ENT Flashcards
What nerve supplies sensation to skin of the face?
Trigeminal
What does the stapedius do?
When contracts pulls the stapes posteriorly and dampens down vibration of ossicles: useful in loud situations
What nerve passes near the mastoid
facial
What is the tensor tympani innervated by?
Nerve to tensor tympani: a branch of mandibular division of trigeminal nerve
Describe a vestibular schawannoma and its presentation?
benign subarachnoid tumour of CN VIII causing local pressure effects causing unilateral hearing loss and tinnitus. A progressive disease. MRI performed to rule out malignancy. Surgical excision
What size do vestibular schwannomas have to be for surgical excision?
OVer 40mm
If under repeat MRI every 6 months
What does the chorda tympani do
Special sensation- Carries taste sensation from anterior portion of the tongue
Parasymp- submandibular and sublingual
What does the vagus nerve pass out of
Jugular foramen
What is the first branch of the vagus nerve
Superior laryngeal nerve
What does the superior laryngeal nerve innervate
The cricothyroid muscle which helps adduct the vocal cords
What does the inferior laryngeal nerve do
motor innervation to intrinsic laryngeal muscles and sensory to larynx
most likely diagnosis for vertigo lasting days/weeks
Labrynthitis and vestibular neuronitis
first line treatment for persistent otitis media with effusion
grommet insertion
Other than antibiotics what treatment for severe tonsilitis
Steroids
Lump between isthmus of thyroid and hyoid bone
Thyroglossal cyst
neck lump associated with dysphagia, aspiration and chronic cough
pharyngeal pouch
pulsatile neck lump
carotid anuersym
What verterbral level is the cricoid cartilage
c6
what vertebral level is the hyoid cartilage
c3
what vertebral level is the thyroid cartilage
c4/5/6
What is seen in glandular fever
- Gross tonsillar enlargement with membranous exudates
- Marked cervical lymphadenopathy
- Generalised lymphadenopathy
- Palatal petchial haemorrahages
- Hepatosplenomegaly, jaundice, hepatitis
- Rash
What is seen on blood film of glandular fever
atypical lymphocytes
paul-bunnel test can be used
Where does ophthalmic branch enter enter the skull
Travels along lateral wall of cavernous sinus through superior orbital fissure
Where does the maxillary nerve enter the skull
Inferior to V1 along cavernous sinus exit at foramen rotundum
Where does the mandibular nerve enter the skull
Does not pass through cavernous sinus, exits at foramen ovale
Where does the mandibular nerve enter the skull
Does not pass through cavernous sinus, exits at foramen ovale
What is Ramsay-Hunt syndrome
Reactivation of varicella zoster virus in the geniculate ganglion of the facial nerve causing a facial nerve palsy and vesicular rash. MM- aciclovir and corticosteroids
What does the tensor tympani attach to
the malleus
What does the ansa cervicalis innervate
Ansa cervicalis muscles:
GHost THought SOmeone Stupid Shot Irene
GenioHyoid
ThyroidHyoid
Superior Omohyoid
SternoThyroid
SternoHyoid
Inferior Omohyoid
Classical symptoms of cholesteatoma
Recurrent aural discharge, assymetrical hearing loss.
Potentially facial weakness due to facial nerve involvement and dizziness and nystagmus from choleastoma eroding into the semi-circular canals
History of previous surgery is key risk factor
Which thyroid malignancy cannot be diagnosed with fine needle aspiration
Follicular carcinoma
What is the dix hallpike manouver
Test for BBPV:
- Patient sits up with head turned to 45 degrees to one side
- Lie patient down with head over the bed and look for nystagmus
- Repeat on contralateral side
ABX for tonsilitis
Phenoxymethypenicillin
How can the vagus nerve be tested
asking the patient to phonate and observing for a symmetrical rise in the palate and uvula due to vagus nerve supplying motor innervation to the soft palate
Nerves of the gag reflex
Afferent: glossopharyngeal
Efferent: Vagus
What is the lingual nerve
A terminal branch of the mandibular nerve
Supplies sensory innervation to anterior 2/3rds of mouth and floor of mouth
Also carries fibres of taste sensation from the chorda tympani from the anterior 2/3rds of the mouth via chorda tympani
Osteosclerosis affects which bone
Stapes
