Ear, Nose, Throat Flashcards
What is the external auditory canal lined with?
The canal lining is protected and lubricated with cerumen; a waxy substance secreted by the apocrine glands in the distal third of the canal. Cerumen provides an acidic environment that inhibits the growth of microorganisms.
What is the tympanic membrane?
The tympanic membrane separates the external ear from the middle ear. It is concave, being pulled in at the center by the malleus.
The tympanic membrane is translucent, causing the middle ear cavity and malleus to be visualized. Its conical shape and oblique position to the auditory canal account for the triangular light reflex (5:00 on right ear and 7:00 on left ear) seen in an otoscope examination.
What differentiates the sinuses between the young child and adult?
Frontal sinuses start slowly developing at ages 6-8 and are fully developed from 12-18.
The ethmoid, sphenoid, and maxillary sinuses develop at a young age.
What occurs in the ear, nose, and throat in pregnant patients?
Elevated levels of estrogen cause increased vascularity of the upper respiratory tract in pregnancy. The capillaries of the nose become swelled, leading to symptoms of nasal stuffiness, decreased sense of smell, epistaxis, a sense of fullness in the ears, and impaired hearing.
This may also increase laryngeal changes which lead to hoarseness, deepening or cracking of the voice, or a persistent cough.
The gums may appear reddened, swollen, and spongy with the hypertrophy resolving within 2 months of delivery.
What occurs in acute mastoiditis?
The pinna is pushed forward due to post-auricular swelling over the mastoid bone.
What does a bulging tympanic membrane look like?
A bulging tympanic membrane is more conical, usually with a loss of bony landmarks, and a distorted light reflex. Indicative of an infection brewing.
What does a red tympanic membrane mean?
Redness in the tympanic membrane means infection in the middle ear such as acute otitis media.
Prolonged crying
What does pain look like with otitis externa, otitis media with effusion, and acute otitis media?
Otitis externa: Intense with movement of pinna, chewing. Purulent drainage from the ear canal. Mild edema and erythema of the pinna
Otitis media with effusion: Discomfort, feeling of fullness
Acute otitis media: Deep-seated earache that interferes with activity or sleep, pulling at ear.
What does a transverse crease indicate?
A transverse crease at the junction between the cartilage and bone of the nose may indicate frequent upward rubbing of the nose due to chronic nasal itching and allergies (allergic salute).
What does nasal discharge look like in different diagnosis?
Allergy: bilateral watery discharge and associated sneezing and nasal congestion.
Epistaxis: bloody discharge
Rhinitis/ Upper respiratory infection: bilateral mucoid or purulent discharge.
Foreign body: unilateral, purulent, thick, greenish, malodorous discharge
Cerebrospinal fluid leakage: unilateral watery discharge occurring after head trauma.
What are characteristics of allergies that can be seen in turbinate?
Turbinate that appears bluish gray or pale pink with a swollen, boggy consistency may indicate allergies.
What does cranial nerve I test?
CN I: Olfactory- ask them if they are able to differentiate between odors. (Sensory).
Where are the most common areas to identify oral cancer?
Vermillion border of the lips, the labial mucosa, the attached gingival tissues, and the vestibule.
When should you perform an ear/oral exam in a young child?
Perform these exams at the end of the visit.
Position the child in the parent’s lap with the back to the parent’s chest and their legs in between the adult’s legs.
- How do you grade tonsils?
1+: visible
2+: halfway between tonsillar pillars and the uvula
3+: nearly touching the uvula
4+: tonsils are touching each other
