ENT Flashcards
Acoustic neuroma
Vestibular nerve.
Schwann cells
UNILATERAL SN HEARING LOSS
+ vertigo
Acute bacterial sinusitis
Lasts 7-30 days.
S. pneumoniae, H. influenza
Fever, discharge, anosmia
clinical diagnosis
Acute laryngitis
increased pressure leads to dysphonia/aphonia
vocal cords and larynx
Acute mastoiditis
acute otitis media.
boggy mass
High dose IV steroids. (usually s. pneumonia).
Acute tonsillitis
Usually viral- 1 week.
Centor criteria
Pen V if bacterial
Oesophagus cancer
Adenocarcinoma or SCC
Tobacco/alcohol/obesity/barrett’s
Adenoid cystic carcinoma
Can happen anywhere
Usually salivary glands
Locally invasive.
Allergic fungal sinusitis
immunoCOMPETENT (not like other fungi and HIV)
breathe in a fungus.
fungal debris and mucin in sinus
RAST test
amount of IgE in blood
Patch testing
suspected allergic contact dermatitis.
Label an otoscopy picture.
Anterior fold Posterior fold Long process of incus Lateral malleolar process. Umbo Pars tensa Pars flaccida Manubrium of malleus.
Benign nasal polyps associated with
Cystic fibrosis
Allergic fungal sinusitis
Branchial cysts
embryonic remnants
anterior border of SCM.
Fluctuant
NO transillumination, no movement on swallowing.
Caloric testing
Cold water: horizontal nystagmus other side.
Warm water: horizontal nystagmus same side.
Basent reflex= weak on side being stimulated.
Laryngeal cancer
Smoking and alcohol
SCC
Leukoplakia
Pre-malignant white patch
Oropharyngeal cancer
persistent sore throat
lump in mouth
pain in ear
Nasopharyngeal cancer
lump in neck
nasal discharge
obstruction
deafness
Hypopharyngeal cancer
pain in ear
dysphagia
hoarseness
Thyroid cancer
usually single.
PainLESS lump
hoarseness
difficulty breathing and swallowing.
Tongue cancer
Smoking
Alcohol
Betel nut
Carotid body tumour
Paraganglioma
Slow growing neck mass.
Anterior SCM near hydoid area.
90% unilateral, don’t hurt nerves
Fontaine sign
Tumour can’t move up/down (only side to side).
Carotid body tumour
Cerebellar lesion
DANISH on same side.
Chorda tympani
Facial nerve.
Tast buds
Runs through th emiddle ear.
Chronic laryngitis
More than 3 weeks.
Irreversible damage- cilia damaged causing mucus pooling and a reactive cough.
‘Smokers cough’, GORD, Intubation.
GORD and cough
a dry cough
Cystic hygroma
Posterior triangle of neck
Transilluminates
Soft and painless
Just lymphatic drainage
Menieres
Recurrent
Vertigo for more than 20 minutes (nausea)
SN hearing loss
Tinnitus
Epistaxis
95% little’s area.
Posterior bleeding: more serious, deeper structures.
Silver nitrate
Nasal packing.
FNA vs. core biopsy
FNA- smaller, collects cells
Core biopsy- larger, tissue samples
Functional dysphonia
voice change- no pathology.
SALT
Granular myringitis
Lateral TM chronic inflammation
Granulation tissue
Chronic discharge
Dilute vinegar + excision.
Granuloma of vocal process
rare. Posterior 1/3rd Like a pyogenic granuloma Caused by trauma, vocal abuse, GORD foreign body sensation. hoarse voice.
Haemotympanum
retrograde bleed from nose or
basilar kull fracture.
pain and deaf
HPV papillomatosis
HPV 6+11
warts in upper airway- airway obstruction
choking episode
Inverting papilloma
benign local growth- destructive.
epithelial cells grow into supportive tissue
malignant transformation (SCC)
cut it out!
When it occurs in the nose or sinuses, it may cause symptoms similar to those caused by sinusitis, such as nasal congestion.
Labyrinthitis
membranes inflammed
SUDDEN vertigo, nausea, vomiting
URTI in 50% before.
Self-limiting.
Laryngeal tumour
usually hypo pharynx
post-cricoid
Laryngoscopy
can see as far as epiglottis + vocal folds
Lipoma
slow growing + rubbery
Loss of taste and smell
head trauma viral infection epilepsy AD + PD schizophrenia tumour Kallman's
Noise induced hearing loss
- Acoustic trauma (bomb)
2. Gradual NIHL (multiple)
Open biopsy
Lymph nodes
Otalgia
Outer ear, inner ear and referred pain
OM with effusion
fluid in middle ear
NO ACTIVE inflammation
Loss of light reflex
Indrawn/concave/retracted drum
OM with cholesteatoma
radical mastoidectomy
Congenital
Primary acquired (chronic negative pressure)
Secondary acquired (after TM damage)
Otosclerosis
increase bone turnover BONES metabolic dysplasia progressive C hearing loss Can also have SN loss. Drum usually appears normal. Tinnitus
Parotitis
old, dehydrated, debilitated, malnourished, bad teeth.
Pendred’s syndrome (Mustafa)
bilateral congenital SN hearing loss and GOITRE
Perennial allergic rhinitis
House dust mites and pets
all year round
Perilymph fistula
connection between middle and inner ear (after head trauma)
Pharyngeal pouch
Killian’s dehiscence
Men
Pleomorphic adenoma
common benign salivary gland cancer- usually parotids slow growing, no pain, firm malignant potential --> remove
Pre-auricular sinus
usually not a problem (unless becomes infected)
Promontary
hollow prominence made by a turn of the cochlear
Sialadenitis
inflammation salivary glands
red, pain, tender, swollen
Squamous cell cancer
most head and neck
smoking
submandibular gland swelling
salivary calculi
sialadenitis
throat swabs
candida
group A strep
Thyroglossal duct cyst
Midline (below hyoid)
Fibrous
no pain, smooth, looks a bit like a wierd keloid.
Moves up and down when you stick your tongue out.
Thyroid adenoma
single lesion, well demarcated
HOT=hyperthyroid
COLD= no change
Tinnitus
objective= pulsatile (carotid stenosis), muscular/anatomical (tympanic membrane), spontaneous
subjective-head trauma, MS, meningitis, drugs.
Tracheal stenosis
Congenital O instead of U
narro
Tracheomalacia
floppy- can collapse
Triangular fossa of anti-helix
yep.
Tympanic sulcus
anatomical groove in tympanic bone
Tympanosclerosis
calcification of tissue in ear drum
Myringosclerosis
Myringosclerosis refers to a calcification only within the tympanic membrane and is usually less extensive than intratympanic tympanosclerosis, which refers to any other location within the middle ear such as the ossicular chain, middle ear mucosa or, less frequently, the mastoid cavity.
Usher syndrome
retinal and SN hearing loss
leading cause of DEAF BLINDNESS
no cure
Vestibular neuronitis
Vestibular neuronitis, also called Vestibular neuritis, can be a paroxysmal, single attack of vertigo, a series of attacks, or a persistent condition that diminishes over three to six weeks.
nausea, vomiting, and previous upper respiratory tract infections.
It generally has no auditory symptoms, unlike labyrinthitis. Nystagmus
Imbalance of neuronal input between the left and right inner ears.
Waadenburg’s syndrome
varying deafness
pigmentation anomalies
Wegeners and ENT
rhinorrhoea- clear epistaxis sinusitis hoarseness cough dyspnoea
