Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

** Basic & Applied Science ENT Topics > General Topics > Flashcards

General Topics Flashcards

You may prefer our related Brainscape-certified flashcards:
Biology 101 flashcards
1
Q

What are the consequences of air embolism

A

>50 cc of air causes intensive pulmonary artery vasoconstriction, pulmonary edema, and cor pulmonale. >200 cc of air is fatal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the incidence of permanent hypoparathyroidism after total thyroidectomy

A

1 - 5%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is the incidence of permanent recurrent laryngeal nerve injury after total thyroidectomy

A

1 -4%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the fistula rate following free jejunal transfer (non-irradiated patients)

A

10- 20%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What % of laryngectomy patients who fail voice restoration following tracheoesophageal puncture (TEP) suffer from cricopharyngeal spasm

A

12%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the incidence of SNHL after radiation therapy for nasopharyngeal cancer

A

14%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the fistula rate in patients who have had prior irradiation requiring total laryngectomy and partial pharyngectomy

A

15 - 20%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the incidence of tracheoinnominate fistula after tracheostomy

A

2%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the most effective duration for perioperative antibiotic administration

A

24 hours.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What % of patients with tracheoinnominate fistulae survive

A

25%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the incidence of significant SNHL after revision stapedotomy

A

3 - 30°/o (up to 14% profound).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the most common complication from microsurgical reconstruction

A

36% suffer medical complications (pulmonary problems, prolonged ventilatory support, acute ethanol withdrawal).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is the recurrence rate following excision of a TGDC without removal of the midportion of the hyoid and the ductal remnant

A

38%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the perioperative mortality rate of gastric pull-up

A

5- 20%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the rate of major complications after gastric pull-up

A

50%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What % of all instances of tracheal bleeding developing 48 hours or longer after surgery are caused by tracheoinnominate fistulae

A

50%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is incidence of persistent diplopia after orbital reconstruction

A

7%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the incidence of complications after PEG

A

9-15%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the most common complications of lateral tympanoplasty

A

Anterior blunting, lateralization, epithelial pearls, canal stenosis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the management of injury to the sigmoid sinus during mastoidectomy

A

Apply gentle pressure, place a Surgicel or Gelfoam patch, and continue with surgery.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Where do strictures most often occur after free jejunal transfer

A

At the inferior anastomosis between the jejunum and esophagus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Where do fistulas most often occur after free jejunal transfer

A

At the superior anastomosis between the jejunum and pharynx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the signs of air embolism

A

Audible sucking sound in the wound, machine-like cardiac murmur, dysrhythmias, sudden systemic hypotension, decreased end expiratory C02, increased CVP.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are the most common complications of pharyngeal flap surgery

A

Bleeding, airway obstruction, obstructive sleep apnea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Which patients are at a higher risk of pneumothorax after tracheostomy

A

Children.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What is the best test to differentiate between cricopharyngeal spasm and stricture in patients who fail voice restoration following TEP

A

Contrast videotluoroscopy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

Which complication is most likely to be avoided with endoscopic diverticulectomy versus open diverticulectomy

A

Damage to the recurrent laryngeal nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the treatment of pneumocephalus

A

Emergent drainage with needle aspiration, airway diversion (i.e. tracheostomy), nasal repacking.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What is the most common complication after orbital reconstruction

A

Enophthalmos.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

What are the symptoms and signs of a poststapedectomy perilymph fistula

A

Episodic vertigo, especially with exertion, sensorineural hearing loss, loss of speech discrimination, and nystagmus with changes of air pressure on the TM.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

What is meant by “carotid blowout precautions”

A

Establish IV access with 2 large bore IVs, type and cross 2 units PRBCs, have an intubation tray at the bedside, and educate nursing staff.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

What is the most serious complication of lateral pharyngotomy

A

Excessive retraction on the great vessels leading to thrombosis or embolism.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

What structure is most at risk during removal of a 1st branchial arch sinus

A

Facial nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

What are the 2”d most commonly isolated bacteria

A

Gram-negative aerobic bacteria.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the most common complication of parotidectomy

A

Hematoma.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What electrolyte problem is disproportionately associated with gastric pull-up

