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ENT stuff Flashcards

1
Q

what duct allows passage of saliva from the submandibular gland to the sublingual papula?

A

whartons duct

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2
Q

what duct allows passage of saliva from parotid gland to mouth?

A

Stensens duct

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3
Q

long term condition in which there is inflammation of the tympanic membrane in the inner ear and formation of granulation tissue within the TM

A

Granular mytingitits

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4
Q

Treatment options for meniers

A

1: Diet, low salt, caffine and ETOH
2: ,edocatopms Dizide and beahistime ( not FDA )
3: Intra TM steroid injections
4: Endolymphatic sac decompression
5: Genamycin inner ear injection or labrithectomy

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5
Q

ECOG reading in Meniers

A

the increase of endolymphatic fluid in Meniers causes a larger summinating potential to action potential ( SP/AP) so eCOG for Meniers is large SP/AP ratio

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6
Q

Sudden SN hearing loss

A

Defin: acute SN hearing loss, Nearly always unilateral, that occurs within 72 hours,

Dx Audio with a 30 DB drop from prior readings, MRI brain

Treatment: Steroid either oral at 60 mg daily x 10 days or Intratympanic dexamethasone 10mg/mL approx 0.5 mL once a week x 3 weeks . Lastly Hyperbaric oxygen therapy.

Prognosis: 78% recover in 3 months

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7
Q

Palulous estachian Tube (PET)

Define

Symptoms

Who:

Dx:

Treatment:

What can patients do for symptom relief.

A

Define: The ET is usually closed except for when we swallow or try to pop our ears. If the ET is consistently open its Patulous

Symptoms:

  • Autophony: hear ones own voice/breath
  • Ear fullness, stuffiness, muffled
  • Tinnitus in time with patients breathing.

Who: Anyone but common in extream weight loss.

Dx:

  • Exam ear.
  • Nasal endoscopy looking at ET opening.
  • CT of temporal bone to look for symptoms that can mimic PET like superior canal dehiscence

Tx

  • ear tube can give some relief.
  • Narrowing of the ET tube with cartilage
  • Premarin nasal ggts, swell ET
  • Hypertrophic saline ggts nasal - swells the ET

Symptom relief, by putting head between legs or laying down.

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8
Q

Nasal spray for Vasomotor rhinitis

A

Astelin (Azelastine)

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9
Q

Culture for CFS leak test name

A

Beta 2 transferin

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10
Q

Nose bleed in the ER with packing, how long does it stay in and what Abx is needed

A

3-5 days before removal, abx with Keflex.

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11
Q

Topical ggt for itchy ear

A

Demotic 0.1% ml use 3 ggt PRN for itch ears.

If that is not covered baby oil ggts.

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12
Q

what is the Capula?

A

The ampullary cupula, or cupula, is a structure in the vestibular system, providing the sense of spatial orientation. The cupula is located within the ampullae of each of the three semicircular canals. … As a result, the cupula is deflected opposite the direction of head movement.

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13
Q

Concha bullosa

A

A concha bullosa is a pneumatized cavity within a nasal concha, also known as a turbinate. Bullosa refers to the air-filled cavity within the turbinate. It is a normal anatomic variant seen in up to half the population.

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14
Q

abnormal readings on Sleep study

A

> 10 apnic episodes per hour or an O2 sat drop less then 90%

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15
Q

Otitis externa bacteria

A

Is an inflammation of the EAC caused by S. Aureus, pseudomonas aeriginosa, less common staph epidermatis

Fungal Otitis externa is caused by aspergillus niger (80%) and less common Candida albicans

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16
Q

Predisposing factors to otitis externa?

A

Heat, humidity, maceration.
These factors result in edema of the stratum corn rum and inclusion of the apopilosebaceous units. Leading to pruritis , edema and a sense of war fullness.

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17
Q

Otomycosis

A

Infection of the eac caused by fungus. Aspergillus or candida.

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18
Q

Exostoses

What is it, prevention, complications

A

Ferm, bony, broad based lesions composed of lamellar Bone in the EAC. These are formed by reactive bone formation and have been associated with thermal irritation. They arise from the bone portion of the external auditory canal. Most require no Intervention.

Prevention: Avoid exposure to cold water may prevent the formation.

Complication. Conductive hearing loss may result occurring secondary to his room and infection or accumulation of debris or complete obstruction of the bony mass

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19
Q

FESS

A

Functional Endoscopic Sinus Surgery (FESS)

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20
Q

causes of conductive hearing loss

A 
Perforation 
Fluid behind TM
Ososclerosis
Ossicular discontinuty
cholesteatoma 
superior canal dehiscence
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21
Q

what is a cholesteatoma

A

cholesteatoma is an abnormal, noncancerous skin growth that can develop in the middle section of your ear, behind the eardrum. It may be a birth defect, but it’s most commonly caused by repeated middle ear infections. A cholesteatoma often develops as a cyst, or sac, that sheds layers of old skin

Occurs in the anterior superior in kids
occurs superior posterior in adults

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22
Q

When putting in a T tube, what quadrant of the TM is avoided

A

superior posterior

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23
Q

Bullous Myringitis

A

defn

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24
Q

What are the 3 layers of TM?

