatus
3 - Polyps extending below middle turbinate
4 - Massive polyposis, occluding entire nasal cavity
Embryology of external ear?
Forms from 1st pharyngeal groove (between 1st and 2nd pharyngeal arch)
Boundaries of Prussak’s space?
Superior - lateral mallear ligament fold
Inferior - lateral process of malleus
Lateral - TM (pars flaccida)
Medial - neck of malleus
Tensor tympani innervation?
Trigeminal nerve - V3 (mandibular)
(via medial pterygoid)
Stapedius innervation?
Facial nerve (via branch in stylomastoid canal)
Tensor tympani inserts….
…handle of malleus
Stapedius inserts….
…neck of stapes
Mastoiditis organisms?
Strep. pneumoniae
H. influenzae
Group A strep progenes
Pseudomonas auriginosa
S. aureus
Sofradex contains?
Framycetin, gramicidin, dex
What are the zoster zones?
Ear (herpes auricularis)
Face (herpes facialis)
Posterior neck (herpes occipito-collairs)
Other cranial neuropathies in Ramsay-Hunt (beside facial n.)?
VIII, IX, V and VI in this order of frequency
Vocal cord layers?
Stratified squamous epithelium
Reinke’s space (lamina propria)
Vocal ligament
Thyroartyenoid muscle (vocalis)
Bloods supply to larynx?
Superior laryngeal a. from ECA
Inferior laryngeal a. from thyrocervical trunk of subclavian
Tonsillitis organisms?
Step pyogenes aka group A beta-haemolytic strep.
EBV
Contents of superior orbital fissure?
Oculomotor
Abducens
Trochlear
Frontal
Lacrimal
Nasocillary
Contents of inferior orbital fissure?
Infraorbital nerve
Infraorbital artery
Zygomatic nerve
Contents of jugular foramen?
IJV
CN 9 (glossopharyngeal)
CN 10 (vagus)
CN 11 (spinal accessory)
Emissary veins and inf. petrosal sinus
Meningeal branches of occipital and ascending pharyngeal arteries
Structures passing through foramen magnum?
CN 11
Vertebral arteries
Spinal arteries
Spinal cord/medulla
Muscles attaching to styloid process?
Styloglossus
Stylohyoid
Stylopharyngeus
Stylohyoid ligament
Stylomandibular ligament
Muscles attaching to mastoid process?
Sternocleidomastoid
Post belly digastric
Splenius capitis
Longissimus capitis
Attachment to pharyngeal tubercle?
Pharyngeal raphe
Superior pharyngeal constrictor
Contents of foramen spinousum?
Middle meningeal artery
Contents of foramen lacerum?
Greater petrosal nerve
Contents of stylomastoid foramen?
Facial nerve
Stylomastoid artery
Contents of IAM?
Facial nerve
Vestibulocochlear nerve
Vestibular ganglion
Labyrinthine artery
Attachment to pharyngeal tubercle?
Pharyngeal raphe
Superior pharyngeal constrictor
Contents of carotid canal?
ICA
Sympathetic nerve fibres of the eye
Non-random association with choanal atresia?
CHARGE
Coloboma of the iris.
Heart defect (e.g. atrial septal defect).
Atresia of the choanae (100%).
Retarded growth and development.
Genitourinary abnormalities (e.g. cryptorchidism, hydronephrosis).
Ear defects (e.g. deafness).
Nose block nerves?
Infratrochlear
Infraorbital
External nasal
Nasopalatine
Adduction of VCs?
Lateral cricoarytenoid muscles
Abduction of VCs?
Posterior cricoarytenoid muscle
Tensing of VCs?
Cricothyroid muscle
Systemic causes of septal perforation?
Wegener’s
Sarcoidosis
SLE
TB
Syphillis
Polyarteritis nodosa
Bat ears?
Underdevelopment of anti-helical fold
Overdevelopment of cochal wall
Helicotrema?
Scala vestibular and tympani meet here (at apex)
Inferior parathyroid gland origin?
3rd pharyngeal pouch
Superior parathyroid gland origin?
4th pharyngeal pouch
Glue ear surgical intervention in children timing (NICE)?
Children with persistent bilateral OME documented over a period of 3 months with a hearing level in the better ear of 25–30 dBHL
