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ENT > General ENT > Flashcards

General ENT Flashcards

1
Q

Sensory nerve supply to the ext. auditory canal

A

Auriculotemporal
Greater auricular Branches of the facial nerve

Arnold’s nerve (cough reflex) - branch of the vagus

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2
Q

What is otosclerosis?

A

Fixation of the stapes footplate leading to conductive hearing loss

Autosomal dominant
Can be precipiated by pregnancy in those who are genetically predisposed

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3
Q

What are responsible for detecting head rotation?

A

Semicircular canals

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4
Q

What are responsible for head tilting and linear acceleration?

A

Utricle (horizontal plane)

Saccule (vertical plane)

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5
Q

Region responsible for detecting linear acceleration

A

Macula (within utricle and saccule)

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6
Q

Where does the facial nerve exit the skull?

A

Stylomastoid foramen

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7
Q

Functions of the nose

A

Olfaction
Humidify/ Warms inspired air
Filtration of particulate matter
Mucus production
Pheremone detection via the organ of Jacobsen
alveolar collapse prevention via nasal cycle

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8
Q

Blood supply of the nose

A 
Superior labial artery (E)
Greater palatine artery (E)
Sphenopalatine artery (E)
Posterior ethmoidal (I)
Anterior ethmoidal (I)
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9
Q

Innervation of the anterior 2/3 of tongue

A
  • SENSORY = Mandibular division of V via the lingual nerve

- TASTE = Chorda Tympani

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10
Q

Innervation of the posterior 1/3 of the tongue

A

Superior laryngeal / glossopharyngeal

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11
Q

Motor innervation of the tongue

A

All internal and external muscles innervated by hypoglossal

Excluding palatoglossus (pharyngeal plexus)

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12
Q

Tongue deviation in hypoglossal nerve palsy

A

Towards the side of weakness

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13
Q

What is Ludwig’s angina?

A

Abscess that form on the floor of the mouth due to a dental root infection

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14
Q

Motor supply of the pharynx

A

Pharyngeal plexus

Stylopharyngeus - IX

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15
Q

Site of Zenker’s diverticulum

A

Killian’s triangle - between thyropharyngeus and cricopharyngeus

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16
Q

Complications of eustachian tube blockage

A

Middle ear effusion

Unilateral maybe caused by nasopharyngeal carcinoma (fossa of Rosenmuller)

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17
Q

Parotid

Type of saliva, duct draiange

A

Serous saliva

Stenson’s duct

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18
Q

Submandibular gland

Type of saliva, duct drainage

A

Mixed serous/mucus saliva
Wharton’s Duct

Forms majority of saliva production at rest

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19
Q

Sublingual duct

Type of saliva, drainage

A

Mucous saliva

submandibular duct and sublingual fold in the floor of the cavity

20
Q

Level 1 lymph

A

Submental and submandibular triangles

Bounded my midline, digastric and the mandible

21
Q

Level 2 lymph

A

Anterior triangle, inc SCM, from skull base to inferior border of hyoid

22
Q

Level 3 lymph

A

Anterior triangle, inc SCM, from inferior hyoid to inferior cricoid

23
Q

Level 4 lymph

A

Anterior triangle, inc SCM, inferior border of cricoid to superior border of clavicle

24
Q

Level 5 lymph

A

Posterior triangle`

25
Q

Level 6 lymph

A

Paratracheal lymph nodes medial to the carotid

26
Q

What does a Rinne’s positive test mean?

A

AC > BC

Normal hearing / Sensorineural loss on opposite side

27
Q

What does a Rinne’s negative test mean?

A

BC > AC

Conductive hearing loss

28
Q

Features of peritonsillar abscess (Quinsy)

A 
Previous tonsillitis
Sore throat
Difficulty swallowing
Trismus
Uvula deviation

Requires IV Abx and drainage

29
Q

What is chronic rhinosinusitis?

A

Inflammatory disorder of the paranasal sinuses and linings of the nasal passages that lasts 12 weeks or longer

30
Q

Features of chronic rhinosinusitis?

A

facial pain: typically frontal pressure pain which is worse on bending forward
nasal discharge: usually clear if allergic or vasomotor. Thicker, purulent discharge suggests secondary infection
nasal obstruction: e.g. ‘mouth breathing’
post-nasal drip: may produce chronic cough

31
Q

Most common site for SCC?

A

Oropharynx

32
Q

Virus associated with Tonsillar SCC

A

HPV 16 & 18

33
Q

HIV increases risk of which malignancies most commonly?

A 
Kaposi sarcoma (HHV-8)
Non-Hodgkin lymphoma
34
Q

EBV associated head and neck malignancies

A

Nasopharyngeal in nature

Lymphoma

35
Q

Treatment for poor response to Abx in otitis externa

A

Refer to ENT
Gentle micro-suction of the ear
Commence IV antibiotics
Continue topical drops with insertion of an aural wick

36
Q

Presentation of viral labyrinthitis

A

Sudden vertigo
Nystagmus
Hearing can be affected
Viral infection often precedes its presentation

37
Q

Treatment of spontaneous sensorineural hearing loss

A

High dose coticosteroids

38
Q

When is myringoplasy performed?

A

Failed spontaneous healing of perforated tympanic membrane

Usually heals within 6-8 weeks

39
Q

How do you differentiate between neuronitis ans labyrinthitis?

A

Neuronitis = unafected hhearing

40
Q

Which drugs can cause gingival hyperplasia?

A

Phenytoin
CCBs (Nifedipine)
Cyclosporin

41
Q

What is double sickening?

A

initial period of recovery followed by a sudden worsening of symptoms
Thought to be caused by a secondary bacterial infection following viral rhinosinusitis
Associated with bacterial sinusitis

42
Q

Cranial nerves affected by acoustic neuroma

A

V: Absent corneal reflex
VII: Facial palsy
VIII: Vertigo, unilateral hearing loss and tinnitus

43
Q

What is a cystic hygroma?

A

Congenital lymphatic lesion (lymphangioma) typically found in the neck, classically on the left side
Most are evident at birth, around 90% present before 2 years of age

44
Q

What is a branchial cyst?

A

An oval, mobile cystic mass
Develops between the SCM and the pharynx
Usually present in early adulthood
Develop due to failure of obliteration of the second branchial cleft in embryonic development

45
Q

Criteria for diagnosing chronic rhinosinusitis

A

Twelve weeks or longer of two or more of the following signs and symptoms:

  • mucopurulent drainage (anterior, posterior, or both),
  • nasal obstruction (congestion),
  • facial pain-pressure-fullness, or
  • decreased sense of smell

AND inflammation is documented by one or more of the following findings:
• purulent (not clear) mucus or edema in the middle meatus or anterior
ethmoid region,
• polyps in nasal cavity or the middle meatus, and/or
• radiographic imaging showing inflammation of the paranasal sinuses

ENT (4 decks)

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