Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Q1 > ent hape > Flashcards

ent hape Flashcards

1
Q

what is a point to remember during your ear exam?

A

The inner two-thirds of the canal are surrounded by bone and lined by thin, hairless skin. Pressure on this inner two-thirds of the canal area causes pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what does the middle ear connect to?

A

the nasopharynx via the proximal end of the eustachian tube.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe the aspects of the vestibulocochlear nerve

A

The cochlea is dedicated to hearing, whereas the semicircular canals and otolith organs are dedicated to balance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

how do you assess the middle and inner ear?

A

Much of the middle ear and all of the inner ear are inaccessible to direct examination. Assess their condition by testing auditory function.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what do hearing disorders of the external and middle ear cause?

A

conductive hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

otitis externa

A

infection of the external ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

exostosis

A

benign bony growth in external ear

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

examples of middle ear disorders

A

otitis media, congenital conditions, cholesteatomas, otosclerosis, tympanosclerosis, tumors, and perforations of the tympanic membrane.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

what kind of hearing loss is caused by disorders of the inner ear?

A

sensorineural hearing loss

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

examples of disorders of the inner ear

A

congenital and hereditary conditions, presbycusis, viral infections such as rubella or cytomegalovirus, Ménière disease, noise exposure, ototoxic drug exposure, and acoustic neuromas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

air conduction is more sensitive than bone conduction (AC > BC) in those with…

A

normal hearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

function of semicircular canals vs otolith organs

A

The three semicircular canals in the inner ear sense rotational movement, whereas the otolith organs sense linear movement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what sinuses are readily accessible on the physical exam?

A

frontal and maxillary sinuses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

common or concerning symptoms on the ear exam

A

Hearing loss
Earache and ear discharge
Ringing in the ears (tinnitus)
Dizziness and vertigo
Nasal discharge (rhinorrhea) and nasal congestion Nosebleed (epistaxis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

conductive vs sensorineural hearing loss

A

-conductive loss, which results from problems in the external or middle ear
-sensorineural loss, resulting from problems in the inner ear, the cochlear nerve, or its central connections in the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what do ppl w sensorineural hearing loss have issues with?

A

understanding speech, often complaining that others mumble; noisy environments make hearing worse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

in conductive hearing loss what kind of environments may help?

A

noisy environments

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

medications known to cause permanent hearing loss

A

aminoglycosides (e.g., gentamicin) and many chemotherapeutic agents (e.g., cisplatin and carboplatin)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

medications that can cause temporary hearing damage

A

aspirin, nonsteroidal anti-inflammatory agents (NSAIDs), quinine, and loop diuretics (e.g., furosemide).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what do acute otitis externa and acute or chronic otitis media with perforation usually present with?

A

yellow green discharge

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

what should you suspect with tinnitus associated with fluctuating hearing loss and vertigo

A

meniere disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

vertigo

A

the sensation of true rotational movement of the patient or the surroundings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

possible causes of rhinorrhea

A

Causes include viral infections, allergic rhinitis (“hay fever”), and vasomotor rhinitis. Itching favors an allergic cause.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

what suggests allergic rhinitis?

A

seasonal onset or environmental triggers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

what causes drug induced rhinitis?

A

excessive use of topical decongestants or intranasal use of cocaine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Acute bacterial sinusitis (rhinosinusitis)

A

unlikely until viral URI symptoms persist more than 7 days; both purulent drainage and facial pain should be present for diagnosis (sensitivity and specificity are above 50%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Ask about drugs that may induce nasal stuffiness.

A

Inquire about all medications or drugs, particularly oral contraceptives, alcohol, and cocaine.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

Is the nasal congestion only on one side?

A

Consider a deviated nasal septum, nasal polyp, foreign body, granulomatous disease, or carcinoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

what are local causes of epistaxis?

A

trauma (especially nose-picking), inflammation, drying and crusting of the nasal mucosa, tumors, and foreign bodies.

30
Q

Is epistaxis a recurrent problem? Has there been easy bruising or bleeding elsewhere in the body?

A

Anticoagulants, NSAIDs, vascular malformations, and coagulopathies can contribute to epistaxis.

