EENT Flashcards

1
Q

2 functions of ear

A

hearing

equilibrium

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2
Q

3 anatomic area of the ear

A

external

middle

inner

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3
Q

auricle/pinna + function

A

cartilage and skin

concentrate sound waves and conduct to external auditory canal

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4
Q

what is cerumen

A

wax from sebaceous gland

traps foreign bodies and lower bacteria (acidic pH)

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5
Q

what is the middle ear filled with and how does it communicate with nasopharynx

A

air

eustachian tube

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6
Q

mucous membrane of middle ear continuous with pharynx and mastoid cells–predisposition to…

A

otitis media (infected middle ear)

mastoiditis (infection of mastoid cells)

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7
Q

what are ossicles, where are they located

A

3 small articulated bones across middle ear cavity

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8
Q

which ossicle attaches to tympanic membrane/oval window

A

tympanic-malleus

oval window-stapes

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9
Q

what fluid is in the bony labyrinth and what are the 3 divisions of the bony labyrinth

A

watery perilymph

vestibule, semicircular canals, cochlea

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10
Q

organ of corti

A

neural end organ of hearing

hair and vibration to electrochemical impulses

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11
Q

what nerve is at risk from swelling and injury to temporal bone (trauma or surgical intervention)

A

facial, 7

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12
Q

what is a myringotomy and why is it done

A

incision into pars tensa of eardrum

relieve fluid pressure or drain pus

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13
Q

what instrument is used to insert a myringotomy tube

A

alligator forceps

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14
Q

what procedure is done to repair the tympanic membrane

A

tympanoplasty

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15
Q

what tissue is harvested to provide graft material to repair the tympanic membrane?

A

temporalis fascia

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16
Q

what is a mastoidectomy and the 3 types

A

removal of diseased bone from mastoid process and space

simple: air cells only

modified radical: air cells and maybe external auditory canal wall

radical: air cells, eardrum, malleus, incus, muscle, lining

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17
Q

cholesteatoma

A

accumulation of squamous epithelium

cystlike mass in middle ear/mastoid process

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18
Q

what is stapedectomy and what is it done for? how is hearing restored?

A

removal of entire stapes for otosclerosis

graft on oval window

prosthesis on incus

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19
Q

what is otosclerosis

A

formation of abnormal bone around stapes footplate-immobilization

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20
Q

meniere’s disease

A

overaccumulation of endolymph

vertigo, tinnitus, hearing loss

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21
Q

what procedure is done to fix meniere’s disease

A

vestibular neurectomy

labyrinthectomy

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22
Q

why is facial nerve decompression done?

A

bell’s palsy

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23
Q

what problems do people with facial nerve paralysis experience?

A

can’t tear, can’t close eye, drooping mouth

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24
Q

what is acoustic neruoma

A

benign schwann cell tumor

vestibular portion of 8th cranial nerve

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25
Q

what is a cochlear implant? when are they used

A

device in mastoid of cochlea to acoustic nerve

patients with hearing loss or learned speech

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26
Q

where is a cochlear device and receiver placed?

A

device in cochlea

receiver in mastoid

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27
Q

the nose is associated with the ears by means of what structure

A

Eustachian tube

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28
Q

4 paranasal sinuses associated with nasal cavity

A

frontal

maxillary

ethmoid

sphenoid

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29
Q

2 local anesthetics for nasal cases

A

cocaine

lido w/ epi

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30
Q

what is on separate prep table for surgeon to prep and inject the nose before draping

A

vasoconstrictor solution, cocaine in patties, bayonet forceps, curved scissor, ky

