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PE midterm > Ear nose and mouth > Flashcards

Ear nose and mouth Flashcards

1
Q

What makes up the external ear?

A

pinna/auricle + ear canal

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2
Q

Be able to identify the helix, antihelix, tragus, lobule, and EAM

A

OK

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3
Q

What are mastoid air cells?

A

part of the external ear that can become infected and lead to mastoiditis which is a surgical emergency and requires drainage

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4
Q

What are the ossicles of the ear?

A

malleus, incus, stapes

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5
Q

What are the components of the middle ear?

A

the ossicles and TM

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6
Q

What are the components of the inner ear?

A

cochlea, eustachian tube

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7
Q

When is the light reflex of the TM obliterated?

A

infection

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8
Q

What is the anatomy of the TM?

A

anterior folds, posterior folds, light reflex, umbo, handle of malleus

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9
Q

What are the different parts of the otoscope?

A

speculum, viewing window, sometimes inflation device to push air against TM

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10
Q

What are the possible reactions of the TM to the inflation device?

A

positive or negative movement with positive and negative pressure, infected ear TM won’t move

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11
Q

What should be palpated on the ear exam?

A

auricle, tragus, mastoid process

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12
Q

How shold pediatric patients be held during ear exam? Why?

A

Cuddle hold, TM can become erythematous after crying

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13
Q

What does a normal TM look like?

A

pearly grey, non-injected, non-erythematous, intact, light reflex

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14
Q

Where does a light reflex show up in the left and right ears?

A

Left: left, right: right

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15
Q

What are bony exostoses?

A

normal variants of the ear caused by repeated exposures to cold water (surfers/divers)

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16
Q

What is cerumen impaction?

A

normal variant, ear wax impaction - abnormal variant can cause tinnitus, pain and conductive hearing loss

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17
Q

What is the most common cause of conductive hearing loss?

A

cerumen impaction

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18
Q

What is the difference in appearance of ear wax that is soft and solid?

A

soft: light-colored, solid: dar brown, black

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19
Q

What is tympanosclerosis?

A

normal variant: due to recurrent infections

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20
Q

What are the physical exam findings of acute otitis media?

A

erythema, no light relfex, no umbo, injection

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21
Q

What is serous otitis media?

A

Result of viral URI or seasonal allergies - a change in pressure leads to fluid accumulation behind the ear. Can cause conductive hearing loss, appreciate fluid bubbles on exam behind TM, landmarks are preserved, light reflex present

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22
Q

What can cause chronic otitis media? What do these pts require?

A

eustachian tube dysfunction, require myringotomy tube (tympanotomy tube)

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23
Q

What happens to myringotomy tubes with age?

A

they fall out

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24
Q

What are the positions the TM can be perforated?

A

central or marginal

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25
Q

How is TM perforation treated?

A

often heal on own, intervene if there is hearing loss

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26
Q

What can cause TM perforation?

A

extremely loud noise, pressure, otitis media

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27
Q

What are the sxs of TM perforation?

A

pain that goes from bad to worse (10/10) then relief with ruptire and discharge

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28
Q

What is swimmer’s ear AKA?

A

otitis externa

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29
Q

What are the sxs of otits externa?

A

pain with palpation anywhere on the external ear

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30
Q

What is the most common cause of otitis externa?

A

pseudomonas infection of the EAM causing rupture

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31
Q

How can you treat swimmer’s ear?

A

ear wick with drops of Rx

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32
Q

Who is most likely to develop fungal otitis externa?

A

pts with DM or immunocompromised

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33
Q

What is BCC?

A

common cause of skin cancer - benign, rarely metastasizes

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34
Q

What is found of physical exam of BCC on the ear?

A

a mass with telangiectasia, pearly appearance, necrosis and ulceration - very slow growing

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35
Q

What are keloids?

A

hypertrophic scars that grow outside the bounds of the wound - common in AA, not painful, common on sternum

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36
Q

What is chondrodermatitis helices?

