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MRCS > DOHNS OSCE > Flashcards

DOHNS OSCE Flashcards

1
Q

Arteries supplying nasal septum

A

SPA
Greater palatine artery
(Both above from maxillary artery from ECA)
Ant ethmoidal (from ophthalmic artery from ICA)
Branches of facial artery (from ECA)

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2
Q

MEN 1

A

3 Ps:
- Pituitary adenoma
- Parathyroid hyperplasia
- Pancreas

MENIN gene - chromosome 11

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3
Q

MEN 2a

A

2Ps + 1M:
- Parathyroid
- Phaeochromocytoma
- Medullary thyroid ca.

RET oncogene - chromosome 10

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4
Q

Men 2b

A

1P + 2Ms:
- Phaeochromocytoma
- Medullar thyroid ca.
- Marfanoid habitus / mucosal neuroma

RET oncogene - chromosome 10

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5
Q

Which nerve related to origin of middle meningeal artery?

A

Auriculotemporal nerve - supplies sensation to the external ear and outermost part of the tympanic membrane

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6
Q

Level of hyoid/epiglottis?

A

C3

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7
Q

Level of thyroid cartilage notch?

A

C4

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8
Q

Level of cricoid?

A

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).

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9
Q

Papillary thyroid ca. route of spread?

A

Lymphatic

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10
Q

Follicular thyroid ca. route of spread?

A

Haematogenous

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11
Q

Branches of external carotid artery?

A

Some angry lady figured out PMS

Superior thyroid
Ascending pharyngeal
Lingual
Facial
Occipital
Posterior auricular
Maxillary
Superficial temporal

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12
Q

Structures passing through foramen ovale?

A

O - otic ganglion
V3 - mandibular
A - accessory meningeal artery
L - lesser petrosal nerve
E - emissary veins

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13
Q

Nerves passing through supraorbital fissure?

A

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

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14
Q

Which foramina does trigeminal nerve exit?

A

Standing Room Only

V1 - superior orbital fissure
V2 - rotundum
V3 - ovale

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15
Q

Cranial nerve exits?

A

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)

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16
Q

Most common parotid malignancy?

A

Mucoepidermoid, followed by adenoid cystic (latter characterised by perineurial invasion)

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17
Q

Branches of ICA?

A

Ophthalmic
Posterior communicating
Choroidal
Anterior cerebral
Middle cerebral

Only Press Carotid Arteries Momentarily

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18
Q

Parasympathetics CNs?

A

1973

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19
Q

Most common thyroid ca.?

A

Papillary
Lymphatic spread predominates

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20
Q

Second most common thyroid ca.?

A

Follicular
Vascular spread predominates

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21
Q

Thy1?

A

Non-diagnostic

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22
Q

Thy2?

A

Non-neoplastic

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23
Q

Thy3?

A

Neoplasm possible

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24
Q

Thy4?

A

Suspicious for malignancy

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25
Q

Thy5?

A

Malignant

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26
Q

U1?

A

Normal

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27
Q

U2?

A

Benign

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28
Q

U3?

A

Indeterminate

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29
Q

U4?

A

Suspicious

30
Q

U5?

A

Malignant

31
Q

ECV in children?

A

0.4 - 1.0 ml

32
Q

ECV in adults?

A

0.6 - 1.5 ml

33
Q

Constrictions of oesophagus?

A
  • 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

34
Q

LASER acronym?

A

Light Amplification by Stimulated Emission of Radiation

35
Q

Classification system for nasal polyps?

A

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

36
Q

Embryology of external ear?

A

Forms from 1st pharyngeal groove (between 1st and 2nd pharyngeal arch)

37
Q

Boundaries of Prussak’s space?

A

Superior - lateral mallear ligament fold
Inferior - lateral process of malleus
Lateral - TM (pars flaccida)
Medial - neck of malleus

38
Q

Tensor tympani innervation?