A

Hypocalcemia secondary to impaired calcium absorption and inadvertent parathyroid resection during thyroidectomy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is the incidence of CV A and mortality from carotid blowout

A

I 0% CV A and I % mortality if volume is repleted prior to going to the OR. 50% CV A and 25°/o mortality if volume is not repleted prior to going to the OR.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What factor best predicts the risk of a major complication following head and neck oncologic surgery

A

I O% loss of baseline body weight.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is the incidence of clinically significant VPI after adenoidectomy

A

I: 1500 - 3000.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is the treatment for post-adenoidectomy VPI

A

If it persists beyond 2 months, speech therapy; beyond 6 - 12 months, palatal pushback, pharyngeal flap surgery, or sphincter pharyngoplasty.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is the management of intraoperative violation of the labyrinth

A

Immediate application of a Gel foam patch or other tissue seal (other than fat).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the rate of wound infection following contaminated head and neck surgery with use of perioperative antibiotics consisting of ampicillin/sulbactam or clindamycin

A

IS%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

During stapedectomy, the entire stapes footplate falls into the vestibule. What should be done

A

It should be left in the vestibule, as attempts to retrieve it are more likely to cause damage than leaving the footplate where it is.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

A patient develops a CSF leak after resection of an acoustic neuroma. A pressure dressing and lumbar drain are placed with no improvement. Wound exploration and reclosure are performed, and the leak recurs. What is the next step

A

It the tympanic membrane is intact and hearing is present, plug the eustachian tube via a middle fossa approach. If the tympanic membrane is not intact and hearing is not present, perform a blind sac closure of the external auditory canal and obliterate the middle ear and eustachian tube.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What is the most common location for iatrogenic labyrinthine fistula formation during mastoidectomy

A

Lateral semicircular canal.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the initial treatment for a chyle leak diagnosed 3 days after neck dissection

A

Maintain drains and begin medium-chain triglyceride tube feedings.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

Where is the facial nerve most commonly injured during mastoid surgery

A

Near the 2”d genu as it enters the mastoid cavity.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

4 weeks after ORlF of a mandibular body fracture, your patients presents with an exposed plate and purulent drainage. The reduction is grossly intact. What do you do

A

Open wound, remove involved tooth if applicable, remove hardware, and assess union; if nonunion is present, most patients will heal with MMF; other option is plate and bone graft (external approach).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

10 days after ORIF of a mandibular body fracture, your patient presents with an exposed plate and purulent drainage. The reduction is grossly intact. What do you do

A

Open wound, remove involved tooth if applicable; if hardware is loose, replace it with a new plate; if hardware is rigid, continue drainage, wound care.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

What are the complications from radiation overdosage in the treatment of NPC

A

Osteoradionecrosis, brain necrosis, transverse myelitis, hearing loss, hypopituitarism, hypothyroidism, optic neuritis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What can cause postoperative pneumocephalus

A

Overly aggressive drainage of CSF via a lumbar drain or ball-valve action of the flaps used to reconstruct the skull base.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the treatment for air embolism

A

Pack wound, compress jugular veins, aspirate air if right atrial catheter is in place, insert needle into right ventricle from under the xiphoid, switch to 1 00°/o 0 2 and stop nitrous, place patient in left lateral Trendelenburg position.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

Which patients are at greater risk for a “perilymph gusher”

A

Patients with congenital stapes fixation and a patent cochlear aqueduct or a large vestibular aqueduct.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What is the most common postoperative complication of pressure equalizing tube insertion

A

Persistent otorrhea.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are the risk factors for innominate artery rupture after tracheostomy

A

Placement of trach below the 3rd ring; aberrant course of the innominate artery; use of a long, curved tube; overhyperextension of the neck during the procedure; prolonged pressure by inflated cuff; and tracheal infection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What is the most common complication of segmental mandibulectomy defect reconstruction with plates

A

Plate exposure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

What is the most common cause of mortality in pediatric patients who undergo tracheostomy

A

Plugging or accidental decannulation in children

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

Unbeknownst to the surgeon, the dura is torn during mastoidectomy, and postoperatively, the patient develops a severe headache, followed by hemiplegia and coma. What has likely happened

