EENT Flashcards
2 functions of ear
hearing
equilibrium
3 anatomic area of the ear
external
middle
inner
auricle/pinna + function
cartilage and skin
concentrate sound waves and conduct to external auditory canal
what is cerumen
wax from sebaceous gland
traps foreign bodies and lower bacteria (acidic pH)
what is the middle ear filled with and how does it communicate with nasopharynx
air
eustachian tube
mucous membrane of middle ear continuous with pharynx and mastoid cells–predisposition to…
otitis media (infected middle ear)
mastoiditis (infection of mastoid cells)
what are ossicles, where are they located
3 small articulated bones across middle ear cavity
which ossicle attaches to tympanic membrane/oval window
tympanic-malleus
oval window-stapes
what fluid is in the bony labyrinth and what are the 3 divisions of the bony labyrinth
watery perilymph
vestibule, semicircular canals, cochlea
organ of corti
neural end organ of hearing
hair and vibration to electrochemical impulses
what nerve is at risk from swelling and injury to temporal bone (trauma or surgical intervention)
facial, 7
what is a myringotomy and why is it done
incision into pars tensa of eardrum
relieve fluid pressure or drain pus
what instrument is used to insert a myringotomy tube
alligator forceps
what procedure is done to repair the tympanic membrane
tympanoplasty
what tissue is harvested to provide graft material to repair the tympanic membrane?
temporalis fascia
what is a mastoidectomy and the 3 types
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
cholesteatoma
accumulation of squamous epithelium
cystlike mass in middle ear/mastoid process
what is stapedectomy and what is it done for? how is hearing restored?
removal of entire stapes for otosclerosis
graft on oval window
prosthesis on incus
what is otosclerosis
formation of abnormal bone around stapes footplate-immobilization
meniere’s disease
overaccumulation of endolymph
vertigo, tinnitus, hearing loss
what procedure is done to fix meniere’s disease
vestibular neurectomy
labyrinthectomy
why is facial nerve decompression done?
bell’s palsy
what problems do people with facial nerve paralysis experience?
can’t tear, can’t close eye, drooping mouth
what is acoustic neruoma
benign schwann cell tumor
vestibular portion of 8th cranial nerve
what is a cochlear implant? when are they used
device in mastoid of cochlea to acoustic nerve
patients with hearing loss or learned speech
where is a cochlear device and receiver placed?
device in cochlea
receiver in mastoid
the nose is associated with the ears by means of what structure
Eustachian tube
4 paranasal sinuses associated with nasal cavity
frontal
maxillary
ethmoid
sphenoid
2 local anesthetics for nasal cases
cocaine
lido w/ epi
what is on separate prep table for surgeon to prep and inject the nose before draping
vasoconstrictor solution, cocaine in patties, bayonet forceps, curved scissor, ky
what is septoplasty, submucous resecton SMR
straigtening cartilagenous or osseous part of septum
after SMR what is the nose packed with
nasal splint of plastic/silastic to prevent adhesions/maintain septum
antibiotic impregnated gauze
what is a moustache dressing
2x2 gauze folded and placed beneath nose bridge
instrument used to repair a nasal fracture using external manipulation
Boies elevator
what is an epistaxis
nosebleed
what can a scrub do to maintain periorbital cavities in FESS
place all tissue into normal saline or lactated ringer’s solution
if floats then brain tissue
where is the incision for a frontal sinus trephination
below the eyebrow
