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YEAR 4 > ENT > Flashcards

ENT Flashcards

1
Q

fluid level behind drum, retracted drum, dull colour

A

otitis media with effusion

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2
Q

difficulty at school, have to shout to hear

A

glue ear

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3
Q

feeling of fullness in ear

A

meniere’s disease

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4
Q

loss of corneal reflex, sensorineural hearing loss, vertigo, tinitus

A

acoustic neuroma (vestibular schwannoma) associated with NF2

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5
Q

vertigo on rotation movement of head

A

BPPV

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6
Q

battle sign

A

bruising on the skull over mastoid process, temporal bone fracture

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7
Q

pearly white on otoscopy and foul, cheesy discharge

A

cholesteatoma

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8
Q

saddle nose

A

wegner’s granulomatosis (granulomatosis with polyangiitis)

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9
Q

BPPV key features

A

vertigo seconds to minutes
dx with hallpikes
tx with epley manoeuvre

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10
Q

Bell’s palsy

A

compression of facial nerve

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11
Q

why avoid adrenaline near the nasal cartilages?

A

cartilage is avascular, chondrocytes receive nutrition through diffusion of nearby arteries. In the nose these are end arteries. Vasoconstriction due to sympathetic stimulation can lead to necrosis

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12
Q

What forms the roof of the nasal cavity?

A

cribriform plate of ethmoid bone

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13
Q

What forms the lateral walls of the nasal cavity?

A

superior and middle conchae of the ethmoid bone

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14
Q

What forms the septum of the nasal cavity?

A

perpendicular plate of the ethmoid bone

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15
Q

What forms the inferior conchae?

A

inferior conchae bone

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16
Q

What are the 3 mucosa of the nosal cavities?

A

keratinised stratified squamous
respiratory mucosa (pseudostratified ciliated columnar)
Olfactory mucosa

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17
Q

Where does the olfactory tract end?

A

temporal lobe

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18
Q

What is somatic sensory supply to nose?

A

anteriorsuperiorly: ophthalmic CNV1
Posteriorinferiorly: maxillary CNV2

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19
Q

What is kiesselbach’s area and where is it?

A

common site of nose bleeds due to high density of arterial anastomosis
nasal septum

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20
Q

What areteries supply the nose?

A

facial and maxillary (from external carotid)

ophthalmic (from internal carotid)

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21
Q

Where does frontal sinus drain?

A

middle meatus (under the middle concha)

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22
Q

Where does the ethmoidal sinuses drain?

A

superior and middle meatus

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23
Q

Where does the sphenoidal sinus drain?

A

sphenoethmoidal recess

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24
Q

Where does the maxillary sinus drain?

A

middle meatus

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25
Q

Where does the nasolacrimal duct drain?

A

inferior meatus

26
Q

What is the H shaped structure that is thin and weak and what bones connect here?

A

pterion

frontal, parietal and temporal

27
Q

What CNs exit/enter the skull in anterior cranial fossa?

A

CNI

28
Q

What CNs exit/enter the skull in middle cranial fossa?

A

CNII - CNVI

29
Q

What CNs exit/enter the skull in posterior cranial fossa?

A

CNVI- CNXII

30
Q

Where is the internal acoustic meatus and what passes through it?

A

petrous part of the temporal bone (passage from posterior cranial fossa into inner ear)
passage for CNVII and CNVIII
Contains vestibular ganglion and labyrinthe artery

31
Q

Functions of external, middle and internal ear?

A

external: collects and conveys sound waves to tympanic membrane
internal: amplifies and conducts sound waves to inner ear
internal: converts sound waves into fluid waves and then APs and conducts to brain

32
Q

What makes up the external acoustic meatus?

A

1/3rd cartilage
2/3rd bone
covered in skin

33
Q

What features are you looking for in a normal tympanic membrane?

A

pars flaccida: thin part of membrane superiorly
pars tens: thick part of membrane posteroinferiorly
umbo: most inwardly depressed part (handle of the malleus)
cone of light: usually anteroinferiorly

34
Q

What causes referred pain?

A

when two different locations are innervated by the same nerve the brain can sometimes confuse where the original pain stimulus is coming from

35
Q

Why can tonsillitis cause earache?

A

spread of infection through eustachian tube

or referred pain (CNIX supplies sensory middle ear, eustachian tube, nasopharynx, oropharynx, tonsils)

36
Q

What is the adenoid?

A

pharyngeal tonsil (just above and behind the uvula)

37
Q

What are the ossicles?

A

malleus
incus
stapes

38
Q

What provides general sensory innervation to tympanic membrane?

A

external mainly CNV3

internal CNIX

39
Q

What forms the oval window?

A

base of the stapes

40
Q

What kind of epithelium line the outer ear and middle ear?

A

outer: keratinised stratified squamous with sebacous glands and ceruminous glands (ectoderm)
middle: cilliated pseudostratified columnar (endoderm)

41
Q

What brain cavity is above the middle ear?

A

middle cranial fossa

42
Q

Where does the facial nerve connect to CNS?

A

brainstem (junction between pons and medulla)

43
Q

How does vibration of the stapes transmit sound?

A

vibration of stapes at oval window creates pressure waves in the perilymph
hair cells in the cochlea are moved and neurotransmitter released and APs fired to the brain down the cochlear nerve
pressure waves descend and become vibrations at the round window dampening the signal

44
Q

What are the two points of entry between inner ear and middle ear?

A 
oval window (vibrations enter)
round window (allows fluid in cochlea to vibrate in a closed system)
45
Q

What is function of eustachian tube?

A

equalise pressures with middle ear and environment

drain secretion of middle ear mucosa

46
Q

What is the resting state of eustachian tube?

A

cartilaginous portion of the tube is closed at rest but opened by palatine muscles

47
Q

What does dysfunction of the eustachian tube cause?

A

middle ear negative pressure

48
Q

Where are low sounds perceived?

A

apex of cochlear

49
Q

Where are high sounds perceived?

A

base of cochlear

50
Q

What is function of vestibular system?

A

balance and sense of orientation (spatial orientation)

51
Q

What causes dizzyness?

A

endolymph fluid in semicircular canals still moving when you are stationary

52
Q

What is anosmia?

A

inability to smell

53
Q

What is hyposmia?

A

reduced smell

54
Q

What is dysomia?

A

altered sense of smell

55
Q

What is aguesia?

A

loss of taste

56
Q

How is smell sensed?

A

odorants bind to the cilia of olfactory rods that are projected on the olfactory mucosa and alter ion channels creating APs.

57
Q

How is taste sensed?

A

binding of tastants to receptor cells alters ionic channels and depolarises cell creating an AP. Different receptors to different structural components of food are located in different areas

58
Q

What are taste buds?

A

made up of sensory receptor cells and support cells

59
Q

What is the life span of taste receptor cells and olfactory receptor cells?

A

10 days

2 months

60
Q

Why does webers test locailse to the affected ear in conductive hearing loss?

A

the middle ear on the affected side is not functioning properly and masks ambient noise of the room while the normal functioning inner ear picks up bone conduction. It appears louder than the unaffected ear which has sounds of the room mixed in with bone conduction.

61
Q

Why does the webers test localise away from the affected ear in sensorineural hearing loss?

A

the inner ear of the affected ear does not detect bone conduction

YEAR 4 (27 decks)

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