A

Pneumocephalus; torn dura can create a ball valve-like effect and trap air from the middle ear. Influx of air may occur during Valsalva or as a result of high intracranial negative pressure due to the rapid escape of CSF through the tear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

What is the most common cause of infection after ORIF

A

Poor plating technique.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

What is the most common complication of stapedotomy

A

Prosthesis displacement.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

What is a “perilymph gusher”

A

Rapid release of perilymph after stapes footplate fenestration due to pressure and fluid from the CSF compartment venting through the inner ear.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

What is the only preoperative factor to significantly increase the risk of postoperative pulmonary complications

A

Recent smoking history.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

What is the management of a “perilymph gusher”

A

Reduction of CSF pressure with mannitol and/or a lumbar drain, application of a tissue seal over the oval window fistula using fascia, perichondrium, or fat and secured with a stapes prosthesis, and postoperative hospitalization with continued reduction in CSF pressure.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

What are the most common complications of gastric pull-up

A

Regurgitation, cervical dysphagia, stricture, anastomotic leak.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

What is the treatment for infected extraoral mandibular ORIF

A

Removal of the tooth and the failed plate, debridement of dead bone, placement of a large reconstruction plate, and primary grafting if inadequate bone contact exists.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

What is the management of injury to the dura with CSF leak during mastoidectomy

A

Repair with temporalis fascia held in place with sutures or packing and continue with surgery; small tears can be managed with a Surgicel or Gelfoam patch.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

What are the most common complications of acoustic neuroma resection

A

SNHL, paralysis of VII, CSF leak (10-35%), meningitis (1-10%), intracranial hemorrhage (0.5-2%).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

What are the most commonly isolated bacteria from wound infections following major contaminated head and neck surgery

A

Staph aureus and beta-hemolytic streptococci.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

What is the most common organism identified in patients with pneumonia after major surgical resection of the upper aerodigestive tract

A

Staphylococcus aureus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

Ten days after stapedectomy, your patient complains of progressive hearing loss and vertigo that does not respond to steroids. What do you do

A

Take the patient back to the OR to explore for a granuloma. If one is found, remove the granuloma and place a new prosthesis with a tissue seal over the oval window.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

What are 2 important techniques to prevent postoperative fistula formation

A

Tension-free closure and perioperative antibiotics.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

If the leak does not resolve, what is the next step in management

A

TPN.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

What surgical procedure is the most common cause of iatrogenic vocal cord paralysis in children

A

Tracheo-esophageal fistula repair.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

Two weeks after undergoing salvage surgery on the neck, a patient loses 800 cc of blood from the operative site. If a bleeding source is not found on carotid arteriogram, what is the next step in management

A

Venous angiography with endovascular occlusion.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

What is the youngest age approved by the FDA for cochlear implantation?

A

12 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

What percent of laryngectomy patients who fail voice restoration following TEP suffer from cricopharyngeal spasm?

A

12%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

What percent of patients with glottic insufficiency will attain complete closure after voice therapy?

A

20%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

What is the critical period for stimulating the auditory system?

A

3 years of age.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

A patient with Meniere’s disease is able to work, drive, and travel but must exert a great deal of effort to do so and is “barely making it.” What functional level is heJshe?

A

4 (out of 6).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

What percent of patients with severe tinnitus are successfully treated with masking devices?

A

56-64%.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

What factor is most predictive of enhanced ability to understand speech with a cochlear implant?

A

Age at onset of deafness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

What are the basic steps of sound processing performed by cochlear implants?

A

Amplification, compression, filtering, and encoding.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

What are the three general types of hearing aids?

A

Analogue devices, digitally programmable systems, and digital signal processors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

After 3 months of voice therapy, what percent of benign vocal cord lesions will reduce in size or resolve?

A

Approximately 45% will reduce in size and 10% will completely resolve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

What type of masking device is recommended for patients with hearing loss?

A

Behind-the-ear hearing aid.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

What is the habituation technique for the treatment of tinnitus?

A

Binaural broad-band noise generators are worn for at least 6 hours everyday for at least 12 months.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

What are the three categories of compression?

