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ENT > ENT trauma > Flashcards

ENT trauma Flashcards

1
Q

When is the best time to asses nasal trauma?

A

immediately or 5 days after

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2
Q

What should be elicited in the history of a nasal trauma?

A

mechanism of injury; when occured; LOC; epistaxis- has it recurred; breathing; discharge

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3
Q

What should be done on exam of nasal trauma?

A

infraoribtal sensation; facial tenderness- esp around orbits; CNs; EXCLUDE septal haematoma

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4
Q

Why is septal haematoma an emergency?

A

septal cartilage is avascular- gets blood from the periochondrium- if haeamatoma separates cartilage from perichondrium- septum loses blood supper and will necrose and abscess- loss of structure of nose and potential for intracranial infection

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5
Q

What would indicate a swelling is a septal haematoma rather than a bony swelling?

A

a boggy feeling- haematoma

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6
Q

How can deviation folloing a nasal # be fixed?

A

within 2 or 3 weeks, digital manipulation to straighten the nasal bones

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7
Q

What are the complications of nasal# ?

A

epistaxis; CSF leak; meningitis; anosmia

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8
Q

What are the arteries that supply the nasal septum?

A

sphenopalatine artery; ethmoid artery greater palatine artery

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9
Q

How can blood flow be arrested or slowed in epistaxis?

A

pressure; ice; topical vasoconstrictor +/- LA; remove clot; cautery; rapid rhino pack

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10
Q

What is the likely site of # in a CSF leak?

A

cribiform plate

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11
Q

How is a septal haematoma treated?

A

drainage

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12
Q

What is the treatemtn for a sub-perichondrial haematoma?

A

aspirate or incision and drainage or pressure dressing

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13
Q

What is the management of lacerations?

A

debridement; closure- primary or reconstruction; LA; antibiotics if affects cartilage

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14
Q

What is the typical bruising pattern seen with a temporal bone #?

A

battle sign behind the ear

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15
Q

What should be checked in a temproal bone# ?

A

coniditon of TM and ear canal; VII; hearing

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16
Q

How are temporal bone #s classified?

A

otic capsule invovled/spared or longitudinal/ transver

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17
Q

What type of blow causes a longitudinal #?

A

lateral blow

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18
Q

What are the symptoms of a longitudinal #?

A

bleeding from external canal due to laceration of skin and ear drum; conductive deafness (haemotympanum and ossicular chain disruption); facial palsy; CSF otorrhoea

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19
Q

What type of blow causes of transvers #?

A

frontal blow

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20
Q

What are hte symptosm of a transverse #?

A

SNHL and facial nerve palsy due to # crossing IAM; vertigo

21
Q

What are the causes of conductive HL?

A

fluid- effusion; blood; CSF; TM perforation; ossicular disruption/fixation; stapes fixation- otosclerosis

22
Q

what are the acuses of SNHL?

A

sensory-cochlea; neural- VIII

23
Q

What is found in zone 1?

A

trachea;oesophagus; thoracic duct; vessels- bachiocephalic, subclavian; common carotid; spinal cord

24
Q

What is found in zone 2?

A

larynx; hypopharynx; CN X; XI; XII; vessels - carotids; internal jugular; spincal cord1

25
Q

What is found in zone 3?

A

pharynx; CNs; vessels- carotids; IJV; spinal cord

26
Q

What should be looked at in a neck trauma?

A

aerodigestive tract- dyspnoea; hoarsenss; dysphonia; dysphagia; haemoptyssi

27
Q

What is zone 2?

A

mandible to cricoid

28
Q

What is the commonest zone affected by neck trauma?

A

zone 2

29
Q

What is platysma?

A

muscle that wraps around the neck

30
Q

When should an urgent exploration be undertaken in neck trauma?

A

expanding haematoma (vascular compromise); hypovolaemic shock; airway obstruction; blood in aerodigestive tract

31
Q

How can urgent exploration be undertaken?

A

laryngoscopy; bronchoscopy; pharyngoscopy; oesophagoscopy

32
Q

Why is the maxilla importnat?

A

a bridge between the cranial base and the dental occlusal plane

33
Q

What is the second commonest midfacial #?

A

orbital floor #s

34
Q

What is the weak point in the orbit?

A

infraorbital groove

35
Q

What is the sign on CT of oribtal #?

A

tear drop sign into the sinuses

36
Q

When would surgical repair happen in orbital #s?

A

if there is entrapment; a large defect or significant enophthalmos

37
Q

What are the 3 types of Le Fort #s?

A

horizontal (maxilla); pyramidal; transverse

38
Q

What is the imaging of choice with facial fractures?

A

CT

39
Q

What is the surgery for Le Fort #s?

A

vertical and horizontal buttresses- reduce # and fix

40
Q

What are the differences between adult and neonate ENT?

A

large head; small nares; relatively large tongue; small, soft larynx; weak neck muscles; narrow subglottis

41
Q

What type of breathing do neonates prefeR?

A

neonates are obligate nasal breathers

42
Q

What is Poiseuille’s equation?

A

air flow resistance- 1/r4

43
Q

What is the difference bewteen stridor and stertor?

A

although both are noisy breathing, stertor is low pitched from nasopharyngeal blockage whereas stridor is a high pitched nosie dur to airway obstruction

44
Q

What is Bedrnoulli’s theorem?

A

if air passes through a tube which has constrictions, the velocity of gas increases at the level of the narrowing, and in order to preserve the law of conservation of energy, the local gas pressure falls.

45
Q

How is a basic assessment of breathing carried out?

A

appearance; work of breathing; skin circulation`

46
Q

How does respiratory distress lead to cardiac arrest?

A

respiratory distress– respiratory failure– respiratory arrest– cardiac arrest

47
Q

What is the most important thing to do with acute epiglottitis?

A

secure the airway

48
Q

What is heliox?

A

a combination of helium and oxygen which is thinner air and so easier to breathe

ENT (13 decks)

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