ENT Anatomy Clinical Cases Flashcards
What connects the middle ear and the pharynx?
Eustachian tube
7 year old boy has a week history of sore L ear with purulent discharge and apparent weakness in his face
Acute otitis media with facial nerve palsy
2 days later (7 yr ld with acute otitis media and facial nerve palsy) he is brought back drowsy and confused with…
intracranial spread, meningitis, intracerebral abscess
Middle ear infections are most likely to travel…
posterior into the mastoid process
the nervous supply of the gag reflex
CN9+10
Innervation of the Sternocleiomastoid
CN11
55 yr old man, right sided maxillary tooth pain, no abnormalities of his teeth Tapping on the right maxilla elicits sharp pain on the right side of face
Maxillary Sinusitis (bilateral sinusitis = dental root!!)
Barotrauma
pressure trauma in ears
Blockages of the euastachian tube would make barotrauma worse / better?
worse
Barotrauma questions
hearing loss? - internal ear, if not could be referred pain
discharge?
flying? - up or down
systemic symptoms?
balance?
Innervation of the external tympanic membrane
CNV3 and CNX
Innervation of the internal tympanic membrane
CNIX
Cranial nerves which can reffer pain to the ear
CNV, CNVII, CNIX, CNX
55 yr old man with 3 week history of L earache but no discharge or loss of hearing
Think referred pain causes
Cranial nerves which can reffer pain to the ear
CNV2, CNV3, CNVII, CNIX, CNX
Pathology of which areas cause referred pain in the ear via CNV3?
Anterior 2/3 tongue lower teeth Mandible (including TMJ) inferior oral cavity salivary glands
Pathology of which areas can cause referred pain in the ear via CNVII?
Sphenoid sinus
nasal mucosa
soft palate
Ramsay Hunt Syndrome
recurrent swelling of CNVII caused by herpes virus usually with vesicles present around the ear
Pathology of which areas can cause referred pain in the ear via CNIX?
Posterior 2/3 tongue
inferior nasopharynx
Pathology of which areas can cause referred pain in the ear via CNX?
supraglottic larynx
laryngeal and lingual surfaces of epiglottis
lower pharynx
What nerves supply the areas of skin around and on the ear which could cause referred pain
CN2 (greater oricular nerve) and CN3 (lesser occipital)
5Ts of referred ear pain
Teeth Tongue Throat TMJ Trigeminal Neuralga
45 yr old F, admitted to hospital with severe headaches, dizziness, vomitting, lack of lacrimation, dryness of sinuses and nasal cavity, loss of taste (radio graphs revile a tumour) which foreman is this tumour likely situated
internal acoustic meatus
Which cranial nerve supplies the muscles of mastication?
CNV