A

Trigeminal nerve - V3 (mandibular)
(via medial pterygoid)

39
Q

Stapedius innervation?

A

Facial nerve (via branch in stylomastoid canal)

40
Q

Tensor tympani inserts….

A

…handle of malleus

41
Q

Stapedius inserts….

A

…neck of stapes

42
Q

Mastoiditis organisms?

A

Strep. pneumoniae
H. influenzae
Group A strep progenes
Pseudomonas auriginosa
S. aureus

43
Q

Sofradex contains?

A

Framycetin, gramicidin, dex

44
Q

What are the zoster zones?

A

Ear (herpes auricularis)
Face (herpes facialis)
Posterior neck (herpes occipito-collairs)

45
Q

Other cranial neuropathies in Ramsay-Hunt (beside facial n.)?

A

VIII, IX, V and VI in this order of frequency

46
Q

Vocal cord layers?

A

Stratified squamous epithelium
Reinke’s space (lamina propria)
Vocal ligament
Thyroartyenoid muscle (vocalis)

47
Q

Bloods supply to larynx?

A

Superior laryngeal a. from ECA
Inferior laryngeal a. from thyrocervical trunk of subclavian

48
Q

Tonsillitis organisms?

A

Step pyogenes aka group A beta-haemolytic strep.
EBV

49
Q

Contents of superior orbital fissure?

A

Oculomotor
Abducens
Trochlear
Frontal
Lacrimal
Nasocillary

50
Q

Contents of inferior orbital fissure?

A

Infraorbital nerve
Infraorbital artery
Zygomatic nerve

51
Q

Contents of jugular foramen?

A

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

52
Q

Structures passing through foramen magnum?

A

CN 11
Vertebral arteries
Spinal arteries
Spinal cord/medulla

53
Q

Muscles attaching to styloid process?

A

Styloglossus
Stylohyoid
Stylopharyngeus
Stylohyoid ligament
Stylomandibular ligament

54
Q

Muscles attaching to mastoid process?

A

Sternocleidomastoid
Post belly digastric
Splenius capitis
Longissimus capitis

55
Q

Attachment to pharyngeal tubercle?

A

Pharyngeal raphe
Superior pharyngeal constrictor

56
Q

Contents of foramen spinousum?

A

Middle meningeal artery

57
Q

Contents of foramen lacerum?

A

Greater petrosal nerve

58
Q

Contents of stylomastoid foramen?

A

Facial nerve
Stylomastoid artery

59
Q

Contents of IAM?

A

Facial nerve
Vestibulocochlear nerve
Vestibular ganglion
Labyrinthine artery

60
Q

Attachment to pharyngeal tubercle?

A

Pharyngeal raphe
Superior pharyngeal constrictor

61
Q

Contents of carotid canal?

A

ICA
Sympathetic nerve fibres of the eye

62
Q

Non-random association with choanal atresia?

A

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).

63
Q

Nose block nerves?

A

Infratrochlear
Infraorbital
External nasal
Nasopalatine

64
Q

Adduction of VCs?

A

Lateral cricoarytenoid muscles

65
Q

Abduction of VCs?

A

Posterior cricoarytenoid muscle

66
Q

Tensing of VCs?

A

Cricothyroid muscle

67
Q

Systemic causes of septal perforation?

A

Wegener’s
Sarcoidosis
SLE
TB
Syphillis
Polyarteritis nodosa

68
Q

Bat ears?

A

Underdevelopment of anti-helical fold
Overdevelopment of cochal wall

69
Q

Helicotrema?

A

Scala vestibular and tympani meet here (at apex)

70
Q

Inferior parathyroid gland origin?

A

3rd pharyngeal pouch

71
Q

Superior parathyroid gland origin?

A

4th pharyngeal pouch

72
Q

Glue ear surgical intervention in children timing (NICE)?

A

Children with persistent bilateral OME documented over a period of 3 months with a hearing level in the better ear of 25–30 dBHL

MRCS (2 decks)

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