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Physical Exam Midterm & Final > Ear, Nose, & Throat > Flashcards

Ear, Nose, & Throat Flashcards

1
Q

What are the parts of the external ear

A 
Helix
Antihelix
Tragus
Lobule (lobe)
External auditory meatus
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2
Q

Which cranial nerve sends the auditory info from the ear to the brain & is responsible for proprioception

A

CN #8

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3
Q

What is the umbo

A

The center of the TM, represents the handle of the maleus

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4
Q

Lack of TM mobility (against pressure) suggests…

A

Fluid build up behind the TM

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5
Q

Tenderness when pushing on the tragus is a sign of…

A

Otitis externa

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6
Q

The most common cause of ear damage is…

A

Q-tips

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7
Q

Signs of an ear infection include…

A

Ejection, inflammation, discharge, loss of light reflex, loss of landmarks (such as umbo), signs of fluid build up behind the ear

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8
Q

What does a normal TM look like

A

Pearly gray, non-injected, non-erythematous, intact, light reflex in tact

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9
Q

Overgrowths of the ear canal that can obscure the TM; caused by repeated exposures to cold water, as in surfers or divers

A

Bony exostoses

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10
Q

The most common cause of conductive hearing loss is…

A

Cerumen impaction

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11
Q

Cerumen impaction is a normal variant. It is abnormal if it causes…

A

Pain, tinnitus, or conductive hearing loss

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12
Q

Treatments for cerumen impaction are….

A

warm water in the ear, mineral oils

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13
Q

Hardening of the TM that is essentially scar tissue and common in pts with frequent OM is…

A

Tympano-sclerosis

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14
Q

Signs of acute otitis media include…

A

Bulging, erythema, loss of landmarks and red cone of light, injection, non-mobile TM with bulging

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15
Q

Serous otitis media is most often caused by

A

Viral URI, pressure changes, or seasonal allergies

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16
Q

The main problem in serous otitis media is…

A

ET tube not working properly causing serous fluid to accumulate

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17
Q

What is a Myringotomy tube (AKA tympanotomy tube or T-tube)

A

It is a tube placed in the TM that may be a solution for ET dysfunction which has SxS of tinnitus, hearing loss, vertigo

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18
Q

Indications for T-tube include…

A

chronic middle ear effusion with hearing loss; reccurent OM with cumulative duration > 6 months; suppurative complications of OM (meningitis, mastoiditis, brain abscess, facial nerve palsy)

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19
Q

Common causes of perforated TMs are

A

very load noise, extreme pressure

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20
Q

Pt complains of immediate pain (intense, 10/10) with d/c that slowly subsides is most likely due to…

A

Perforated TM

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21
Q

Infection of the external auditory canal, occurs when the epithelium is breached and becomes infected is called…

A

Otitis externa

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22
Q

Most common cause of otitis externa is…

A

Pseudomonas auriginosa

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23
Q

Otitis externa is also called…

A

Swimmer’s ear

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24
Q

Fungal infections of the ear are common in…

A

Pts with DM or that are immunocompromised

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25
Q

Discharge seen in OE or AOM with perforation and often seen with perforated TM or with infection is called…

A

Otorrhea

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26
Q

One of the most common forms of skin cancer, very benign & hardly has Mets

A

Basal cell carcinoma

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27
Q

Appearance of telangectasias and necrosis/ulceration is indicative of…

A

Basal cell carcinoma

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28
Q

Hypertrophic scar tissue; more common in blacks; can grow in any area where there has been trauma to the skin, not painful

A

Keloids

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29
Q

Chronic inflammatory lesion on helix or antihelix

A

Chondrodermatitis helicis

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30
Q

What do you need to do with chondrodermatitis helicis

A

Biopsy to rule out carcinoma

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31
Q

Pain in the ear canal, not due to direct infection, more common in people who live in poor socioeconomic conditions

A

Bug in the ear canal that can erode through the TM

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32
Q

Air conduction phase characterized by…

A

sound waves conducted through the ear, TM, ossicles, to choclea

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33
Q

Bone conduction phase characterized by…

A

sound waves travel through the bone, bypass the external/middle ear structures, and reach the choclea, muffled sound

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34
Q

Which conduction phase should normally be louder

A

Air conduction

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35
Q

This test measures bone conduction vs air conduction

A

Rhinne test

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36
Q

A normal rhinne test result is…

A

Louder noise with air conduction

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37
Q

Most common causes of conductive hearing loss

A

cerumen impaction then AOM

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38
Q

Sensorineural hearing loss is caused by…

A

Disorder of the Inner Ear, Brain, or CN VIII

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39
Q

Normal SN hearing loss due to aging

A

Presbycusis

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40
Q

This test checks for sensoroneural hearing loss by checking for lateralization of sound

