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ENT > ENT Emergencies > Flashcards

ENT Emergencies Flashcards

1
Q

What trauma most commonly causes nasal fracture?

A

Fight
Contact sports
Falls

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2
Q

What symptoms must you always remember to ask about in a nasal trauma history?

A

Loss Of Consciousness
Epistaxis
Breathing difficulty

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3
Q

What should you look for in a nasal fracture examination?

A 
Bruising, Swelling
Tenderness
Deviation
Epistaxis
Infraorbital sensation
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4
Q

What should always be considered when there is bruising over the infraorbital area?

A

Potential damage to the infraorbital nerve

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5
Q

What is the consequence of a septal haematoma?

A

Necrosis of cartilage due to haematoma pulling perichondrium away and depriving cartilage of blood supply

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6
Q

An X-ray is always required in nasal fracture. TRUE/FALSE?

A

FALSE

Diagnosis is based on inspection and palpation

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7
Q

What are the complications of a nasal fracture?

A

Epistaxis – anterior ethmoid artery
CSF leak - can predispose to meningitis
Anosmia – cribriform plate fracture

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8
Q

What is the main blood supply to the lateral nasal wall and septum?

A

Sphenopalatine artery

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9
Q

What first aid measures can be used for epistaxis?

A

External Pressure to Nose and sit forward
Ice
Cautery
Nasal Packing

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10
Q

What topical vasoconstrictor can be used for nosebleeds?

A

Adrenaline on a cotton bud and inserted into nose

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11
Q

What is the aim of a rhino pack in epistaxis?

A

Compresses sphenopalatine artery and kiesselbach’s area

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12
Q

Why should sedation not be considered as treatment in nosebleed?

A

Would allow aspiration of blood

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13
Q

What systemic management should be considered after epistaxis?

A
  • Reversal of effect of anticoagulants
  • Correction of clotting abnormalities
  • Platelet transfusion
  • Treatment of hypertension
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14
Q

What complication can result from a haematoma on the pinna of the ear?

A

“Cauliflower ears”

Necrosis of cartilage due to haematoma moving perichondrium away from cartilage

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15
Q

How are pinna haematomas treated?

A

Aspirate
Incision and drainage
Pressure dressing
No contact sport for short period of time

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16
Q

How are lacerations of the ear treated?

A

Debridement to prevent chondritis

Closure and stitch in anatomical postition

17
Q

What other symptoms should be investigated if there is a suspected temporal bone fracture?

A

Hearing loss
Facial palsy
Vertigo
CSF leak

18
Q

What are the two types of temporal bone fracture

A

Longitudinal (more common)

Transverse (otic capsule involved)

19
Q

What sign can be visible behind the ear after a temporal bone fracture?

A

Battles sign

20
Q

What can a temporal fracture cause to happen to the incus and malleus?

A

Pulled away from each other

Induces a conductive hearing loss

21
Q

Temporal fracture treatment is often delayed. TRUE/FALSE?

A

TRUE

due to polytrauma

22
Q

What is the rule of 3s with regards to sudden sensorineural hearing loss?

A

Occurs within 3 days

Drops 30dB at 3 frequencies

23
Q

What test is used to determine whether or not a patient has had a sensorineural hearing loss?

A

Webers test (tuning fork)

24
Q

How is a sudden sensorineural hearing loss treated?

A

Steroids and urgent ENT referral

intratympanic steroids can also be given

25
Q

What foreign bodies should be removed immediately?

A

Batteries!

26
Q

How are live insects removed?

A

Oil is placed into ear to kill insect and then dead insect can be removed

27
Q

What structures are in Zone 1 for neck injuries?

A 
Trachea
Oesophagus
Thoracic duct
Thyroid
Large Vessels – brachiocephalic, subclavian, common carotid
Spinal cord
28
Q

What structures are in Zone 2 for neck injuries?

A 
Larynx
Hypoharynx
CN 10,11,12
Vessels – carotids, internal jugular
Spinal Cord
29
Q

What structures are found in Neck injury zone 3?

A

Pharynx
Cranial Nerves
Vessels – Carotids, IJV, Vertebral
Spinal Cord

30
Q

When would a neck injury not be considered penetrating?

A

If the platysma is still intact

31
Q

What usually causes a deep neck space infection?

A

Extension of infection from tonsil or oropharynx into deeper tissues

32
Q

What features of the history would make you suspect a deep neck space infection?

A

sore throat, unwell, limited neck movement (move torso instead

33
Q

How are deep neck space infections treated?

A

Fluid resuscitation
Intravenous antibiotics
Incision and Drainage of neck space

34
Q

Where in the neck is known as the danger zone of infection?

A 
Retropharyngeal space 
(infection can track down to mediastinum)

ENT (16 decks)

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