ENT

Question 1

Ear anatomy

Answer 1

see image

Question 2

Air conduction

Answer 2

depends on external, middle, and inner ear, CN 8, and central auditory pathways

Question 3

Bone conduction

Answer 3

depends on inner ear, CN 8, and central auditory pathways

Question 4

Weber test

Answer 4

Will lateralize OPPOSITE the side with SENSORINEURAL loss or TO the side with CONDUCTIVE hearing loss

Question 5

Rinne test

Answer 5

Tests air conduction. Air should be louder than bone conduction; if not the test is positive. Will lateralize TO side with CONDUCTIVE hearing loss. In sensorineural hearing loss, both will be reduced equally, so the test will not be positive.

Question 6

Conductive hearing loss

Answer 6

Due to lesion in either external meatus, tympanic membrane, or middle ear all the way up to oval window. Weber lateralizes TO affected ear; Rinne positive

Question 7

Sensorineural hearing loss

Answer 7

Due to lesion in the inner ear, CN 8, or central auditory structures. Weber lateralizes AWAY; Rinne negative.

Question 8

Epistaxis local causes

Answer 8

Trauma (nose picking), septal perf 2/2 cocaine, polyps, infection, angiofibroma of nasopharynx

Question 9

Epistaxis systemic causes

Answer 9

Infection (malaria, scarlet fever, typhoid), vascular (hereditary hemorrhagic telangiectasia, aortic coarctation), bleeding disorders, overdose of anticoag/antiplatelet medications

Question 10

Epistaxis initial management

Answer 10

Pinch nostrils against septum and flex head anteriorly. This will stop bleeding originating from Kiesselbach’s plexus. If bleeding source is posterior to that, blood will pool up into nasopharynx and get coughed up

Question 11

What is the only muscle of the pharynx not innervated by CN 10, vagus?

Answer 11

Stylopharyngeus is innervated by CN 12, glossopharyngeal

Question 12

Possible complications of tonsillectomy

Answer 12

Bleeding is most common. Damage to glossopharyngeal nerve. Damage to internal carotid (runs lateral to the tonsil)

Question 13

Tonsils picture

Answer 13

see attached

Question 14

Salivary glands picture

Answer 14

see attached

Question 15

Parotid tumors

Answer 15

Most common type of salivary gland tumor. Majority of parotid gland tumors are benign. Can affect facial nerve

Question 16

Most common histologic type of parotid tumor

Answer 16

Pleomorphic adenoma: benign but recurs, rarely undergoes malignant transformation

Question 17

Oropharyngeal cancer prognosis by location

Answer 17

Best: lips. Worst: hypopharynx

Question 18

Oropharynx anatomy

Answer 18

see attached

Question 19

Nasopharyngeal carcinoma

Answer 19

Risk factors: tobacco, EBV association. Bimodal age distribution in teens and 45-55 yo. Radiation therapy is initial treatment for primary nasopharyngeal cancer

Question 20

Oropharyngeal cancer treatment

Answer 20

Surgery and radiation

Question 21

Hypopharyngeal cancer treatment

Answer 21

Surgery with postop radiation. Need radical neck dissection because LN mets are frequently not well controlled by radiation alone

Question 22

Branchial cleft cysts

Answer 22

In children presents as painless lateral neck mass. In adults, more likely to present with infection of cyst. First fistula dissection can injure facial nerve. Second fistula dissection can injure hypoglossal nerve, also adjacent to carotid bifurcation.