ENT Emergencies

Question 1

what should you exclude in nasal trauma?

Answer 1

septal haematoma

Question 2

is investigations necessary in nasal fractures?

Answer 2

no

diagnosis is purely clinical

Question 3

consider digital ______________ in a nasal fracture in <3 weeks

Answer 3

consider digital MANIPULATION in a nasal fracture in <3 weeks

Question 4

epistaxis is usually from which artery?

Answer 4

anterior ethmoid artery

Question 5

the anterior and posterior ethmoidal artery are branches of what artery?

Answer 5

internal carotid artery

Question 6

the greater palatine and sphenopalatine artery are both branches of what artery?

Answer 6

external carotid artery

Question 7

what are the first aid measures in the management of epistaxis? (4)

Answer 7

external pressure to nose

ice

cautery

nasal packing

Question 8

what do you use to arrest/slow flow in epistaxis?

Answer 8

pressure
ice
topical vasoconstrictor +/- LA

Question 9

CSF leaks often settle spontaneously

true or false?

Answer 9

true

Question 10

name the common ENT emergency in rugby players

Answer 10

pinna haematoma (cauliflower ear)

Question 11

pinna haematoma treatment?

Answer 11

aspirate
incision and drainage
pressure dressing

Question 12

laceration to ear management?

Answer 12

debridement
closure - primary or reconstruction
LA

Question 13

when should you use antibiotics in an ear laceration?

Answer 13

when you can see cartilage

Question 14

name the 2 types of temporal bone fracture

Answer 14

longitudinal or transverse

Question 15

what is the name for bruising behind the ear?

Answer 15

battle sign

Question 16

name the nerve associated in battle sign

Answer 16

VII

Question 17

lateral blows results in what type of temporal bone fracture?

Answer 17

longitudinal

Question 18

frontal blows results in what type of temporal bone fracture?

Answer 18

transverse

Question 19

longitudinal or transverse:

otic capsule involvement

Answer 19

transverse

Question 20

longitudinal or transverse:

otic capsule sparing

Answer 20

longitudinal

Question 21

longitudinal or transverse:

fracture line parallels the long axis of the petrous pyramid

Answer 21

longitudinal

Question 22

longitudinal or transverse:

harm-tympanum and ossicualr chain disruption resulting in conductive deafness

Answer 22

longitudinal

Question 23

longitudinal or transverse:

fracture at right angles to the long axis of the petrous pyramid

Answer 23

transverse

Question 24

longitudinal or transverse:

sensorineural hearing loss due to damage to 8th cranial nerve

Answer 24

transverse

Question 25

longitudinal or transverse: cross the internal acoustic meatus causing damage to auditory and facial nerves

Answer 25

transverse

Question 26

longitudinal or transverse: facial nerve palsy and vertigo

Answer 26

transverse

Question 27

longitudinal or transverse: 80% - 20% -

Answer 27

80% - longitudinal | 20% - transverse

Question 28

longitudinal or transverse: bleeding of external ear

Answer 28

longitudinal

Question 29

what test is performed in sudden sensorineural hearing loss?

Answer 29

weber test

Question 30

what drug is given in sudden sensorineural hearing loss?

Answer 30

steroids - prednisolone 1mg per kg for a week

Question 31

foreign bodies can normally wait for removal unless the foreign body is what?

Answer 31

a watch battery

Question 32

how do you remove love animals from the ear?

Answer 32

drown with oil and remove the next day

Question 33

name the classifications of penetrating neck injuries

Answer 33

zone I zone II zone III

Question 34

what anatomical features are included in a zone I neck injury

Answer 34

``` trachea oesophagus thoracic duct thyroid spinal cord brachiocephalic, subclavian, common carotid ```

Question 35

what anatomical features are included in a zone II neck injury

Answer 35

``` larynx hypoharynx CN 10,11,12 carotids and internal jugular spinal cord ```

Question 36

what anatomical features are included in a zone III neck injury

Answer 36

pharynx cranial nerves carotids, IJV, vertebral spinal cord

Question 37

what structure must the injury go through to be classed as a penetrating injury of the neck?

Answer 37

platysma

Question 38

name the 2 areas affected in deep neck infection

Answer 38

parotid | parapharyngeal space

Question 39

deep space neck infection treatment?

Answer 39

fluids IV antibiotics incision and drainage

Question 40

in blow out fractures of the skull, what sign is seen on CT?

Answer 40

tear drop sign