A

chronic inflammatory lesion of the helix/antihelix - Bx to rule out BCC

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37
Q

How is sound conducted when you cover your ears?

A

bone conduction

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38
Q

What are the causes of conductive hearing loss?

A

breach in air conduction in the external/middle ear: cerumen, foreign body, infection, tumor

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39
Q

Which cranial nerve is reponsible for hearing?

A

VIII

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40
Q

What is presbycusis?

A

high frequency hearing loss with age, normal, senescent, miss consonants

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41
Q

What is sensorineural hearing loss?

A

disorder of the inner ear, brain, or CN VIII

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42
Q

What can cause damage to the inner ear?

A

tumor, high decibel sound, infection

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43
Q

What is a normal result of the rinne test?

A

air conduction greater than bone conduction (same for sensorineural hearing)

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44
Q

With obstruction, what is the result of the Rinne test?

A

AC<BC or AC=BC

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45
Q

Why is it difficult to demostrate sensorineural hearing loss

A

both bone and air conduction are similar sounding

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46
Q

What is a normal result of the weber test?

A

no lateralization of sounds

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47
Q

What happens to results of the weber test with conductive hearing loss?

A

lateralizes to the blocked ear

48
Q

What happens to results of webers test when there is CN VIII impairment?

A

lateralizes to the good ear

49
Q

What are the functions of the nasal mucosa?

A

cleanse, humidify, control the temperature of inspired air

50
Q

What are the sinus ostia?

A

maxillary sinuses - drain into the middle meatus

51
Q

Which plexus is responsible for posterior nosebleeds?

A

woodruff’s

52
Q

Which type of nosebleed is an emergency?

A

posterior - can compromise the airway, pt has trouble breathing

53
Q

Which nasal plexus is responsible for anterior nosebleeds?

A

Kiesselbach’s plexus

54
Q

What are common causes of anterior nosebleeds?

A

dry, irritated, infected mucosa, coagulopathy, trauma

55
Q

When can nasal speculum be used to identify the source of epistaxis?

A

anterior nosebleeds

56
Q

What is a common cause of septal perforation?

A

drug use - cocain, methamphetamine

57
Q

What are common causes of septal deviation?

A

trauma, congenital

58
Q

What are sxs of deviated nasal septum?

A

anosmia, sleep apnea, infection, bleeds

59
Q

is it necessary to treat a nondisplaced nasal fx?

A

no

60
Q

How do you test for nasal obstruction?

A

have pt close one nostril and inhale in each

61
Q

What do normal turbinates look like?

A

pink, moist

62
Q

What does allergic rhinitis present with on PE?

A

pale, blue/purple turbinates, stringy mucous

63
Q

What causes nasal polyps?

A

allergies

64
Q

What do pts with nasal polyps also likely have?

A

allergy to ASA, allergic triad, cystic fibrosis

65
Q

What is the allergic triad?

A

eczema, asthma, allergic rhinitis

66
Q

What is rhinophyma?

A

lumps on nose as a result of severe/untreated rosacea

67
Q

What are the names of the types of teeth?

A

incisors, (1st medial, 2nd lateral), canines, premolars, molars

68
Q

what is the crown of the tooth?

A

the part of the tooth exposed above the gums

69
Q

What are the 3 layes of the tooth from outside to inside?

A

enamel, dentin, pulp (contains vasculature)

70
Q

What helps cement the tooth into the jaw

A

peridontal membrane

71
Q

Where do the tonsils reside?

A

between the palatoglossal and palatopharyngeal arches

72
Q

What are vallate papillae?

A

the larger bumps on the back of the tongue

73
Q

What are fungiform papillae?

A

taste buds

74
Q

What are the anterior and posterior pillars?

A

Anterior: palatoglossal arch, posterior: palatopharyngeal arches

75
Q

What is the lingual frenulum?

A

the midline of the ventral side of the tongue

76
Q

What is the buldge at the bottom of the lingual frenulum?

A

the papilla

77
Q

what is the difference between the alveolar mucosa and the gingiva?

