ENT Flashcards
1
Q
What fascia contains the larynx?
A
Pretracheal fascia of the neck (visceral layer)
2
Q
What structures does the pretracheal fascia enclose?
A
strap muscles thyroid gland trachea and larynx oesophagus and pharynx recurrent laryngeal nerves
3
Q
What is the laryngopharynx?
A
region of the pharynx from the epiglottis to the oesophagus
4
Q
Between what vertebral levels in the larynx situated?
A
Between C4-C6
5
Q
At what vertebral level does larynx become trachea?
A
C6
6
Q
At what vertebral level does pharynx become oesophagus?
A
C6
7
Q
What bone make up the septum?
A
Vomer and ethmoid
8
Q
What is the lateral wall of nasal cavity composed of?
A
Conchae
9
Q
What is the floor of nasal cavity composed of?
A
hard palate
10
Q
What is the roof of nasal cavity composed of?
A
Anterior cranial fossa
11
Q
Why are cartilage rings around trachea?
A
Mai ntains patency
12
Q
What kind of cartilage is the epiglottis made from?
A
Elastic cartilage
13
Q
Where is the access point for cricothyroid puncture?
A
Cricothyroid membrane
14
Q
why is Cricothyroid membrane used for puncture to breath?
A
Below vocal cord
Relatively asvascular
15
Q
What allows the thyroid cartilage to “nod”
A
the capsule of the right cricothyroid cartilage
16
Q
What kind of joint is the capsule of the right cricothyroid cartilage?
A
Synovial
17
Q
What does cricoid pressure do?
A
Compresses oesophagus onto c6, prevents aspiration during ventilation
18
Q
What two places do the vocal cords attach to ?
A
Thyroid cartilage
Vocal processes of arytenoid cartilage
19
Q
What is the space between the vocal cords called?
A
Rims glottidis
20
Q
What is the space between the tongue and the epiglottis called?
A
Vallecula
21
Q
What kind of mucosa lined the larynx?
A
Respiratory epithelium (except vocal cords)
22
Q
What mucosa covers the vocal cords?
A
Stratified Squamous epithelium
23
Q
What is the mucociliary escalator?
A
Cilia beat up mucous, bacteria etc into pharynx so it can be swallowed.
24
Q
What CN gives sensory innervation to laryngeal mucosa?
A
Vagus nerve (CN X)
25
What branch innervates false vocal folds?
Superior laryngeal branches of CN x
26
What branch innervates vocal fold and inferior?
Reccurent laryngeal branches of CN X
27
What are the intrinsic muscles of the larynx?
Circothyroid muscles
Thyro-arytenoid muscles
Lateral circo-arytenoid muscles
Arythenoid muscles
28
What do the Cricothyroid muscles do?
Tense the vocal cords.
| causes "nodding"
29
What does the thyro-arytenoid muscles do?
Relax the vocal cords.
| Pulls the arytenoid cartilage towards the thyroid cartilage
30
What do the arytenoid muscles do?
Adduct the vocal cords.
Assist the arytenoid cartilages to gently close the rima glottidis
Sphincter function
31
What do the lateral crico-arytenoid muscles do?
Adduct vocal cords
| Rotate the arytenoid cartilages so that the vocal processes of the cartilages come together in the midline
32
What do the posterior cricoacrtilage muscles do?
Abduct the vocal cords
Rotate the arytenoid cartilages so that the vocal processes of the cartilages move laterally
Widnes the rima glottidis
33
What happens to the muscles in normal respiration at the vocal cords?
Laryngeal musles relax
34
What happens to the muscles in forced respiration at the vocal cords?
posterior cricoarytenoids contract
35
What happens to the muscles in phonation at the vocal cords?
arytenoids contract
| Assist lateral cricoarytenoids
36
What happens to the muscles in whispering at the vocal cords?
Lateral cricoarytenoids contract
37
What muscles control inspiration?
Diaphragm and intercostal muscles
38
What sounds are deemed nasal sounds?
"m"
"n"
"ing"
39
What nerve is the sensory and motor supply to palate, pharynx and larynx?
CN X (vagus)
40
What tests can be done to see if vagus nerve is working?
Ask patient to swallow sip of water
Listen to patient speak (hoarness?)
Ask patient to cough (normal or powerful cough)
41
What does the axons that synapse in submandicular ganglion pass through?
Internal acoustic meatus
42
What do the axons that supply general sensation to palate pass through?
Foramen rotundum
43
What muscle am I ?
```
Located within the pretracheal fascia
Located below C3
Covered in mucosa
Supplied by vagus nerve
Attaches to 2 hyaline cartilages
Function during pronation
Attached to muscular process
```
Arytenoid muscle
44
Must be compressed against the pharyngeal / oesophageal junction during emergency induction of general anaesthesia?
Lamina
45
Surface landmark in crciothyroectomy (cricothyroid puncture)
Arch
46
What is the sensory nerve supply to Tonsillar aran?
CN IX
47
What laryngeal cartilage is at vertebral level C5?
Thyroid cartilage
48
What is the nerve supply to palatoglossus muscle?
Vagus (CN X)
49
What vertebral levels is hyoid bone at?