A

Compression limiting, wide dynamic range compression, and automatic volume control.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

What is the gain of a hearing aid?

A

Difference in the output of the instrument relative to its input.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

What are the three options for speech production after total laryngectomy?

A

Esophageal speech, tracheoesophageal puncture (TEP), and electrolarynx.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

What are the different types of assisted listening devices?

A

FM systems, soundfield systems, infrared systems.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

What utensil can be used to help move food to the back of the tongue in patients who have had a glossectomy?

A

Glossectomy feeding spoon.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

What are the components of a cochlear implant?

A

Implantable stimulator, headpiece and transmitter, and speech processor.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

What are the criteria for pediatric cochlear implantation?

A

In both prelingual and postlingual children, bilateral severe to profound SNHL (only profound hearing loss in children < 20-30% in children capable of testing; lack of auditory development with a proper binaural hearing aid trial documented by testing or parental questionnaire (for very young children); no medical contraindication with intact cochlea and auditory nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

What exercises have been shown to help improve swallowing function?

A

Isotonic/isometric neck exercises where the patient lies on his/her back and lifts the head and isometric resistance tongue exercises.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

How can one determine if maskers will be effective in the treatment of tinnitus?

A

Measure the minimum masking level (MML) and loudness matching; if the MML is lower or equal to the loudness matching, maskers will likely be effective.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

What is a linear amplification system?

A

One in which the amplitude output is directly proportional to the signal input until saturation is reached.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

After cochlear implantation, children have better outcomes in which type of learning environment: total communication or oral education?

A

Oral education.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

What device can be used to decrease nasal regurgitation in patients who have a defect in their palate?

A

Palatal obturator.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

What is the supraglottic swallow?

A

Patient inhales, takes food into mouth, performs Valsalva to close the glottis, coughs to clear debris from the glottis, swallows, and then exhales.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

Which patients are least likely to benefit from vestibular rehabilitation programs?

A

Patients with fluctuating nonstable vestibular lesions such as Meniere’s disease; patients in whom no provocative maneuvers or postural control abnormalities are found on examination.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

How do linear amplification systems limit output?

A

Peak clipping.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

What are the criteria for cochlear implantation in prelingual deaf adults?

A

Profound bilateral SNHL; minimal benefit from properly fitted hearing aids; psychological and motivational suitability; no medical contraindications to surgery with intact cochlea and auditory nerve.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

Why are patients prone to aspiration after supraglottic laryngectomy?

A

Secondary to loss of epiglottis and closure of false cords, to decrease in laryngeal elevation and loss of afferent stimulation to the vocal cords with tracheostomy, and to decrease in sensation from loss of superior laryngeal nerves during tumor resection.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

What are the criteria for cochlear implantation in postlingual deaf adults?

A

Severe to profound bilateral sensorineural hearing loss (SNHL); properly aided sentence recognition score (HINT)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
105
Q

What is the frequency response of a hearing aid?

A

The gain of the hearing aid across a range of frequencies.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
106
Q

What is a nonlinear amplification system?

A

The ratio of input to output is

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
107
Q

Why are in-the-ear hearing aids not recommended in patients with tinnitus?

A

They can produce too much occlusion effect and amplification of the lower frequencies, resulting in exacerbation of tinnitus.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
108
Q

Which patients benefit most from nonlinear amplification systems?

A

Those with a small range between their threshold for hearing and their loudness discomfort level (LDL).

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
109
Q

How do prelingually deafened children with cochlear implants compare with those with multichannel tactile aids in open-set word recognition skills?

A

Those with cochlear implants do better.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
110
Q

What is the purpose of the “chin-tuck” when swallowing?

A

To decrease the speed of the bolus passage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
111
Q

What is the basic function of assisted listening devices?

A

To improve the signal-to-noise ratio at ear level by 15-20 dB in moderate noise and reverberation.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
112
Q

In which direction should a hemiparetic patient turn their neck to assist with swallowing?

A

Toward the hemiparetic side.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
113
Q

True/False: Cochlear implantation has been shown to relieve tinnitus in a large percentage of profoundly deaf individuals.