A

The outer layer arises from the ectoderm which consist of squamous epithelium.

The inner layer originates from the endoderm And consist of cuboidal mucosal epithelium

The middle layer originates from the mesenchyme And is called the middle of virus layer

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25
Q

how does exposure to cigarette smoke possibly cause OM?

A

passive smoking results in inflammation of the mucoa of the middle ear cleft as well as impaired mucociliary clearance which lead to an increase susceptibility to infection.

26
Q

why is breast feeding protective against AOM?

A

antibacterial immunological benefits conferred by breast milk which can help prevent middle ear infections, additionally during bottle feeding the child tends to be more horizontal position then when they are breast fed whick is more likely to result in the reflux of the stomach contents to the nasopharynx and middle ear.

27
Q

Acute
Subacute
Chronic

A

4 weeks or less
4-12
> 12 weeks

28
Q

fukuda stepping test

A

A rotation greater than 30 degrees is considered a positive Fukuda, indicating peripheral vestibular dysfunction likely consistent with the side to which the patient has rotated.

29
Q

Aspirin-exacerbated respiratory disease (AERD), also known as Samter’s Triad

A

is a condition in which an individual has asthma, sinus inflammation with recurring nasal polyps, and sensitivity to aspirin and some other NSAIDs. When aspirin or a similar drug is taken, people with Samter’s Triad have a severe reaction with both upper and lower respiratory symptoms.

30
Q

keratinous structures emerging from the surface of the tongue epithelium. They are densely packed on the central axis and more sparse on the lateral edges filiform papillae cover the dorsal tongue from the sulcus terminalis to the tip.

A

Filiform papillae

31
Q

when can you blow your nose after sinus surgery

A

2 weeks.

32
Q

how long after complex ear surgery until you can fly?

A

3 weeks.

33
Q

thyroglossal cyst

A

Patients with a TGDC usually present with a midline upper neck mass that is cystic. The mass usually causes no symptoms but may be slightly tender. Often the patient has or recently had an upper respiratory tract infection, but whether the infection leads to cyst formation or simply increases the likelihood of detection of a preexisting cyst is uncertain.

The cyst may occur anywhere along the thyroglossal duct tract from the foramen cecum at the base of the tongue to the level of the suprasternal notch (figure 1). In most cases, the cyst is at or just below the hyoid bone adjacent to the thyrohyoid membrane

34
Q

Reinke’s edema

A

Polypoid corditis is also known as Reinke’s edema (picture 1). Viscous material accumulates in the superficial lamina propria (Reinke’s space) of the true vocal folds as a result of chronic irritation and inflammation secondary to smoking. The vocal folds appear swollen and “floppy” and may cause respiratory symptoms in severe cases. The condition is frequently seen in middle-aged women and causes a husky, low-pitched voice

35
Q

capsaicin nasal spray

A

” hot spicy” nasal spray for allergic rhinitis, NOT regularly used, refractory treatment.

36
Q

Atrovent

A

Ipratropium bromide - is an anticholinergic (parasympatholytic)

37
Q

Astelin (Azelastine Hydrochloride)

A

antihistamine nasal spray

38
Q

what are the 6 levels of the neck

A

Level I: Sub mandibular
Level II: Upper jugular nodes. from the ear to the hyoid bone on SCM
Level III: Middle jugular nodes. Hyoid bone to bottom of cricoid cartilage on SCM
Level IV: Lower jugular nodes. .cricoid cartilage to the clavicle. on SCM
Level V: Posterior triangle. linear space behind the SCM
Level VI: Nodes of the anterior compartment - pretracheal, paratracheal, precricoid lymph nodes.

39
Q

Sleep Study in kids, ABIs

A

Any ABI > 1 is postive.
ABI >5 moderatwe
ABI> 10 severe

40
Q

Peds Flonase start?

A

2 years

41
Q

IgA deficiency causing….

A

IgG deficiency, IgA deficiency, and antibody deficiency can all present with sinusitis. “The immune deficiency itself is not the cause of sinusitis. Often it’s a cold, allergies, and triggers that people may not associate with aggravating the sinusitis

42
Q

mal disembarkment syndrome

A

A perception of self-motion and imbalance is described by some individuals following exposure to passive motion. Water travel is the most usual trigger, but others (air or land travel, flight simulators, water beds) have been described [72,73]. Persons with this syndrome do not in general describe rotational vertigo but rather disequilibrium and a sense of swaying or rocking, or walking on uneven ground. There is often a latency of several minutes to an hour or two between return to solid ground and symptom onset. Patients are not nauseous, and physical examination is normal

43
Q

rare form of objective pulsatile tinnitus which includes tensor tympani-associated tinnitus caused by the contraction of the tensor tympani (TT) muscle.