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31
Q

what is septoplasty, submucous resecton SMR

A

straigtening cartilagenous or osseous part of septum

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32
Q

after SMR what is the nose packed with

A

nasal splint of plastic/silastic to prevent adhesions/maintain septum

antibiotic impregnated gauze

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33
Q

what is a moustache dressing

A

2x2 gauze folded and placed beneath nose bridge

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34
Q

instrument used to repair a nasal fracture using external manipulation

A

Boies elevator

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35
Q

what is an epistaxis

A

nosebleed

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36
Q

what can a scrub do to maintain periorbital cavities in FESS

A

place all tissue into normal saline or lactated ringer’s solution

if floats then brain tissue

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37
Q

where is the incision for a frontal sinus trephination

A

below the eyebrow

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38
Q

part of mouth outside teeth

A

buccal cavity

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39
Q

part of mouth inside teeth

A

lingual cavity

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40
Q

fingerlike moveable projection from soft palate

A

uvula

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41
Q

what is the pharynx in between and what is its purpose

A

posterior nose to esophagus and larynx

digestive and respiratory systems

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42
Q

3 sets of tonsils

A

palatine

adenoid

lingual

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43
Q

why is the location of the larynx strategic

A

protects airway during swallowing and breathing

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44
Q

how many cartilage rings form the larynx

A

9

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45
Q

thyroid cartilage is also called

A

adam’s apple

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46
Q

which cartilage is a complete ring vs. c-shaped of trachea

A

cricoid

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47
Q

the epiglottis does what

A

protects larynx during swallowing

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48
Q

what is the glottis

A

region of larynx at vocal cords

triangular space between vocal cords

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49
Q

what branch of the vagus nerve motivates the pharynx and larynx

A

recurrent

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50
Q

3 categories of salivary gland disorders

A

inflammatory

obstructive

neoplastic

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51
Q

most issues of salivary glands come from which gland

A

parotid

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52
Q

where does the submandibular gland lie and what is its duct called

A

above and below posterior mandible

wharton’s duct

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53
Q

where is the parotid gland located

A

below zygomatic arch in front of mastoid process

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54
Q

what nerve divides parotid into superficial and deep portions and risks injury during parotid gland surgery

A

facial, 7

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55
Q

2 things used to make a head drape

A

half-sheet and 2 towels

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56
Q

when using endoscopic equipment why should scopes be checked

A

hurt patient, harder to clean, intrusion into instrument

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57
Q

what is triple endoscopy

A

laryngoscopy

bronchoscopy

esophagoscopy

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58
Q

incision for parotidectomy

A

below angle of mandible to above the ear

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59
Q

what is tracheostomy

A

opening into trachea and inserting a cannula below cricoid

60
Q

what is done to trach tube before insertion

A

test for air leaks by inflating and deflating balloon

61
Q

what is a uvulopalatopharyngoplasty UPPP done for

A

obstructive sleep apnea

62
Q

why is supraglottic laryngectomy performed? can the patient speak afterwards?

A

tumor in epiglottis

yes, with a hoarser voice

63
Q

how are postop total laryngectomy patients taught to speak

A

esophageal voice or artificial larynx

64
Q

after total laryngectomy how does a patient breathe

A

through trachea

65
Q

what is removed in radical neck dissection

A

tumor, soft tissue from inferior mandible to midline of neck, clavicle, trapezius muscle, and en bloc nodes

66
Q

when sternoclediomastoid muscle is preserved what happens postop for patient?

A

Minimal defect and shoulder function loss

67
Q

2 self-retaining retractors in T&A?

A

Jenning’s

Davis

68
Q

absorbable or nonabsorbable suture ligature?

A

absorbable

69
Q

another name for type 1 tympanoplasty

A

myringoplasty

70
Q

2 functions of nose

A

filter inspired air

smell

71
Q

what sinus is Caldwell-Luc done on

A

maxillary

72
Q

why are adenoidectomies not done after adolescence

A

they atrophy

73
Q

position and anesthesia for tonsillectomy

A

supine

general

74
Q

7 bones of orbit

A

maxilla, palatine, frontal, sphenoid, ethmoid, zygomatic, lacrimal

75
Q

function of lacrimal gland

A

produce and secrete tears onto anterior eye

76
Q

tears go through what to nasal cavity

A

nasolacrimal duct

77
Q

conjunctiva

A

thin transparent mucous membrane

palpebral-inside eyelids

bulbar-surface of globe

78
Q

where upper and lower eyelids meet

A

canthus

79
Q

6 extraocular extrinsic eye muscles

A

lateral, superior, inferior, medial rectus

superior, inferior oblique

80
Q

3 layers of eyeball

A

corneoscleral

uvea

sensory retina

81
Q

outer layer of eyeball

A

sclera - tough white fibrous

cornea- transparent

82
Q

3 structures of middle layer in eyeball

A

iris-colored, open to let light in (pupil)

ciliary body-smooth muscle, lens accomodation

choroid-vascular nutrients to retina

83
Q

sensory retina

A

converts impulses to electrical signals on optic nerve

84
Q

nerve fibers on inner layer converge to form what…?

A

orbital septum

85
Q

optic disc/anatomic blind spot

A

optic nerve exits on retina

86
Q

macula lutea

A

area of highest sensitivity for detail

center of retina

87
Q

refractive apparatus of eye

A

cornea

aqueous humor

iris

vitreous body

88
Q

2 transcellular eyeball fluids for shape

A

aqueous humor-anterior to lens in anterior chamber and posterior chamber

vitreous humor-behind lens to retina (posterior cavity)

89
Q

where cornea joins sclera

A

limbus

90
Q

lens of eye

A

behind iris, connected to ciliary body by zonules

91
Q

optic nerve

A

2nd

92
Q

3 cranial nerves for motor innervation of eye

A

3, oculomotor

4, trochlea

6, abducens

93
Q

arterial supply to eyeball

A

ophthalmic artery

94
Q

where are eyedrops placed

A

cornea/lower conjunctival sac

95
Q

retrobulbar block

A

regional anesthesia-base of eyelids behind eyeball

block nerves and paralysis of extraocular muscles

96
Q

peribulbar block

A

regional anesthesia-around soft tissue of globe/floor or roof of globe

97
Q

cycloplegic drug

A

paralyzes ciliary muscles preventing lens accomodation

dilates pupil

98
Q

miotic drug

A

constricts pupil

cholinergic

99
Q

mydriatic drug

A

dilates pupil

100
Q

Wydase (Hyaluronidase)

