ENT Flashcards
Drainage of sinuses in meatus
Supreme - sphenoid
Superior - posterior ethmoid
Middle - Maxillary, frontal, anterior & middle ethmoid
Inferior (largest) - Nasolacrimal duct
Sphenoethmoidal
Recess - Supreme meatus
Air cell - onodi cell
Pus in posterior pharyngeal wall
Sphenoid sinusitis
Postnasal drip
Allergic fungal rhino sinusitis
Peanut butter
Heterogenous opacity
Bent & Kuhn criteria
Fungal smear - major
Fungal culture - minor
Doubles
Double density - AFRS
Double ring
- HRCT - Cochlear otosclerosis
- tissue paper - CSF rhinorrhea
Button battery in EAC
Facial nerve palsy
Named Air cells
Agger nasi - most anterior
Onodi Most posterior
Bulla ethmoidalis - largest
Haller - Floor of anterior ethmoid
Concha bullosa - pneumatization of middle turbinate
Hypertrophic rhinitis
Inferior turbinate
Mulberry mucosa
Mulberry
Polyp - Rhinosporodiosis
Mucosa - hypertrophic rhinitis
Foul smelling crust
Merciful anosmia - Atrophic rhinitis
Woody nose - Rhinoscleroma
Wood
Woody nose - Rhinoscleroma
Wood industry - Adeno cell ca of ethmoid
Woody swelling in DM - Ludwig abscess
Woodman procedure - removing aretynoid in cordectomy
Woodruff plexus - venous plexus in posterior lateral wall
Red polyp from
Septum - capillary hemangioma
Inferior turbinate - cavernous hemangioma
Malignancy from septum
Red - capillary hemangioma
White - papilloma
Dark brown - malignant melanoma
Malignancy from lateral wall
Posterior wall of maxillary sinus -
Damaged - Squamous cell ca
Intact - inverted papilloma
Ohngren’s line
Root of nose to angle of mandible
Below - good prognosis
Above - poor prognosis
Guerin sign
Palatal ecchymosis in le fort I fracture
Olfactory test
CC SIT - 12 stimuli
UP SIT - 10 stimuli
Smell diskette
Quienke disease
Edema over soft palate
Abscess lower limit extend upto
Parapharyngeal - hyoid bone - I/D Ant. SCM
Retropharyngeal - bifurcation of trachea - I/D post SCM
Swelling in posterior pharyngeal wall
Localized - retro pharyngeal abscess
Diffuse - prevertebral abscess
Angiofibroma
Teenage boy
Sphenopalatine foramen
Hollman miller sign
Epistaxis
No biopsy
No debulking
Surgery in toto → embolize internal maxillary artery
Hollman miller sign
Posterior wall of maxillary sinus bending down in angiofibroma
Posterior wall of EAC bending down
Sagging of canal
Mastoiditis
Trotter’s triad
Glue ear
V CN palsy
X CN palsy
Trotters method
Epistaxis
T/t TELSPA - Trans Endoscopic Ligation of Sphenopalatine Artery
Gradenigo triad
Otorrhea
V CN palsy
VI CN palsy
Chalky white mass
Tympanic sclerosis
Cholesteatoma - necrosis
Keratosis obturans - B/L - centripetal squamous growth
Malignant otitis externa stages
I - Ear discharge + Granulation (Tc99 -ve)
II - I + Tc99 +ve (necrosis)
III - CN palsy (VII)
IIIa - single CN
IIIb - multiple CN
IV - Intracranial complications
Prognosis - gallium, ESR
↓ ESR after 2 weeks - good prognosis
Psuedomonas - 3rd gen cephalosporins
Tullios phenomenon
Sound induced Vertigo
Seen in
Sensory deafness
Fistula
Superior SSC Dehiscence
Tympanic membrane colour
Blue - Serous otitis media
Red - cart wheel appearance - ASOM
Tympanoplasty
Type I - Myringotomy
Type II - Myringoincudopexy
Type III - Collumellar effect
Type IV - Minor cavem
Type V - Round window shielding
Schwartz
Sign - flamingo pink sign - reddish cochlear promontory - otosclerosis - C/I for surgery
Procedure - cortical mastoidectomy - canal wall up procedure
Mastoidectomy
Modified radical - preserve normal - CSOM
Radical - remove normal - block ET - Malignancy
Brown sign
Blanching of glomus tumor on exerting pressure
Aquino sign
Blanching of glomus tumor on occluding neck vessels
Artery embolization in ENT
Ear - Ascending pharyngeal artery - Glomus tumor
Nose - TELSPA - Epistaxis
Throat - Internal maxillary artery - Angiofibroma
IOC for conductive deafness
Impedance audiometry - Tympanogram + Stapedial reflex
Higher centre for stapedial reflex
Superior olivary complex
Noise induced hearing loss
Dip in PTA at 4000 Hz
Maximum db
WHO - 85 dB
Indian factory act - 90 dB
City - 45 dB
Recruitment phenomenon
Oversensitivity >70%
Sensory deafness
SISI
Roll over phenomenon
Fatiguability
Neural deafness
Decay test
Paracusis willsi
Comfortable in noisy surrounding
Conductive deafness
Auditory pathway
Eighth nerve
Cochlear nucleus
Trapezoid body
Superior olivary nucleus
Lateral lemniscus
Inferior colliculus - BERA upto IC
Medial geniculate body - CERA after IC - not done in children
Auditory cortex
OAE -ve, next
ECOG - presence of cochlea
Impedance audiometry - Middle ear pathology
Donaldson line
Line along HSCC, bisecting PSCC end in endolymphatic sac
ABLB
SISI
Alternate Binaural Loudness Balance - U/L sensory deafness
Short Increment Sensitivity Index - B/L sensory deafness
BERA
Largest wave - V
Sensitive wave - I (reliable)
Latency period
↑ - neural deafness
↓ - sensory deafness
Coclear and brainstem Implants
CI : electrode in scala tympani
Stimulate 8th nerve
BI : electrode in lateral recess of 4th ventricle
Stimulate cochlear nucleus
Nystagmus
Superior - rotational
Posterior - vertical
Lateral - horizontal
Slow component - same side - slow(hypo)active ear
Mc site for hypopharynx malignancy
Pyriform fossa
Nerve damaged in retrieval of FB from pyriform fossa
Internal branch of superior laryngeal nerve
Vocal cord paralysis
Type I: Medialization - B/L SLN palsy - Aphonia, Aspiration
Type II: Lateralization - B/L RLN palsy
Type III: shortening, relaxation (lower pitch) - Puberphonia
Type IV: lengthening, tension (raise pitch) - Androphonia
Gutsman test
Pressure over thyroid, pitch lowers, puberphonia
Croup
Acute Laryngotracheobronchitis
Children - 6 months to 3 years of age
Para influenza virus
Barking cough
Biphasic stridor
Narrowing of subglottic region - steeple sign
Treatment:
Supportive care
Oxygen therapy
Single dose Dexamethasone
Nebulized epinephrine
Sudden sensorineural hearing loss
Lyme disease and syphilis
30dB in 3 frequencies over 3 days
Treatment
Steroids
Carbogen (95% O2 and 5% CO2)