A

True.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
114
Q

True/False: Speech perception of prelingually deafened children who have had cochlear implants for 5 years is likely to be equal to or better than postlingually deafened patients.

A

True.

115
Q

What devices are used in the habituation technique for the treatment of tinnitus?

A

Viennatone maskers.

116
Q

Which of these is most appropriate for patients with substantially reduced dynamic ranges?

A

Wide dynamic range compression.

117
Q

A 3-year-old child with cerebral palsy and bilateral severe SNHL meets the above criteria. Is he/she eligible for cochlear implantation?

A

Yes.

118
Q

What is the best imaging study to differentiate between cricopharyngeal spasm and stricture in patients who fail voice restoration following TEP?

A

Contrast videofluoroscopy.

119
Q

NAME THE SYNDROME Large calvaria with frontal bossing, low nasal bridge, midface hypoplasia, congenital hearing loss:

A

Achondroplasia.

120
Q

NAME THE SYNDROME Craniosynostosis, beak nose, stapedial fixation, hypoplastic midface with relative mandibular prognathism, syndactyly, cervical fusion, foramen magnum stenosis:

A

Apert’s syndrome (acrocephalosyndactyly).

121
Q

NAME THE SYNDROME Facial port-wine stain, macroglossia, hypertrophy of pancreatic islet cells with hyperinsulinemia and hypoglycemia, and hypertrophy of the renal medulla and liver:

A

Beckwith-Wiedemann syndrome.

122
Q

NAME THE SYNDROME Multiple blue, compressible, cutaneous angiomas and visceral angiomas

A

Blue rubber bleb nevus syndrome.

123
Q

What are the differences between Apert’s syndrome and Crouzon’s syndrome?

A

Children with Apert’s syndrome also have syndactyly of the hands, a significant incidence of cleft palate and more serious facial deformities.

124
Q

What are the differences between Apert’s syndrome and Crouzon’s syndrome

A

Children with Apert’s syndrome also have syndactyly of the hands, a significant incidence of cleft palate and more serious facial deformities.

125
Q

NAME THE SYNDROME Ipsilateral tongue paralysis and fasciculations along with manifestations of Vernet’s syndrome secondary to a lesion in the jugular foramen extending below the skull base:

A

Collet’s syndrome.

126
Q

NAME THE SYNDROME Craniosynostosis, maxillary hypoplasia, shallow orbits, proptosis, cervical fusion:

A

Crouzon’s syndrome (craniofacial dysostosis).

127
Q

NAME THE SYNDROME Epicanthal folds, macroglossia, short neck, occipitoatlantoaxial instability:

A

Down syndrome.

128
Q

NAME THE SYNDROME Hyperextensible skin, joint hypermobility, easy bruising, cervical ligament instability:

A

Ehlers-Danlos syndrome.

129
Q

NAME THE SYNDROME Microcephaly, short palpebral fissures, epicanthal folds, long and smooth philtrum, thin upper lip vermilion border, congenital hearing loss, midface hypoplasia, C2-C3 fusion:

A

Fetal alcohol syndrome.

130
Q

What syndromes are associated with well-differentiated thyroid carcinoma in children?

A

Gardner’s syndrome and Cowden syndrome.

131
Q

What syndromes are associated with well-differentiated thyroid carcinoma in children

A

Gardner’s syndrome and Cowden syndrome.

132
Q

NAME THE SYNDROME Hemifacial microsomia, epibulbar dermoids, colobomas, micrognathia, cleft lip/palate, microtia, facial nerve anomalies:

A

Goldenhar’s syndrome (oculo-auriculo-vertebral spectrum).

133
Q

NAME THE SYNDROME Nevoid basal cell carcinomas, odontogenic keratocysts, palmar pits, bifid ribs:

A

Gorlin.

134
Q

NAME THE SYNDROME Uveitis, parotid enlargement, Vllth nerve paralysis:

A

Heerfordt’s syndrome.

135
Q

What are the characteristics of Crouzon’s syndrome

A

Hypoplasia of the orbits, zygomas and maxilla and variable craniosynostoses.

136
Q

What are the characteristics of Crouzon’s syndrome?