A

Tensor Tympani Syndrome

44
Q

VPI

A

Velopharyngeal insufficiency (VPI)

During normal speech, the soft palate muscle in the mouth moves up and down and touches the back of the throat. To produce oral consonants (letters such as p, w, and x), the soft palate closes against the back of the throat. When the muscle closes tightly against the back of the throat, air cannot come out the nose. Velopharyngeal insufficiency (VPI) is when the soft palate does not close tightly against the back of the throat, leading to air coming out the nose (characterized by hypernasality and/or nasal air emission) during speech. This can cause speech that is difficult to understand.

45
Q

what is a submucosal cleft and what symptoms are present

A

A submucous cleft palate (SMCP) results from a lack of normal fusion of the muscles within the soft palate as the baby is developing in utero.

rouble feeding as an infant (taking a long time to feed, liquid coming through the nose, etc.)
chronic ear infections and effusions (fluid buildup behind the eardrum)
speech sound errors
speech problems that make the child hard to understand
hypernasality (“nasally sounding” speech)
nasal air emissions (hearing air leak out the nose during speech)

46
Q

what is a submucosal cleft and what symptoms are present

A

A submucous cleft palate (SMCP) results from a lack of normal fusion of the muscles within the soft palate as the baby is developing in utero.

rouble feeding as an infant (taking a long time to feed, liquid coming through the nose, etc.)
chronic ear infections and effusions (fluid buildup behind the eardrum)
speech sound errors
speech problems that make the child hard to understand
hypernasality (“nasally sounding” speech)
nasal air emissions (hearing air leak out the nose during speech)

47
Q

hearing loss in newborn

A

if fail newborn OAE.
Need to repeat OAE at 1 month
if fail again BEAR at 3 months
if failed Hearing aids by 6 months

48
Q

eagle syndrome

A

Eagle syndrome is due to a calcified stylohyoid ligament or an elongated styloid process.[1] The styloid process is a pointed part of the temporal bone that serves as an anchor point for several muscles associated with the tongue and larynx

Eagle syndrome is characterized by recurrent pain in the middle part of the throat (oropharynx) and face. “Classic Eagle syndrome” is typically seen in patients after throat trauma or tonsillectomy. Symptoms include dull and persistent throat pain that may radiate to the ear and worsen with rotation of the head. Other symptoms may include difficulty swallowing, feeling of something stuck in the throat, tinnitus, and neck or facial pain

49
Q

afrin overuse

A

rhinitis medicamentosa

wean off afrin over 6 weeks, prednisone wean, start Flonase twice a day

50
Q

phantom sense of smell

A

Phantosmia

51
Q

COVID causing loss of smell

A

the nasal pharynx is a resolver of the virus, this is why we swab the nose, it is likely like it causes damage to the mucosa and tissue in the nose, as well as the nerve to smell.

52
Q

RhinAer uses low-temperature radiofrequency energy to disrupt the nerve fibers associated with triggering a runny nose. During the procedure, a small, flexible tube enters the nasal passageway through a nostril and is maneuvered into place by your ENT physician.

A

rhinaer procedure

53
Q

rubber band like drain for small incisions.

A

Penrose drain.

54
Q

actinomyces infection

A

bacterial infection that begins in the space between the teeth and gums and penetrates the surrounding muscle bone and skin of the face.

Would need a CT scan to eval.

shows as an abscess at line of the mandible.
Cultures needed.

55
Q

haller cells

A

air cells situated beneath the ethmoid bulla along the roof of the maxillary sinus and the most inferior portion of the lamina papyracea, including air cells located within the ethmoid infundibulum.

Haller cells can interfere with the normal drainage of the maxillary sinus and result in sinusitis.

56
Q

Temporary threshold shift

A

A temporary threshold shift is a temporary shift in the auditory threshold. It may occur suddenly after exposure to a high level of noise, a situation in which most people experience reduced hearing. A temporary threshold shift results in temporary hearing loss.

57
Q

poor dentition, poor oral health, bacteria that penetrates the mucosal barriers. Causes jaw line abscess.

A

actinomyces infection

58
Q

antrochoanal polyp

A

are solitary sinonasal polyps that arise within the maxillary sinus. They pass to the nasopharynx through the sinus ostium and posterior nasal cavity, enlarging the latter two.

59
Q

medication given for salocele

A

Glycopyrrolate 1 mg tab q 8 hours. `

60
Q

Surgery name for opening up the maxillary sinus opening

A

maxillary antrostomy

ENT stuff (1 decks)

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