ENT Flashcards
What are 3 functions of the nose?
- Moistens, warms and filters air
- Resonating chamber for sound
- Houses the olfactory receptors
Which 2 of the sinuses should you be able to palpate?
- Frontal
- Maxillary
What does ottorrheoa mean?
Ear discharge
How does otitis externa typically present?
- Tender pinna/tragus
- Exudate
- Otalgia
How does otitis media typically present?
- Normal pinna and ear canal
- Bulging tympanic membrane
- Otalgia
What are the two red flag conditions to consider with a patient presenting with ear symptoms?
- Mastoiditis
- Malignant otitis externa
What are some causes for conductive hearing loss?
- Allergies
- Foreign Body
- Ruptured ear drum
Is vertigo more likely to be secondary to a peripheral cause or a central cause?
Peripheral
What red flag symptoms might be present if a patient has quinsy?
- Trismus
- Deviated uvula
- Obstructed airway
Palpable lymph nodes that are soft, tender and mobile are less concerning… true or false
True
Which three area of the ear do we assess as part of an examination?
- External ear
- External meatus
- Tympanic membrane
Name and palpate the 11 lymph nodes
Submental
Submandibular
Tonsillar
Parotid
Preauricular
Posterior Auricular
Occipital
Superficial Cervical
Deep Cervical
Posterior Cervical
Supraclavicular
Name the 4 parasinus’ and location
PALPABLE
Frontal (between the eyebrows)
Maxillary (either side nose)
NON-PALPABLE
Ethmoid sinus (between eyes/top of nose)
Sphenoid sinus (behind nose above the pharynx)
What are the causes of sensorineural deafness?
Aging
Noise Damage
Drug side effects
Auditory Tumours
Blast/explosion
(Damage to the inner ear or nerve pathways)
What are the causes of conductive deafness?
Fluid
Foreign Objects
Allergies
Ruptured eardrum
Impacted earwax
Where sound through the external or middle ear is blocked
What can be causes of sensorineural or conductive hearing loss?
Genetic disorders
Infections
Head trauma
What are you observing when conducting a general inspection of a patient as part of an ENT exam?
Unwell
Flushed
Discharge from ears or nose
Coughing
Hearing aids
Gait - unsteady or dizzy
Neck swelling or stiffness
Drooling
Hoarseness
Halitosis
Walking aids
What are you looking for as part of a specific ear exam inspection?
Redness/swelling to pinna/tragus/mastoid
Intact pinna/lobe - full thickness cartilage damage = ENT
Exudate from concha or tragus
Piercings (infected/embedded)
What do you palpate for during an ear inspection?
Pinna/tragus/mastoid: tenderness or heat
Bogginess to mastoid
Lymph Nodes: hopefully unilateral, small, smooth, movable
More concerned if bilateral or fixed and craggy
What are you looking for with the otoscope in the ear?
Exudate
Slough
Foreign bodies
Wax
TM - cone of light , membrane intact , grommets, bulging , perforation, bubbles behind
What are you examining in a specific throat inspection?
Patent airway
Neck swelling (goitre/lymph)
Trismus
Odour
Lips
Buccal mucosa
Teeth
Mucous membranes
Soft/hard palate
What abnormalities might you find in a throat inspection?
?blistering
exudate
dental hygiene
inflamed mucosa
leukoplakia (white patches)
dryness
Redness/swelling
Abscess
Tonsil stones
Deviated uvula
What type of hearing loss is caused by fluid, foreign objects, allergies, ruptured ear drum or impacted wax
Conductive
What type of hearing loss is caused by noise damage, aging, drug side effects, auditory tumours, blasts/explosions?
Sensorineural
List 7 causes of sensorineural deafness
Noise Damage
Old Age
Genetics
Virus
Drug side effects (ossification from drugs)
Tumour (benign acoustic neuroma)
Blast/explosion (cochlear/central damage)
Name 7 causes of conductive hearing loss
Swollen ear canal
Tumour blockage
Wax build up
Foreign body
Perforated ear drum
Pus/infection
Fluid build up
Which cranial nerve is responsible for hearing
8
Name the 4 parasinuses
Frontal
Maxillary
Ethmoidal
Spehnoidal
Identify the 2 clinical reasoning tools use to aid decision making for sore throat presentations
CENTOR
Fever Pain
How would otitis media present? 3 signs, 2 absent signs
Bulging TM
Possible Fever
Otalgia (pain)
Non tender pinna
Normal ear canal
List 5 associated risks of otitis media
Meningitis
Mastoiditis
Intracranial abcess
Sinus Thrombosis
Facial Nerve Palsy
How may mastoiditis present?
Name 4 symptoms
Fever
Systemically Unwell
Boggy, tender swelling to mastoid process
Pre and post auricular tender nodes
What are the 6 stages of hearing?
- External ear collects and concentrates sound energy
- Ear canal carries sound to the TM
- The TM vibrates in response to the sound energy - setting 3 tiny bones into motion
- Tiny bones in middle ear vibrate against fluid filled cochlea - transmitting sound energy into the fluid
- Nerve cells in the cochlea pick up sound waves in the fluid and generate nerve impulses
- The auditory nerve carries the impulses from the cochlea to the brain - where they are heard as sound
What symptoms can issues with the fluid in the inner ear/vestibular system cause?
vertigo/balance issues
What does a healthy TM look like?
Shiny with a cone of light
May see ossicles behind it
What landmarks are you assessing in the throat?
Hard Palate
Soft palate
Uvula
Tonsils
Tongue
Name 5 red flag ENT conditions
Mastoiditis
Malignant Otitis Externa
Quincy
Epiglottitis
Head/Neck Ca
What tests might you use to identify hearing loss?
Weber’s
Rhinnes
