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Audiology and ENT > ENT > Flashcards

ENT Flashcards

1
Q

what is the aetiology of laryngeal cancer?

A

no known cause but there are risk factors such as

  • age
  • excessive alcohol consumption
  • smoking
  • HPV infection
  • family history
  • acid reflux
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2
Q

What are the symptoms of laryngeal cancer?

A

hoarseness/change in voice for over 3 weeks
weight loss
difficulty in swallowing
lump in neck

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3
Q

What is the diagnosis process of laryngeal cancer?

A
  1. see GP
  2. be referred to ENT where they will give you an endoscopy and may biopsy
  3. once cancer has been confirmed then they will test for its stage, this might include CT, MRI or PET
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4
Q

what is the management process for laryngeal cancer?

A

dependent on type of cancer and stage
T1&2= transoral laser surgery, partial laryngectomy, radio
T3 = chemoradiotherapy, potentially surgery
T4 = chemo, radiotherapy, total laryngectomy and removal of lymph nodes

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5
Q

Discuss speech restoration after a laryngectomy

A

patients are no longer able to breathe through their mouths but instead breathe through the hole in their throat called a STOMA.
Pre-surgery they will have an SLT consult
Post-surgery there are three types of alternative communication

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6
Q

what are the three types of alternative communication available after a total laryngectomy?

A
  1. tracheo oesophageal puncture TEP/voice prosthesis
  2. oesophageal speech
  3. electrolarynx
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7
Q

what is a TEP?

A

when the surgeon makes a fistula at the back of the stoma, then inserts a speech valve (or voice prosthesis).

when the patient puts their finger over the stoma, the air is diverted through the puncture and up through the oesophagus. The muscles of the pharynx vibrate as air passes through, producing phonation needed.

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8
Q

what are the disadvantages of TEP?

A

the muscles of the pharynx can go into spasm

you cannot breath whilst your finger is over the stoma so speech is very segmented as time for breathing is allowed.

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9
Q

what is oesophageal speech?

A

it is when you move air down your oesophagus, as the air passes it vibrates the muscles in the throat, and the articulators move as you are speaking

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10
Q

what are the advantages of oesophageal speech?

A

you need no equipment

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11
Q

what are the disadvantages of oesophageal speech?

A

it can be very hard to learn

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12
Q

what is an electrolarynx?

A

a battery operated machine that produces vibration for you in order that you may have voicing.
It is useful if you cannot have a speech valve for medical reasons, however they can sound very mechanical and not like ‘normal’ speech

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13
Q

what are the functions of the larynx?

A
  1. to prevent choking
  2. protection of the LRT
  3. phonation
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14
Q

when doing an oral exam, what kind of findings would be abnormal?

A 
lesions
dry/cracked lips
red, inflammation of tongue, cheeks or gums
bleeding gums
swollen tonsils/uvula
exudate
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15
Q

a grayish membrane covering the tonsils, uvula and soft palate is indicative of what?

A

glandular fever

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16
Q

what are the symptoms of laryngitis?

A

hoarseness
sore throat
mild fever

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17
Q

what causes laryngitis?

A
  • viral infection e.g. cold/flu

- damage to larynx - usually by straining your voice

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18
Q

how is laryngitis treated?

A

told not to smoke, drink plenty water, rest voice

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19
Q

what is a tracheostomy?

A

it is an opening created at the front of the neck so a tub can be inserted into the trachea TO AID BREATHING

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20
Q

Why would a tracheostomy be used?

A

to allow breathing if

  • muscles are too weak
  • if your throat is blocked

to reduce the risk of aspiration

21
Q

how is a trache carried out?

A

incision made below the vocal chords

22
Q

what is the difference between a tracheostomy and a laryngectomy?

A

in a trache there is still a continuation - the tube may bypass the larynx but the larynx is still there.
in a laryngectomy there is no epiglottis or larynx at all, the base of tongue is connected right to the oesophagus

23
Q

what allows voicing in a tracheostomy?

A

fenestration

24
Q

what are some complications of a trache tube?

A
  • ulceration/bleeding due to movement of fenestration tube

- pneumothorax

25
Q

what causes snoring?

A

relaxed upper respiratory tract (tongue, mouth, throat)

26
Q

risk factors of snoring are

A 
being overweight
smoking
drinking
sleeping on your back
-- more seriously sleep apnoea can cause snoring --
27
Q

what are the five functions of the nose?

A
  1. airway
  2. filtration
  3. humidification
  4. temperature control
  5. smell (olfaction)
28
Q

what causes sinusitis?

A

an upper respiratory tract infection (e.g. cold)

29
Q

what are the symptoms of sinusitis?

A

discharge from nose
blocked nose
sinus headache

30
Q

how would you treat sinusitis?

A

painkillers
decongestants
if persistent GP will prescribe antibiotics/corticosteroid spray

31
Q

what are some worrying nasal symptoms?

A

if any kind of symptom is only unilateral
bleeding
visual symptoms
cheek swelling

32
Q

what is epistaxis?

A

nosebleeding

33
Q

what causes epistaxis?

A

trauma
irritation (picking yir nose ya weirdo)
spontaneous
if your’e on blood thinners/anticoagulants that cause you to bleed more easily

34
Q

how do you stop epistaxis?

A

pinch top of the nose, put pressure on it in order to help the blood clot

35
Q

what are the symptoms in nasal polyps?

A

blocked nose
runny nose
reduced olfaction
obstructive sleep apnoea OSA

36
Q

what causes nasal polyps?

A

inflammation of the nasal lining

asthma can be a trigger

37
Q

how would you diagnose nasal polyps?

A

endoscopy

38
Q

how would you treat nasal polyps?

A

corticosteroid spray/tablets

surgery if persistent

39
Q

what is a deviated nasal septum?

A

septum displaced to one side making one nasal passage smaller

40
Q

what causes a deviated septum?

A

congenital

injury to the nose

41
Q

how would a deviated septum be treated?

A

medical management (decongestants) until surgery = septoplasty

42
Q

what are adenoids?

A

part of the immune system in a child, they disappear in adults

43
Q

why would adenoids be removed?

A

if they are swollen and causing breathing and sleeping difficulties
also if there is persistent otitis media

44
Q

what will be done to treat infected/swollen adenoids?

A

adenoidectomy surgery

45
Q

discuss allergic rhinitis

A

commonly known as having allergies
these are inhaled substances that cause hypersensitivity

symptoms include congestion and sneezing

it is treated with antihistamines or steroids

46
Q

what happens physiologically in cleft palate?

A

the maxillary bone does not properly fuse which results in the cleft of bone and mucosa

47
Q

what does cleft palate pose a problem to?

A
  1. feeding
  2. hearing
  3. speech
  4. respiration
48
Q

what is a pharyngeal pouch?

A

a diverticulum (abnormal sac) of the inferior pharyngeal constrictors

49
Q

what are the symptoms of a pharyngeal pouch?

A

dysphagia
regurgitation
halitosis

Audiology and ENT (2 decks)

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