31
Q

key components of the ear exam

A

-Inspect the auricle and surrounding tissue (deformities, lumps, pits, or skin lesions).
-Move the auricle and palpate the auricle, tragus and mastoid (tenderness).
-Examine ear canals and tympanic membranes with an otoscope.
*Inspect the ear canal (cerumen, discharge, foreign bodies, redness of the skin, or swelling).
*Inspect the tympanic membrane and malleus (color, contour, perforations, mobility).
-Test auditory acuity or gross hearing with the whispered voice test.
-If hearing loss or difficulty is present, determine sensorineural versus conductive hearing loss with tuning fork tests.
-Test lateralization if unilateral hearing loss or difficulty (Weber) is present.
-Compare air conduction versus bone conduction (Rinne).

32
Q

when is movement of the auricle and tragus painful and when is it not?

A

acute otitis externa (inflammation of the ear canal), but not in otitis media (inflammation of the middle ear).

33
Q

what is associated with tenderness behind the ear?

A

otitis media and mastoiditis.

34
Q

bullous myringitis

A

a common sequela of otitis media presenting with painful hemorrhagic vesicles on the tympanic membrane

35
Q

examining the ears with the otoscope

A

-Position the patient’s head so that you can see comfortably through the otoscope.
-Straighten the right ear canal using the fingers of your left hand to grasp the auricle firmly but gently and pull it upward, backward, and slightly away from the head.
-Hold the otoscope handle securely with the right hand between your thumb and fingers, and brace your remaining right fingers against the patient’s face. -Your right hand and instrument can then follow unexpected movements by the patient.
-Insert the speculum gently into the ear canal, directing it somewhat down and forward and through the hairs, if any.

36
Q

what does the ear canal look like in acute otitis externa?

A

canal is often swollen, narrowed, moist, erythematous or pale, and tender.

37
Q

what does the ear canal look like in chronic otitis externa?

A

the skin of the canal is often thickened, red, and itchy.

38
Q

serous effusion

A

Otitis media with effusion (OME) is a collection of non-infected fluid in the middle ear space. presents as an amber color

39
Q

what does an unusually prominent short process and a prominent handle that looks more horizontal suggest

A

retracted tympanic membrane

40
Q

when does the ear drum have NO mobility?

A

when there is a perforation

41
Q

the whispered voice test

A

whispered voice test is a reliable screening test for hearing loss if the examiner uses a standardized and consistent method of testing. Positive likelihood ratio (LR) is 2.3 and negative LR is 0.73

42
Q

what should you note about older adults with presbycusis? (sensorineural hearing loss related to age-appropriate changes in the auditory system)

A

they have higher frequency hearing loss, making them more likely to miss sibilant consonants (producing the sound of or a sound resembling that of the s or the sh), which have higher frequency sounds than vowels. The hearing loss is typically gradual, progressive, and bilateral.

43
Q

what do tuning fork tests not distinguish?

A

normal hearing from bilateral sensorineural loss or from mixed conductive–sensorineural loss

44
Q

sensitivity and specifity of the weber test

A

about 55%;s pecificity for sensorineural loss is about 79%, and for conductive loss, 92%.

45
Q

Sensitivity and specificity of the Rinne test

A

60% to 90% and 95% to 98%

46
Q

where is sound heard in unilateral conductive hearing loss?

A

sound is heard in (lateralized to) the impaired ear. Explanations include otosclerosis, otitis media, perforation of the eardrum, and cerumen

47
Q

where is sound heard in unilateral sensorineural hearing loss?

A

the good ear

48
Q

key components of the nose and paranasal sinus exam

A

-Inspect the anterior and inferior surfaces of the nose (asymmetry, deformities, tenderness).
-Test for nasal obstruction on each ala nasi (if indicated).
-Inspect the nasal mucosa, nasal septum, inferior and middle turbinates, and corresponding meatuses with a light source or otoscope with large speculum (deviation, marked asymmetry, polyps, ulcers).
-Palpate the frontal sinuses (tenderness, pressure, fullness).
-Palpate the maxillary sinuses (tenderness, pressure, fullness).

49
Q

what does tenderness of the nasal tip or ala suggest?

A

local infection such as a furuncle, particularly if there is a small erythematous and swollen area.

50
Q

compare the mucosa in viral vs allergic rhinitis

A

In viral rhinitis, the mucosa is reddened and swollen; in allergic rhinitis, it may be pale, bluish, or red.

51
Q

causes of septal perforation

A

trauma, surgery, and intranasal use of cocaine or amphetamines, which also cause septal ulceration.

52
Q

nasal polyps

A

pale saclike growths of inflamed tissue that can obstruct the air passage or sinuses, seen in allergic rhinitis, aspirin sensitivity, asthma, chronic sinus infections, and cystic fibrosis

53
Q

what are malignant tumors of the nasal cavity associated with?