C3
50
What is a normal bilateral features of anterior hard palate?
Rugae
51
What are the four boundaries of the oral cavity
Upper and lower teeth
Floor or mouth/tongue
Oropharynx
Hard and soft palate
52
What are the opening ducts of the submandibular salivary glands?
The sublingual papillae
53
What are the veins under the tongue that are very prominent and can be used for sublingual medications?
Lingual veins
54
What are the 3 main salivary glands?
Parotid
Submandibular
Sublingual
55
Where does to parotid gland open to?
Parotid papilla of buccal mucosa (at the back of molars)
56
What nerve supplies the submandibular salivary gland?
CN VII
57
What nerve innervates parotid gland?
CN IX (hitches a ride of V3)
58
What branch of the facial nerve moves through the parotid gland?
Chorda Tympani
59
What mucosa covers the tongue
Lingual mucosa
60
What is the general sensory nerve for anterior 2/3rds of tongue?
CN V3
61
What is the special sensory for the anterior 2/3rd of the tongue?
CN VII
62
What is the general and sensory supply for the posterior 1/3rd of the tongue?
CN IX
63
In developmental stage, where does the thyroid gland come from?
Foramen caecum
64
How many pairs of muscles suspend the tongue?
4
65
What are the extrinsic muscles of the tongue?
Palatoglossus (comes from soft palate to tongue)
Styloglossus (comes from styloid process to tongue)
Hypoglossus (from hyoid bone to tongue)
Genioglossus (the genial tubicles on the inside of the mandible to the tongue)
66
What do the extrinsic muscles of the tongue do?
Function to change the position of the tongue during mastication, swallowing and speech
67
What do the intrinsic muscles of the tongue do?
Modify the shape of the tongue during function
68
Why should adnrealine containing local anaesthetic be used near the nasal cartilages?
The cartilage is avascular
69
What part of the ethmoid bone is part of the roof of the nasal cavity?
Cribiform plate
| Crista galli
70
What part of the ethmoid bone is part of the lateral walls of the nasal cavity?
Superior concha
Middle concha
Ethmoid air cells
Orbital plate
71
What part of the ethmoid bone is part of the septum of the nasal cavity?
Perpendicular plate
72
What facial fractures disrupt the cribiform plate of the ethmoid bone?
Le fort II and III
73
How is a septal haematoma treated?
Incised and drained to prevent avascular necrosis of the septal hyaline cartilage
74
In area 1 of the nasal cavity (vestibule) what is the surface mucosa?
Keratinised stratified squmous epithelium.
| Acts as protection e.g. against fingers
75
In area 2 of the nasal cavity what is the surface mucosa?
Respiratory epithelium
76
In area of the nasal cavity, what is the surface mucosa?
Olfactory mucosa (specialised for smell)
77
Where does the olfactory tract end?
Temporal lobe
78
Where are the specialised olfactory receptor cells situated?
Pass through cribiform plate of ethmoid bone into olfactory mucosa
79
On what side of the nasal cavity is the olfactory mucosa situated?
Both lateral and medial aspects (lateral wall and septum)
80
What is the sensory somatic nerve supply in the nasal cavity?
Trigeminal nerve (V5)
81
What part of the nasal cavity does the V1 nerve supply?
Anterosuperior
82
What part of the nasal cavity does the V2 nerve supply?
Posteroinferior
83
What are the 3 main arteries supplying the face?
Opthalmic artery
Facial artery
Maxillary artery
84
What major artery does the opthalmic artery originate from?
Internal carotid
85
What major artery does the maxillary and the facial artery originate from?
External carotid
86
What branches come off the opthalmic artery?
Superior and anterior ethmoidal arteries
87
What branches come off the maxillary artery?
Sphenopalatine and grater palatine arteries
88
What branches come off the facial artery?
Lateral nasal branch of facial or septal branch of superior labial artery
89
What is bundle of arteries called which are most likely to cause epitaxis?
Kiesselbach's (Littles) area
90
What are the 3 concha?
Superior
Middle
Inferior
91
What are the 4 meatuses?
Sphenoethmoidal recess
Superior meatus
Middle meatus
Inferior meatus
92
What are the functions of the nasal cavities?
Convey respiratory gases between atmosphere and goblet cells
- warm
- humidify
- remove particulate matter
- turbulent air flow, mucous, cilia
93
Where "holes" do the paranasal sinuses drain through?
Ostia
94
What are the 4 paranasal sinuses?
Frontal
Sphenoid
Ethmoid air cells
Maxillary
95
Which sinus is most likely to get infected and why?
Maxillary because of the ostia is superior
96
What are the function of the paranasal sinuses?
Resonate voice
Lighten head
Buoyancy
97
Where does the frontal sinus drain into?
Middle meatus
98
Where does the ethmoidal air cells drain into?
Superior and middle meatus
99
Where does the sphenoid sinus drain into?
Sphenoethmoidal recess
100
Where does the maxillary sinus drain into?
Middle concha
101
Where do tears drain into?
Nasolacrimal duct , then inferior meatus
102
What other infection can can a dental abscess cause?
Infection of maxillary sinus
103
Can kind of fistula can excision of a tooth cause?
oro-antral fisula