A

Hypoplasia of the orbits, zygomas and maxilla, and variable craniosynostoses.

137
Q

NAME THE SYNDROME Short, webbed neck, congenital hearing loss, cervical and/or thoracic fusion:

A

Klippel-Feil syndrome.

138
Q

Port-wine stain, AV fistula, extremity angiomatosis, and skeletal hypertrophy:

A

Klippel-Trenaunay-Weber syndrome.

139
Q

NAME THE SYNDROME Midface retrusion, depressed and broad nasal bridge, congenital joint dislocations, congenital hearing loss, cervical instability:

A

Larsen’s syndrome.

140
Q

Multiple cavernous hemangiomas, dyschondroplasia, and propensity for development of chondrosarcoma:

A

Maffucci syndrome.

141
Q

What other syndromes is blue rubber bleb nevus syndrome associated with?

A

Maffucci’s and Klippel-Trenaunay-Weber syndromes.

142
Q

NAME THE SYNDROME Coarse facial features, prominent frontal bones, mandibular prognathism, vertebral anomalies:

A

Mucopolysaccharidoses.

143
Q

What is a sequence

A

Multiple defects arising from a single structural anomaly (ie Pierre Robin).

144
Q

What is an association

A

Nonrandom occurrence of a group of anomalies not known to be a sequence or a syndrome (ie CHARGE, VATER)

145
Q

Multiple telangiectasias of the skin and mucous membranes:

A

Osler-Weber-Rendu syndrome (hereditary hemorrhagic telangiectasia).

146
Q

NAME THE SYNDROME Congenital hearing loss, blue sclerae, scoliosis:

A

Osteogenesis imperfecta.

147
Q

What is a syndrome

A

Pattern of multiple anomalies pathogenetically related.

148
Q

NAME THE SYNDROME Cleft palate, micrognathia, glossoptosis:

A

Pierre Robin sequence.

149
Q

What is the most frequently involved cranial suture in Crouzon’s syndrome?

A

The coronal suture.

150
Q

What is the most frequently involved cranial suture in Crouzon ‘s syndrome

A

The coronal suture.

151
Q

Treacher Collins syndrome (mandibulofacial dysostosis) is characterized by hypoplasia of what embryologic structures?

A

Those derived from the first and second brachial arches.

152
Q

Treacher Collins syndrome (mandibulofacial dysostosis) is characterized by hypoplasia of what embryologic structures

A

Those derived from the first and second brachial arches.

153
Q

NAME THE SYNDROME Pterygium colli, epicanthal folds, cervical cystic hygromas, cervical hypoplasia:

A

Turner’s syndrome.

154
Q

NAME THE SYNDROME Tracheoesophageal fistula with esophageal atresia, cervical segmentation defects, imperforate anus:

A

VATER syndrome.

155
Q

NAME THE SYNDROME Cardiac malformations, hypernasal speech, clefting of the secondary palate, slender hands, learning disabilities:

A

Velocardiofacial syndrome.

156
Q

NAME THE SYNDROME Paralysis of IX, X, and XI from a lesion in the jugular foramen:

A

Vernet’s syndrome.

157
Q

NAME THE SYNDROME Sympathetic trunk compromise in addition to IX-XII paralysis secondary to a lesion extending out of the jugular foramen:

A

Villaret’s syndrome.

158
Q

Hemangiomas of the cerebellum and retina and cysts of the pancreas and kidney:

A

Von Rippel-Lindau disease.

159
Q

NAME THE SYNDROME White forelock, hearing loss, iridial chromic heterogeneity, dystopia of medial canthi:

A

Waardenburg’s syndrome.

160
Q

NAME THE SYNDROME Klippel-Feil anomaly with SNHL, VI nerve palsy, retracted globe, fused ribs:

A

Wildervanck syndrome (cervico-oculo-acoustic).

161
Q

What is the critical period for stimulating the auditory system

A
  • 3 years of age.
162
Q

What are normal ear canal volumes in children and adults

A

0.5 - 1.0 cc in children, 0.6 - 2.0 cc in adults.