A

exposure to tobacco or chronically inhaled toxins.

54
Q

what does local tenderness, together with symptoms such as facial pain, pressure or fullness, purulent nasal discharge, nasal obstruction, and smell disorder, especially when present for >7 days suggest?

A

acute bacterial rhinosinusitis involving the frontal or maxillary sinuses

55
Q

important topic for health promotion and counseling

A

Screening for hearing loss

56
Q

tophi

A

A deposit of uric acid crystals characteristic of chronic tophaceous gout.

57
Q

common or concerning symptoms with the oral cavity exam

A

-sore throat
-Gum swelling/bleeding gums Hoarseness
-Malodorous breath (halitosis)

58
Q

Centor’s clinical prediction

A

rules for streptococcal and Fusobacterium necrophorum pharyngitis have been used in the past to help guide diagnosis and treatment of bacterial infection: fever history, tonsillar exudates, swollen tender anterior cervical adenopathy, and absence of cough

*has led to overuse of antibiotics tho

59
Q

current diagnostic guidelines for streptococcal and Fusobacterium necrophorum pharyngitis

A

rapid antigen testing or throat culture for diagnosis and treatment.

60
Q

possible causes of hoarseness

A

Causes range from diseases of the larynx to extralaryngeal lesions that press on the laryngeal nerves

61
Q

what to do if hoarseness lasts over 2 weeks

A

refer for laryngoscopy and consider causes such as reflux; vocal cord nodules; hypothyroidism; head and neck cancers including thyroid masses; and neurologic disorders like Parkinson disease, amyotrophic lateral sclerosis, or myasthenia gravis

62
Q

common causes of breath malodor

A

poor oral hygiene, tobacco smoking, plaque retention on teeth and mouth appliances such as retainers and dentures, periodontal diseases (gingivitis, ulcers, periodontitis)

63
Q

systemic causes of breath malodor

A

The most common ones are respiratory causes such as sinusitis, tonsillitis, pharyngitis, foreign bodies, neoplasms, abscesses, and bronchiectasis. Other systemic causes are uncommon such as gastric acid reflux, hepatic cirrhosis, poorly controlled diabetes mellitus, impaired fat digestion, and inborn errors of metabolism such as trimethylaminuria

64
Q
A

-Inspect the lips (color, moisture, lumps, ulcers, cracking, or scaliness
-inspect the oral mucosa (discoloration, ulcers, white patches, nodules).
-Palpate the oral mucosa (if indicated for any lesions, thickening).
-Inspect the gingiva (erythema, discoloration, ulceration, swelling).
-Inspect the gum margins and interdental papillae (swelling, ulceration).
-Inspect the teeth (missing, discolored, misshapen, or abnormally positioned).
-Inspect the roof (hard palate) and floor of the mouth (erythema, discoloration, nodules, ulcerations, or deformities).
-Test the hypoglossal nerve, or CN XII (symmetry of tongue protrusion).
-Inspect the tongue (color, texture, lesions). Palpate the tongue (if indicated for any lesions, thickening).
-Inspect the soft palate, anterior and posterior pillars, uvula, tonsils, and pharynx (color, symmetry, exudate, swelling, ulceration, or tonsillar enlargement).
-Test the vagus nerve, or CN X (symmetry of uvula)

65
Q

denture stomatitis (denture sore mouth)

A

Bright red edematous mucosa underneath a denture suggests

66
Q

who is at the highest risk for cancers of the tongue or oral cavity?

A

Men age >50 years, smokers, and heavy users of chewing tobacco and alcohol

67
Q

CN X paralysis

A

the soft palate fails to rise and the uvula deviates to the opposite side and “points away from the lesion”

68
Q

Asymmetric tonsils, particularly when associated with other symptoms, may signify what?

A

an underlying pathology such as lymphoma.

69
Q

important topics for health promotion and counseling regarding the oral exam

A

-Oral health
-Oral and pharyngeal cancer

70
Q

why should clinicians should play an active role in promoting oral health?

A

it is integral to an individual’s overall health and well-being. Up to 19% of children aged 5 to 19 years have untreated caries, as do about 91% of adults aged 20 to 64 years. Dental caries among adults aged 35 to 64 years were higher (94% to 97%) compared with adults aged 20 to 34 years (82%). Nearly 19% of those older than age 60 years have no teeth at all (edentulous)

Q1 (15 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions