ENT - Preading Flashcards

1
Q

What is the difference between anterior and posterior rhinorrhea?

A
  • Anterior rhinorrhea = mucus secretions coming out of nose
  • Posterior rhinorrhea = mucus secretions flowin down throat
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2
Q

What are the 5 main symptoms to ask about for the nose?

A
  1. Nasal obstruction
  2. Runny nose (i.e. anterior rhinorrhoea)
  3. Loss of sense of smell (i.e. hyposmia or anosmia)
  4. Nose bleeds (i.e. epistaxis)
  5. Facial pain

Other symptoms:

  • Post nasal drip (excess mucus secretions dripping down throat)
  • Nasal itch
  • Sneezing
  • Ocular itching
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3
Q

What are the 5 main symptoms to ask about for the ear?

A
  1. Earache (i.e. otalgia)
  2. Ear discharge (i.e. otorrhoea)
  3. Hearing loss
  4. Tinnitus (the sensation of sound without any external stimulus)
  5. Dizziness

Other symptoms:

  • Aural blockage (ear block)
  • Itching
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4
Q

What are the 5 main symptoms to ask about for the throat?

A
  1. Sore throat
  2. Difficulty swallowing (i.e. dysphagia)
  3. Pain on swallowing (i.e. odynophagia)
  4. Hoarse voice (i.e. dysphonia)
  5. Regurgitation

Other symptoms:

  • A feeling of a lump in the throat
  • Burning in the throat (GORD)
  • Weight loss
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5
Q

What are the 6 anatomical triangles of the neck + what are their borders?

A

Anterior triangle:

  • Submental triangle:
    • Post border = anterior belly of digastric
    • Ant border = throat midline
    • Inf border = body of hyoid
    • Contains = lymph nodes draining floor of mouth
  • Submandibular / digastric triangle:
    • Post border = posterior belly of digastric
    • Ant border = anterior belly of digastric
    • Sup border = lower border of mandible
    • Contains = submandibular nerve, hypoglossal nerve, internal + external carotids, internal jugular vein
  • Carotid triangle:
    • Post border = ant border of sternocleidomastoid
    • Ant.inf border = omohyoid
    • Ant.sup border = posterior belly of digastric
    • Contains = lower part of pharynx + upper larynx, carotid sheath and this in turn contains:
      • common, internal and external carotid arteries, the vagus nerve and the sympathetic chain
  • Muscular triangle
    • Sup border = hyoid bone
    • Med border = midline of throat
    • Sup.lat = sup. belly of omohyoid
    • Inf.lat = inferior part of sternocleidomastoid

Posterior triangle:

  • Ocipital triangle
  • Subclavian triangle
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6
Q

Neck lymphatics are split into levels and correspond to a specific area of drainage.

What are these levels and their drainage?

A
  • Level 1: Submental and submandibular
  • Level 2: Upper deep cervical
  • Level 3: Mid-deep cervical
  • Level 4: Lower deep cervical
  • Level 5: Posterior triangle
  • Level 6: Paratracheal
  • Level 7: Upper mediastinal

N.B. Lymph nodes in a specific region can indicate the area of a tumour

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7
Q

Why do patients with sore throat often complain of earache (otalgia)?

A

The glossopharyngeal nerve supplies sensation to the throat (tonsils and pharynx) but also to the ear (middle ear) !!

This is called referred otalgia

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8
Q

What are the features of acute tonsillitis?

A

Symptoms:

  • Sore throat (due to pharyngitis)
    • Tonsils appear: oaedematous, yellow / white pustules may be present
  • Fever
  • Malaise
  • Lymphadenopathy

Info:

  • > 50% cases are bacterial (Streptococcus pyogenes = most common)
  • Infectious mononucleosis may mimic the condition
  • Severe acute bacterial tonsillitis can results in a peritonsillar abscess i.e. Quinsy
    • Local anaesthetic + aspiration or incision and drainage

Management:

  • Penicillin-type Abx for bacterial tonsillits e.g. Phenoxymethylpenicillin
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9
Q

A peritonsillar abscess i.e. quinsy is a complication of severe bacterial tonsillitis.

What are the features of a quinsy?

A

Features:

  • severe throat pain - which lateralises to one side
  • uvula deviation - to unaffected side
  • trismus (difficulty opening the mouth)
  • ↓ neck mobility
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10
Q

What are the common causes of referred otalgia?

A
  1. TMJ pathology
  2. Pharyngeal pathology
  3. Dental infection
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11
Q

Examine the following image of an ear drum.

Identify all relevent structures.

A
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