163
Q

What is the normal interaural attenuation value for bone conduction

A

0db

164
Q

SRT should be within __ dB of pure tone average (PTA).

A

10 dB.

165
Q

When determining interpeak latencies, which waves are compared

A

1-111, 1-V.

166
Q

What noise level begins to cause pain

A

140 dB.

167
Q

A patient has a negative Rinne at 256 Hz AS. At 512 Hz and 1024 Hz it is positive as it is at all three frequencies AD. The Weber test lateralizes to the left at all three frequencies. He hears a soft whisper AD and a soft to medium whisper AS. What is his hearing loss

A

15 dB conductive H L AS.

168
Q

What range of frequencies can the human ear detect

A

20 - 20,000 Hz (greatest sensitivity is from 500 to 3000 Hz).

169
Q

What is the incidence of ossification after pneumococcal meningitis

A

20-30%.

170
Q

Which frequencies are air conduction thresholds obtained from

A

250 - 8000 Hz at octave intervals.

171
Q

What % of normal ears emit spontaneous OAEs

A

35- 60%.

172
Q

What is normal interaural attenuation of air conducted tones

A

40 - 80 dB depending on whether ear inserts or headphones are used and also on the frequency being tested.

173
Q

What % of the time will the Rinne test miss an air-bone gap

A

50%.

174
Q

What % of patients will have new bone growth covering the round window niche and membrane during cochlear implantation

A

50%.

175
Q

In the normal ear, contraction of middle ear muscles occurs at which pure tones

A

65 - 95dB HL.

176
Q

What is a normal word recognition score

A

90- 100°/o.

177
Q

What % of normal ears demonstrate evoked OAEs

A

96 - IOO%.

178
Q

What is rollover

A

A decrease in speech discrimination scores when presented at higher intensities; suggestive of a retrocochlear lesion.

179
Q

When comparing the summating to the compound action potential, what value is considered abnormal

A

A ratio greater than or equal to 0.45.

180
Q

How is this measured

A

A signal is presented I 0 dB above the acoustic reflex threshold for I 0 seconds; if the response decreases to one half or less of the original amplitude within 5 seconds, the response is considered abnormal and suggestive of retrocochlear pathology.

181
Q

What stimulus is used to evoke the auditory brainstem response

A

A simple acoustic click, between 2000-4000 Hz.

182
Q

What is a spondee

A

A two-syllable word spoken with equal stress on both syllables.

183
Q

What factor is most predictive of enhanced ability to understand speech with a cochlear implant

A

Age at onset of deafness.

184
Q

What are the basic steps of sound processing performed by cochlear implants

A

Amplification, compression, filtering, and encoding.

185
Q

What is the glycerol test

A

An audiogram is given just prior to and 3 hours after ingesting 6 oz of 050. An improvement of 15 dB for at least one frequency, 12% SDS, or I 0 dB SRT is significant for Meniere’s disease (the glycerol acts as a diuretic).

186
Q

What are the 3 general types of hearing aids

A

Analogue devices, digitally programmable systems, and digital signal processors.

187
Q

Where is the earliest lesion of otosclerosis most commonly found

A

Anterior edge of the oval window (fissula ante fenestrum).

188
Q

What technique can be used to differentiate the summating potential (SP) from the nerve potential of VIII (AP)

A

AP is a neural response that will respond to higher rates of stimulation. SP is a preneural response that is not affected by higher rates of stimulation. Therefore, increasing the click rate of the stimulus will affect the AP but not the SP.

189
Q

Where are the recording electrodes placed

A

As close as possible to the cochlea and auditory nerve (promontory, tympanic membrane, external auditory canal).

190
Q

What test can be use to exclude the absence of aidable hearing when the ABR is absent at maximum levels

A

ASSEP (Auditory steady-state evoked potentials).

191
Q

What is the significance of a negative Rinne at 256 Hz? 512 Hz? 1024 Hz

A

At least a 15 dB conductive hearing loss (CHL), 25-30 dB CHL, and 35 dB CHL, respectively.

192
Q

What 3 audiometric test techniques are used to obtain behavioral response levels from a child

A

Behavioral observation audiometry (BOA), visual reinforcement audiometry (VRA), and conditioned play audiometry (CPA).