A

diffusing enzyme

prolongs effect and increases perfusion

101
Q

irrigant in ophthalmic surgery

A

BSS

102
Q

chalazion

A

benign tumor of eyelid/blocked meibomien gland

103
Q

how to treat a chalazion

A

excision

104
Q

instruments for treating chalazion

A

green chalazion clamp

105
Q

entropion

A

inward turning of eyelid/lashes scrape cornea

bleopharoplasty of lower lid (involutional)

Wies procedure (cicatrical)

106
Q

ectropion

A

eversion (outward turning) of eyelid exposing conjunctiva

lateral canthal sling

107
Q

ptosis

A

dropping of upper lid

levator aponeurosis procedure

108
Q

dacrocystorhinostomy DCR

A

construction of new tear drainage from lacrimal sac to nasal cavity

109
Q

3 procedures for eyeball removal

A

enucleation: complete removal + muscles/optic nerve
evisceration: contents of eyeball only; sclera and muscles intact
exenteration: removal of entire eye and orbital contents

110
Q

squint eye or cross eye

A

strabismus

111
Q

rectus resection to correct strabismus

A

strengthen extraocular eye muscles by shortening the muscle

muscle reattached to original site

section of muscle removed

112
Q

recession procedure for strabismus

A

weaken extraocular eye muscles by changing attachment site of muscle

muscle attached further back from front of eye

113
Q

pterygium and treatment

A

fleshy triangular encroachment of conjunctiva on cornea

excision

114
Q

keratoplasty

A

corneal transplant from another human eye

115
Q

radical keratotomy

A

small cuts in peripheral cornea to flatten, and reshape, fixing nearsightedness (myopia)

116
Q

cataract

A

opacification of lens

117
Q

intracapsular cataract extraction ICCE

A

remove lens within capsule w/cryoprobe and alpha-chemotrypsin

118
Q

extracapsular cataract extraction ECCE

A

anterior capsule ruptured, remove cataract in pieces

119
Q

ECCE structure left

A

posterior capsule

120
Q

most common visual correction after lens removed

A

IOL

PCL if ECCE

ACL if ICCE

121
Q

what is an intraocular lens made of

A

silicone or acrylic resin

122
Q

what IOL is implanted after ECCE

A

posterior chamber lens

123
Q

what IOL is implanted after ICCE

A

anterior chamber lens

124
Q

glaucoma

A

increased IOP caused by excessive aqueous humor

125
Q

closed/narrow angle glaucoma surgery

A

laser iridiotomy or iridectomy to widen angle

126
Q

open/wide angle glaucoma surgery

A

laser trabeculoplasty

127
Q

normal IOP

A

10-22mmHg

128
Q

iridectomy

A

remove section of iris

reestablish communication between ant + pos chambers to fix mechanical obstruction

129
Q

iridotomy

A

cut small opening into iris

increase drainage of aqueous humor from posterior –> anterior chamber

130
Q

trabeculectomy

A

artificial fistula between anterior chamber and subconjunctival space

bypass obstruction of drainage

131
Q

what are glaucoma drainage devices?

A

implanted in posterior subconjunctival space when filtering procedures are unsuccessful

132
Q

retinal detachment

A

tear allows vitreous humor to flow behind retina

separates retina from choroid

133
Q

scleral bulking

A

return retina to normal position

134
Q

pneumatic retinopexy

A

intraocular injection of air bubble pressurizes vs. retinal breaks

135
Q

fluid retinopexy/tamponade

A

inject silicone oil into vitreous in pos. chamber to compress retina against choroid.

stays in for many months

136
Q

vitrectomy

A

removal or some or all vitreous humor

137
Q

why perform vitrectomy

A

improve vision

138
Q

indications for anterior vitrectomy

A

vitreous loss in cataract surgery

opacity in anterior segment

complication of vitreous in anterior

139
Q

indications for posterior vitrectomy

A

opacity

diabetic eye disease

intraocular trauma

retinal detachment

foreign body

proliferative vitrecordiopathy

140
Q

most common incisional approaches of ear

A

periauricular

endaural

transcanal

141
Q

iris

A

colored portion controls size of pupil allowing light in to retina

142
Q

condition of aging that progressively lessens accomodative power of eye - bifocals

A

presbyopia

143
Q

blood supply to tonsils

A

external carotid

144
Q

Types of cycloplegic drugs

A

TropicamidE

Atropine

Scopolamine hydrobromide

145
Q

Mydriatic drugs

A

Phenylephrine

146
Q

Miotic drugs

A

Carbachol

Acetylcholine chloride

Pilocarpine hydrochloride