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ENT > Emergency > Flashcards

Emergency Flashcards

1
Q

Describe the movement of the epiglottis and vocal cords

A

They open up when we breathe and close when we swallow

Vocal cords are close together during phonation

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2
Q

List the special features of the airway in children and babies

A 
They breathe through their nose 
Have a relatively large tongue and large head 
Small and soft larynx that sits higher 
Weak neck muscles 
Floppy head
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3
Q

What is the equation for air flow resistance

A

Its proportional to 1 over the radius to power 4

Exponential increase in resistance as the radius gets smaller

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4
Q

List common causes of airway obstruction

A 
Inflammation 
Infection 
Allergy 
Foreign bodies 
Physical compression 
Trauma 
Burns 
Neurological causes 
Neoplastic causes 
Congenital problems
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5
Q

List symptoms of airway obstruction

A 
SOB 
Coughing 
Choking 
Sternal or subcostal recession 
Dysphagia 
Dysphonia 
Cyanosis 
Stridor
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6
Q

List signs of acute epiglottitis

A

Red, swollen epiglottis
Breathlessness
Drooling

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7
Q

What causes recurrent respiratory papillomatosis

A

HPV infection

There is no cure

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8
Q

What can respiratory distress progress on to

A

Respiratory failure
Respiratory arrest
Cardiac arrest

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9
Q

How do you manage an airway obstruction

A 
A,B,C: Resuscitation
Oxygen
Heliox - helium mixed with oxygen 
Steroid
Adrenaline
Endoscopy 
Tracheostomy (if needed) 
Treat underlying problem
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10
Q

List signs of nasal trauma

A 
Bruising and swelling 
Tenderness 
Deviation 
Epistaxis 
Cranial nerve dysfunction
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11
Q

What is a septal haematoma

A

Bulging mass in nostril – seen on otoscope
Blood under the perichondrium – loss of blood supply to cartilage
Occurs after trauma
Treat by draining and sewing back into place

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12
Q

List complications of nasal trauma

A

Epistaxis
CSF leak
Meningitis
Anosmia

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13
Q

How do you treat nasal fracture

A

Treatment is based in deviation, breathing and cosmesis
Leave for 5-7 days to let swelling settle
If needed use digital manipulation

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14
Q

What is epistaxis

A

Nose bleed

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15
Q

Which blood vessles are found in the nose and may lead to epistaxis

A

Sphenopalatine artery
Etmoid arteries
Greater palatine artery

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16
Q

How do you manage a nose bleed

A 
Apply external pressure to the nose and lean forward 
Ice 
Cautery 
Nasal packing 
Topical vasoconstrictors 
Remove any clots
17
Q

At what point does a nose bleed need medical attention

A

If it doesn’t stop in 20 mins

18
Q

What can cause a CSF leak

A

Fracture to part of the skull - usually ethmoid as so thin
It often resolves itself
Needs surgery if not

19
Q

What is a pinna haematoma

A

Caused by trauma to the outer ear - common in rugby
Bleed occurs under the perichondrium
If not treated the cartilage loses blood supply and becomes deformed - cauliflower ears

20
Q

How do you treat a pinna haematoma

A

Aspirate
Incision and drainage
Pressure dressing
Avoid contact

21
Q

How do you treat an ear laceration

A

Debridement
Closure - done under LA
Need antibiotics if cartilage is exposed

22
Q

What are the classifications of temporal bone fractures

A

Longitudinal or transverse

23
Q

Describe the presentation of longitudinal temporal bone fractures

A 
Caused by lateral blows to head 
Bleeding from external ear canal 
Haemotympanum and ossicular chain disruption  cause conductive deafness
Facial palsy 
CSF leak from nose
24
Q

Describe the presentation of transverse temporal bone fractures

A 
Caused by frontal blows 
Can damage facial and auditory nerves 
SN hearing loss 
more likely than long to cause hearing loss
Facial nerve palsy 
Vertigo
25
Q

What one foreign body must be removed from the ear immediately

A

Small batteries - chemical s can burn the ear

26
Q

How do you treat a bug in the ear

A

Drown it in oil and remove when able

27
Q

In terms of neck trauma, what is included in zone 1

A 
Low down on neck: 
Trachea
Oesophagus
Thoracic duct
Thyroid
Vessels 
Spinal cord

Very dangerous area to injure

28
Q

In terms of neck trauma, what is included in zone 2

A 
Middle of neck 
Larynx 
CN 10,11,12
Vessels – carotids, internal jugular
Spinal Cord
29
Q

In terms of neck trauma, what is included in zone 3

A 
Upper neck - between jaw and skull base 
Pharynx
Cranial Nerves
Vessels – Carotids, IJV, Vertebral
Spinal Cord
30
Q

What are the signs of a deep neck space infection

A 
Sore throat 
Limited neck movement 
Systemically unwell 
Febrile 
Red and tender neck
31
Q

How do you treat a deep space neck infection

A

Fluid resuscitation
Intravenous antibiotics
Incision and drainage of neck space

32
Q

What are the signs of an orbital fracture

A 
Pain 
Red eye 
Decreased visual acuity or double vision
Oedema 
Restricted eye movement 
Numb around eye 
Bruising
33
Q

What is seen on a CT of an orbital fracture

A

Tear drop sign

Caused by contents of orbits pushing through break

34
Q

Describe the Le Fort fracture classifications

A

1 - breaks horizontally above the upper teeth (through maxilla)
2 - Pyramidal shape to fracture, through maxilla, lacrimal bone, zygoma etc. over nose and under eyes
3 - transverse, whole lower face detached (lower orbit and nose etc)

ENT (9 decks)

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