A

Webber test

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41
Q

Webber test with sensoroneural loss result is…

A

Laterilzes to the good ear because the sound won’t be transmitted through the bad side

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42
Q

Webber test with obstruction/conduction loss result is…

A

Lateralizes to the blocked ear because it will travel through the obstruction

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43
Q

Functions of the nasal mucosa

A

Cleanse, Humidify, Control temperature of inspired air

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44
Q

Nasolacrimal duct drains into

A

The inferior meatus

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45
Q

This drains the maxillary sinuses into the middle meatus; drainage from this common in sinus infections

A

Sinus ostia

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46
Q

Deviated septum may be due to

A

congenital defect, trauma, drug use

47
Q

Pts with deviated septum may have

A

anosmia (difficulty smelling), more prone to infections, breathing problems, more common to have nosebleeds

48
Q

Septal perforations are commonly caused by…

A

snorting crack/cocaine or crystal meth

49
Q

Broken nose w/o significant displacement, nasal bleeding, or breathing trouble. Is it treated or not?

A

No need to treat, likely will heal on its own

50
Q

Network of vessels in the anterior of the nasal cavity; most common source of nose bleeds

A

Kiesselbach’s plexus

51
Q

Potential causes of bleed from Kiesselbach’s plexus include…

A

If plexus mucosa is dry, experienced trauma, or has platelet problems may be more prone to bleeds

52
Q

Posterior nasal network of vessels

A

Woodruffs plexus

53
Q

Bleed from Woodruffs plexus

A

Are uncommon and represent a true emergency, may lead to compromised airway

54
Q

Bleeding coming out of the nose is due to…

Bleeding draining from nose into the back of the throat is due to…

A

Kiesselbach’s plexus

Woodruffs plexus

55
Q

Why is it important to thoroughly examine nasal trauma?

A

Because trauma to the nose, in the correct place and angle, may lead to brain trauma through the cribiform plate

56
Q

Normal/healthy turbinates should be…

A

mucosa pink, no d/c, no deformities, no swelling

57
Q

Allergic rhinitis may present as…

A

Paleness of mucosa and string like d/c

58
Q

The allergic triad

A

eczema, seasonal allergies, asthma

59
Q

People with the allergic triad are more likely to form these

A

Nasal polyps

60
Q

Causes of perforated septum

A

trauma, surgery, cocaine of amphetamine use

61
Q

Large bulbous ruddy nose d/t granulomatous inflammation often secondary to severe, untreated Rosacea

A

Rhinophyma

62
Q

Growth on nose with telangectasia, pearly appearance

A

Basal cell carcinoma

63
Q

Outer layer of the tooth

A

enamel, gives tooth strength/protection

64
Q

Mid layer of the tooth contains

A

Dentin

65
Q

Inner layer of the tooth

A

pulp, has blood & nerve supply

66
Q

Cements the tooth into the gum & periodontal membrane

A

Cementum

67
Q

System used for staging dental fractures

A

Ellis classification

68
Q

Ducts that open on the papila on each side of frenulum

A

Wharton’s ducts (opening for submandibular gland)

69
Q

Ducts that open near upper second molar

A

Stenson’s duct (opening for parotid gland)

70
Q

Where teeth meet from sucking and chewing irritation

A

Wavey white patch

71
Q

Black line across the gums is seen in…

A

Lead poisoning

72
Q

Red line across the gums is seen in…

A

Gingivitis

73
Q

Movement of the tongue is controlled by CN #…

A

CN #9

74
Q

Softening of the corners of the mouth followed by fissuring, common with nutritional deficiency or denture wearers, leads to candiada

A

Angular cheilitis

75
Q

Results from excessive exposure to sunlight, primarily affects the lower lip; lips become scaly, somewhat thickened, and slightly everted

A

Actinic cheilitis

76
Q

Recurrent and painful vesicular eruptions of the lips and surrounding skin; first develops as cluster of vesicles which then break and form a yellow-brown crust; heal in 10-14 days

A

Herpes simplex virus (AKA Cold sores or fever blisters)

77
Q

Localized subcutaneous or submucosal swelling of the lips caused by leakage of the intravascular fluid into the interstitial tissue; commonly caused by mast cells in allergic & NSAID reactions or with ACE-I users; usually benign and resolves in 24-48hrs

A

Angiodema

78
Q

Multiple small red spots on the lips strongly suggest hereditary hemorrhagic telangiectasia, also visible on the oral mucosa & fingertips; commonly also have nosebleeds, GI bleeding, & iron deficiency