A

the gingiva is around the teeth, the alveolar mucosa is below that

78
Q

what is the inside of the lip called?

A

labial mucosa

79
Q

What is malloclussion?

A

over/underbite

80
Q

Which nerve is responsible for tongue movement?

A

XII

81
Q

What do crackled lips denote?

A

dehydration

82
Q

What is torus palatinus?

A

benign midline lump that is hard, not tender and bony

83
Q

What CN mediates the symmatrical rise of the soft palate on “ah”?

A

XII

84
Q

What are normal variants of the uvula?

A

pointy, bifurcated, none at all

85
Q

What are the signs of SCC on the tongue?

A

painless ulcer on the tongue

86
Q

What are normal variants of the tongue?

A

fissured/geographic tongue/hairy tongue

87
Q

What can cause hairy tongue?

A

tobacco use, hx of trush, poor hygeine, abx use, coffee, overuse of bismuth

88
Q

are sublingual varices normal variants?

A

yes, normal with age, veins on ventral side of tongue are varicosed

89
Q

What are mandibular tori?

A

growths on the bottom of the mouth, pink, normal, bony, non-tender

90
Q

What is the most common cause of herpes outbreak on the mouth?

A

HSV1

91
Q

What does herpes look like on the mouth?

A

vesicular on erythematous base - “dew drops on a rose petal”

92
Q

What is the normal progression of herpes mouth lesions?

A

vesicles –> ulcer (contagious) –> crusting = healing

93
Q

What is angioedema?

A

deep tissue inflammation due to hypersensitivity reaction (ACEi)

94
Q

What is leukoplakia?

A

SCC precursor what is fixed and painless on the buccal mucosa/tongue

95
Q

Who gets hairy leukoplakia?

A

HIV pts

96
Q

What does hairy leukoplakia look like?

A

feathery, corrugated, well demarcated

97
Q

How is trush distinguished from leukoplakia?

A

painful, scrapes off with an erythematous base, bleeds after scraping

98
Q

Who gets thrush?

A

babies, people using advair (rinse mouth), prednisone, immunocompromised, abx use

99
Q

What is periapical abscess?

A

odontogenic infection that is tender, nodular, fluctuant (smooshy) found at the apex of the tooth

100
Q

What 3 conditions cause gingival hyperplasia?

A

leukemia (if there is bleeding), chronic dilatin use, pregnancy

101
Q

What is a common presentation of gum recession?

A

you can see dentin, pts don’t normally floss, associated with heart disease

102
Q

What is a common cause of gum recession?

A

chronic periodontal disease

103
Q

Who develops pyogenic granulomas?

A

pregnant women (1-5%)

104
Q

What does dyptheria present as?

A

grey/white membrane on posterior pharynx which can lead to respiratory obstruction

105
Q

What causes kaposi sarcoma?

A

HHV-8

106
Q

What does kaposi sarcoma look like?

A

vascular tumor, purple, can occur in multiple organs

107
Q

What is a common finding of oral exam in pts with bullemia?

A

yellow teeth with caries

108
Q

What does HAND stand for?

A

used for bullemia: Halitosis, abrasions onf knuckles, negative gag reflex, dentition in ill repair

109
Q

What are common signs of bullemia?

A

maintain body weight, cuts on the back of the throat from forks to wretch

110
Q

What do pts with ANUG present with?

A

fever, malaise, LAN, halitosis, found in AIDs pts

111
Q

What do petechiae on the hard palate represent?

A

mono, HIV, trauma, coagulopathy (ITP)

112
Q

When you see eshar necrosis, what do you think of?

A

black necrosis of the mouth - sign of oral CA, painless, yellow slough

113
Q

When should tongue lacerations be sewed?

A

if laceration is all the way through the tongue

114
Q

What is actinic cheilitis?

A

thickening whitish discoloration of the lip at the border of the lip and skin, loss of vermillion border

115
Q

What is angular cheilitis?

A

inflammation of one or more corners of the mouth

PE midterm (10 decks)

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