part of mouth outside teeth
buccal cavity
part of mouth inside teeth
lingual cavity
fingerlike moveable projection from soft palate
uvula
what is the pharynx in between and what is its purpose
posterior nose to esophagus and larynx
digestive and respiratory systems
3 sets of tonsils
palatine
adenoid
lingual
why is the location of the larynx strategic
protects airway during swallowing and breathing
how many cartilage rings form the larynx
9
thyroid cartilage is also called
adam’s apple
which cartilage is a complete ring vs. c-shaped of trachea
cricoid
the epiglottis does what
protects larynx during swallowing
what is the glottis
region of larynx at vocal cords
triangular space between vocal cords
what branch of the vagus nerve motivates the pharynx and larynx
recurrent
3 categories of salivary gland disorders
inflammatory
obstructive
neoplastic
most issues of salivary glands come from which gland
parotid
where does the submandibular gland lie and what is its duct called
above and below posterior mandible
wharton’s duct
where is the parotid gland located
below zygomatic arch in front of mastoid process
what nerve divides parotid into superficial and deep portions and risks injury during parotid gland surgery
facial, 7
2 things used to make a head drape
half-sheet and 2 towels
when using endoscopic equipment why should scopes be checked
hurt patient, harder to clean, intrusion into instrument
what is triple endoscopy
laryngoscopy
bronchoscopy
esophagoscopy
incision for parotidectomy
below angle of mandible to above the ear
what is tracheostomy
opening into trachea and inserting a cannula below cricoid
what is done to trach tube before insertion
test for air leaks by inflating and deflating balloon
what is a uvulopalatopharyngoplasty UPPP done for
obstructive sleep apnea
why is supraglottic laryngectomy performed? can the patient speak afterwards?
tumor in epiglottis
yes, with a hoarser voice
how are postop total laryngectomy patients taught to speak
esophageal voice or artificial larynx
after total laryngectomy how does a patient breathe
through trachea
what is removed in radical neck dissection
tumor, soft tissue from inferior mandible to midline of neck, clavicle, trapezius muscle, and en bloc nodes
when sternoclediomastoid muscle is preserved what happens postop for patient?
Minimal defect and shoulder function loss
2 self-retaining retractors in T&A?
Jenning’s
Davis
absorbable or nonabsorbable suture ligature?
absorbable
another name for type 1 tympanoplasty
myringoplasty
2 functions of nose
filter inspired air
smell
what sinus is Caldwell-Luc done on
maxillary
why are adenoidectomies not done after adolescence
they atrophy
position and anesthesia for tonsillectomy
supine
general
7 bones of orbit
maxilla, palatine, frontal, sphenoid, ethmoid, zygomatic, lacrimal
function of lacrimal gland
produce and secrete tears onto anterior eye
tears go through what to nasal cavity
nasolacrimal duct
conjunctiva
thin transparent mucous membrane
palpebral-inside eyelids
bulbar-surface of globe
where upper and lower eyelids meet
canthus
6 extraocular extrinsic eye muscles
lateral, superior, inferior, medial rectus
superior, inferior oblique
3 layers of eyeball
corneoscleral
uvea
sensory retina
outer layer of eyeball
sclera - tough white fibrous
cornea- transparent
3 structures of middle layer in eyeball
iris-colored, open to let light in (pupil)
ciliary body-smooth muscle, lens accomodation
choroid-vascular nutrients to retina
sensory retina
converts impulses to electrical signals on optic nerve
nerve fibers on inner layer converge to form what…?