A

Osler-Weber-Rendu Syndrome

79
Q

Osler-Weber-Rendu Syndrome is a ___________ genetic disorder

A

Autosomal dominant

80
Q

Prominent small brown pigmented spots in the dermal layer of the lips, buccal mucosa, and perioral areas; also accoompanied by intestinal polyps

A

Peutz-Jeghers Syndrome

81
Q

Peutz-Jeghers Syndrome is a ____________ genetic disease

A

Autosomal dominant

82
Q

Ulcerated papule with an indurated edge, usually appears after 3-6 weeks of incubation, caused by spirochete infection, resemble carcinoma or crusted cold sores; appear on tongue, lips, and genitals

A

Chancre of Primary Syphilis

83
Q

Where the lips meet the frenulum; very important in suturing

A

Vermillium border

84
Q

Benign midline lump, may be mandibular or maxillary, normal variant

A

Torus palatinus

85
Q

Soft palate rise controlled by CN #

A

Controlled by CN #12

86
Q

Hypertrophied tonsils common in those with…

A

Recurrent bacterial pharyngitis

87
Q

Normal variance of the uvula include…

A

Pointed uvula, biphid uvula, no uvula

88
Q

Ulcerative lesions on the tongue are suspicious for…

A

Malignancy (squamous cell carcinoma); remember over 50 smokers, men, drinkers; lesion should be biopsied especially if not tender

89
Q 
Normal or abnormal?
Fissured tongue
Geographic tongue
Thrush tongue
Hairy tongue
A

Fissured tongue = normal
Geographic tongue = normal
Thrush tongue = normal
Hairy tongue = may be normal or abnormal

90
Q

What can you do with thrush

A

Scrape it off

91
Q

What is hairy tongue associated with

A

Antibiotics, poor hygeine, smoking/chewing tobacco use, thrush, sometimes coffee

92
Q

Incompetent valves of the veins, common as people age

A

Sublingual varices

93
Q

Pink, not ulcerative or necrotic, shouldn’t be tender, bony, normal variant, can be unilaterl or bilateral

A

Mandibular tori

94
Q

Most commonly caused by HSV 1 but can also be caused by genital herpes; Vessicles on an erythematous base (dew drops on a rose petal description) with crusting; very painful

A

Herpes simplex virus

95
Q

During herpes infection, crusting indicates…

A

Healing phase

96
Q

What are the 3 phases of herpes infection

A

Vessicles -> lesions/ulcerative (infective phase) -> crusting (healing phase)

97
Q

Painless white patches on the tongue or buccal mucosa; precursor to SCC

A

Leukoplakia

98
Q

Can you scrape off leukoplakia?

A

No, it won’t scrape off b/c it is fixed

99
Q

Type of leukoplakia that is found in HIV Pts

A

Hariy leukoplakia

100
Q

Very painful, scrapes off to yeild red inflammed bleeding tissue; seen in immunocompromised, babies/infants, denture wearers, & some Pts on inhaled corticosteroids

A

Thrush Oral Candidiasis

101
Q

Inflamation of tongue

A

Glossitis

102
Q

Smooth tongue, shrinkage/inflammation

A

Atrophic glossitis

103
Q

Infection of the apex of the tooth, seen on the gingival margin (odontogenic infection), often caused by bacteria entering through a cracked tooth

A

Periapical abscess

104
Q

Gingival hyperplasia is commonly seen in…

A

Chronic use of Dilantin can cause it (CLASSIC long term side effect)
Pregnancy (reversible)

105
Q

Overgrowth of the gums or access gum tissue

A

Gingival hyperplasia

106
Q

Looks very gross/bad but it is not cancerous and is a “normal” side effect in pregnancy but still should be biopsied

A

Pyogenic Granuloma

107
Q

Very rare disease in the U.S.; grey-white pseudomembrane on the back of the throat; undiagnosed leads to airway obstruction; bacterial infection

A

Diphtheria

108
Q

Low grade purple vascular lesion/tumor d/t HHV 8 in AIDS patient mostly men

A

Kaposi’s sarcoma

109
Q

Erosions in the teeth

A

Dental carries

110
Q

Pts with balemia often are found to have what oral sign?

A

Poor dentition due to continuous exposure to gastric acids

111
Q

Fever, malaise, LAD, foul breath, bleeding, pain, spread of grayish pseudomembrane across gum margins; common in AIDs Pts

A

ANUG = Acute necrotizing ulcerative gingivitis

112
Q

Can get very bad if tonsils impeed on the airway or progresses to peritonsial abcess or rheumatic feve

A

Exudative Pharyngitis

113
Q

When do you surgically repair the tongue

A

Full thickness tongue lacerations or those at risk of retaining foreign bodies

Physical Exam Midterm & Final (11 decks)

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