ENT pathology Flashcards
WHAT TEAM?!
WILDCATS!
what type of cells line the following/compnents:
- auditory meatus & auditory canal
- middle ear
- inner ear
- nasal vestibule
- nasal sinus
- throat
- vocal chords
- epidermis containing sebaceous & ceruminous glands
- columnar lined mucosa, contains ossicles
- cochlea and vestibular apperatus
- squamous
-schneiderian epithelium (resp mucosa)
columnar, seromucinous glands
- resp and squamous epithelium
- squamous
Salivary glands
- type of gland
- cells present
-exocrine gland
-serous cells (contain digestive enzymes), mucinous cells,
peripheral myoepithelial cells- flat or cuboidal with clear cytoplasm
Name the 4 major forms of pathology in the ear
Otitis media
Cholesteatoma
tumours
Shwannoma
Otitis media
- what is it?
- caused by?
- onset?
- inflammation of the inner ear
- usually viral, occasionally bacterial- Strep Pneumoniae/H.influenzae
- can be acute or cronic
Cholesteatoma
- what is it?
- occurs where
- associations
- appearance
- Abnormally situated squamous epithelium with increased cell turnover & keratin production causing inflammation
- superior posterior middle ear and petrous apex
- chronic OM and perforated tympanic membrane
- blackened with keratin flakes
Vestibular shwannoma
- what is it?
- bilaterally in young then assoc with?
-tumour o the VIIICN sheath in the shwann cells within the temporal bone
-NF type 2 autosomal dominant neurofibromas bony defects Cafe au liât spots, axillary freckling, lisch nodules meningiomas and gliomas
6 main pathologies of the nose?
Rhinitis sinusitis polyps Wegeners granulomatosis NPC- nasal pharangeal carcinoma neuroblastoma
Nasal polyps
- causes?
- in children then…?
- appearance
- allergy, infection, asthma, aspirin sensitivity, nickel exposure
- consider CF
- fluid filled sacs with normal purple mucosa outline
Rhinitis & sinusitis
- name the two types
- examples
-infectious e.g common cold
allergic e.g.hayfever
Wegener’s granulomatosis
- also know as
- what is it?
- presentation
- antibody
- histology
- Granulomatosis with polyangitis
- auto-immmune disorder in the small vessels of the kidneys and resp tract
-pulmonary or renal disease OR nasal symptoms of congestion
+ septal perforation and ulcers
- c-ANCA
- intense inflammatory process with multinucleate giant cells
Name the benign nasal tumours (3)
squamous papilloma
Shneiderian papillomas
angiofibromas
Name the malignant nasal tumours (5)
-the virus associated with lymphoma?
most commonly squamous cell carcinoma primary adenoma nasopharangeal carcinoma neuroblastoma lymphoma
-EBV
Name the 5 most common pathologies in the throat?
excluding infection
larangeal polyps ulcers papillomas dysplasia/cancer paragangliomas
Larangeal polyps
- caused by what?
- difference between nodules and polyps
- appearance
-vocal abuse, infection, smoking, hypothyroidism
-nodules= bilateral polyps= unilateral and pedunculated
-polopoid protrusion with oedema and infectious infiltrate
Ulcer
- caused by what?
- appearance
- histology
-benign response to injury
chronic throat or voice abuse e.g. GORD
- see a break in the epithelium below the basement membrane
- granulation tissue and an influx of fibroblasts & inflammatory cells act as scaffold
Papillomatosis
- assoc with which virus
- histology
- HPV 6&11m aggressive in children
- fibrovascular core with epithelium surrounding
paraganglioma
- what are they & what do they arise from
- name the two types and where they arise from
-tumours arising from clusters of neuroendocrine cells
-chromaffin positive
sympathetic NS secretes catecholamines (adrenal medulla or paravertebral)
Non-chromaffin
carotid bodies, aortic bodies, jugulotympanic ganglia, clusters around the oral cavity, nose, nasopharynx, larynx and orbit
SCC
- risk factors
- role of assoc virus
- location
- smoking, alcohol, HPV 16&18
- produce proteins E6 and E7 disrupting the P53 and RB pathway to cause cellular immortality
- tonsils, toungue base
SSC staging in the larynx T1a T1b T2 T3 T4a T4b
- 1 vocal chord
- both vocal chords
- extension into the supra/subglottis
- vocal chord fixation/extension into the paraglottic space/minor thyroid cartilage
- thyroid cartilage/trachea/tongue muscles/strap muscles/thyroid/oesophagus
- prevertebral spine/ mediastinal structures/carotid artery
Salivary gland pathology
- name the 4 different types of salivary gland
- name the 3 most common pathologies
-parotid, submandibular, sublingual, minor salivary glands
-sialolithiasis (stones)
paramyxovirus (mumps)
tumours
name the two benign salivary gland tumours
-features and assoc
pleomorphic adenoma
males over 60 yrs
jelly centre and weak capsule
if longstanding risk of malignant transformation
Warthin’s tumour
assoc with smoking
bilateral and multicentric
what is the most common malignant salivary gland tumour
- location
- invasion
adenoid cystic carcinoma
- parotid or palate gland
- frequent perineural invasion & assoc pain or loss of function