orbital septum
optic disc/anatomic blind spot
optic nerve exits on retina
macula lutea
area of highest sensitivity for detail
center of retina
refractive apparatus of eye
cornea
aqueous humor
iris
vitreous body
2 transcellular eyeball fluids for shape
aqueous humor-anterior to lens in anterior chamber and posterior chamber
vitreous humor-behind lens to retina (posterior cavity)
where cornea joins sclera
limbus
lens of eye
behind iris, connected to ciliary body by zonules
optic nerve
2nd
3 cranial nerves for motor innervation of eye
3, oculomotor
4, trochlea
6, abducens
arterial supply to eyeball
ophthalmic artery
where are eyedrops placed
cornea/lower conjunctival sac
retrobulbar block
regional anesthesia-base of eyelids behind eyeball
block nerves and paralysis of extraocular muscles
peribulbar block
regional anesthesia-around soft tissue of globe/floor or roof of globe
cycloplegic drug
paralyzes ciliary muscles preventing lens accomodation
dilates pupil
miotic drug
constricts pupil
cholinergic
mydriatic drug
dilates pupil
Wydase (Hyaluronidase)
diffusing enzyme
prolongs effect and increases perfusion
irrigant in ophthalmic surgery
BSS
chalazion
benign tumor of eyelid/blocked meibomien gland
how to treat a chalazion
excision
instruments for treating chalazion
green chalazion clamp
entropion
inward turning of eyelid/lashes scrape cornea
bleopharoplasty of lower lid (involutional)
Wies procedure (cicatrical)
ectropion
eversion (outward turning) of eyelid exposing conjunctiva
lateral canthal sling
ptosis
dropping of upper lid
levator aponeurosis procedure
dacrocystorhinostomy DCR
construction of new tear drainage from lacrimal sac to nasal cavity
3 procedures for eyeball removal
enucleation: complete removal + muscles/optic nerve
evisceration: contents of eyeball only; sclera and muscles intact
exenteration: removal of entire eye and orbital contents
squint eye or cross eye
strabismus
rectus resection to correct strabismus
strengthen extraocular eye muscles by shortening the muscle
muscle reattached to original site
section of muscle removed
recession procedure for strabismus
weaken extraocular eye muscles by changing attachment site of muscle
muscle attached further back from front of eye
pterygium and treatment
fleshy triangular encroachment of conjunctiva on cornea
excision
keratoplasty
corneal transplant from another human eye
radical keratotomy
small cuts in peripheral cornea to flatten, and reshape, fixing nearsightedness (myopia)
cataract
opacification of lens
intracapsular cataract extraction ICCE
remove lens within capsule w/cryoprobe and alpha-chemotrypsin
extracapsular cataract extraction ECCE
anterior capsule ruptured, remove cataract in pieces
ECCE structure left
posterior capsule
most common visual correction after lens removed
IOL
PCL if ECCE
ACL if ICCE
what is an intraocular lens made of
silicone or acrylic resin
what IOL is implanted after ECCE
posterior chamber lens
what IOL is implanted after ICCE
anterior chamber lens
glaucoma
increased IOP caused by excessive aqueous humor
closed/narrow angle glaucoma surgery
laser iridiotomy or iridectomy to widen angle
open/wide angle glaucoma surgery
laser trabeculoplasty
normal IOP
10-22mmHg
iridectomy
remove section of iris
reestablish communication between ant + pos chambers to fix mechanical obstruction
iridotomy
cut small opening into iris
increase drainage of aqueous humor from posterior –> anterior chamber
trabeculectomy
artificial fistula between anterior chamber and subconjunctival space
bypass obstruction of drainage
what are glaucoma drainage devices?
implanted in posterior subconjunctival space when filtering procedures are unsuccessful
retinal detachment
tear allows vitreous humor to flow behind retina
separates retina from choroid
scleral bulking
return retina to normal position
pneumatic retinopexy
intraocular injection of air bubble pressurizes vs. retinal breaks
fluid retinopexy/tamponade
inject silicone oil into vitreous in pos. chamber to compress retina against choroid.
stays in for many months
vitrectomy
removal or some or all vitreous humor
why perform vitrectomy
improve vision
indications for anterior vitrectomy
vitreous loss in cataract surgery
opacity in anterior segment
complication of vitreous in anterior
indications for posterior vitrectomy
opacity
diabetic eye disease
intraocular trauma
retinal detachment
foreign body
proliferative vitrecordiopathy
most common incisional approaches of ear
periauricular
endaural
transcanal
iris
colored portion controls size of pupil allowing light in to retina
condition of aging that progressively lessens accomodative power of eye - bifocals
presbyopia
blood supply to tonsils
external carotid
Types of cycloplegic drugs
TropicamidE
Atropine
Scopolamine hydrobromide
Mydriatic drugs
Phenylephrine
Miotic drugs
Carbachol
Acetylcholine chloride
Pilocarpine hydrochloride