193
Q

Where is the peak pressure point in a normal tympanogram in an adult

A

Between -1 00 and +40 daPa.

194
Q

When does masking dilemma occur

A

Bilateral 50 dB or greater air-bone gaps.

195
Q

What are the criteria for pediatric cochlear implantation

A

Bilateral SNHL of 90 dB HL or poorer in the better ear across the speech frequencies and no better than chance performance on open-set word and sentence materials (30%); no appreciable benefit from hearing aids, and no medical contraindication to surgery.

196
Q

How are air and bone conduction thresholds measured

A

By first obtaining a positive response, then lowering the intensity by I 0 dB increments until no response is obtained.

197
Q

How is SRT measured

A

By starting at minimal intensity and ascending in I 0 dB increments until the correct response is identified.

198
Q

What is measured in electrocochleography

A

Cochlear microphonic action potential, action potential of VIII, the summating and compound action potentials.

199
Q

What are the 3 categories of compression

A

Compression limiting, wide dynamic range compression, and automatic volume control.

200
Q

What is adaptation

A

Continuous stimulation leads to decrease in the intensity of stapedial contraction.

201
Q

What are the typical objective auditory findings in patients with auditory neuropathy

A

Decreased or absent ABR, normal OAEs, absent auditory reflexes, very poor speech discrimination, mild to profound pure tone hearing loss.

202
Q

What is the gain of a hearing aid

A

Difference in the output of the instrument relative to its input.

203
Q

Where is bone-conducted sound transmitted

A

Directly to the cochlea.

204
Q

Which of these is evoked by 2 pure tones

A

DPOAE.

205
Q

When is monopolar electrocautery contraindicated in cochlear implant patients

A

During revision and other head and neck surgery in a patient with a cochlear implant and during primary cochlear implantation in a patient with another electronic medical device.

206
Q

T/F: The absence of the click-evoked ABR at maxiumum levels (100 dB) excludes the presence of aidable hearing

A

False.

207
Q

What are the most common complications of cochlear implantation

A

Flap complications, electrode dislocation or malinsertion, facial nerve injury, stimulation of facial nerve postoperatively.

208
Q

What are the different types of assisted listening devices

A

FM systems, soundfield systems, infrared systems.

209
Q

What is the speech detection threshold (SDT)

A

Hearing level at which 50°/o of the spondaic words are detected; usually 6 - 7 dB lower than the SRT.

210
Q

What condition increases the likelihood of this happening

A

History of meningitis.

211
Q

What does each wave represent

A

I - eighth nerve II - cochlear nucleus I I I - superior olivary complex IV - lateral lemniscus V- inferior colliculus {note: e.colij

212
Q

How many times louder is 60 dB than 0 dB

A

I ,000,000 times.

213
Q

What are the components of a cochlear implant

A

Implantable stimulator, headpiece and transmitter, and speech processor.

214
Q

What effect does pre-test familiarization with spondee words have on SRT

A

Improves speech reception threshold by 4-5 dB.

215
Q

What is the difference in these interpeak latencies

A

Increased 1-111 intervals are almost always indicative of retrocochlear pathology, whereas increased 1-V intervals is more likely associated with noise-induced SNHL.

216
Q

Into which ear is the implant placed if there is no difference acoustically between ears

A

Into the better surgical ear as determined by CT scan (side with the least amount of ossification or fibrosis within the scala tympani).

217
Q

Into which ear is the implant placed if the patient has had different durations of hearing impairment in each ear

A

Into the ear that has had the shortest duration of deafness.

218
Q

What factors influence outcome after cochlear implantation

A

Length of auditory deprivation, pre-versus post-lingual onset of deafness, etiology of deafness, electrode insertion length, patient motivation, family support, age at the time of implantation.

219
Q

What is the speech awareness threshold (SAT)

A

Lowest level at which the patient can detect the presence of speech.

220
Q

What does an abnormal ratio suggest

A

Meniere’s disease.

221
Q

What is conditioned play audiometry (CPA)

A

Method of assessing hearing levels in children aged 2-5 years where the child is trained to respond to auditory stimuli with a motor response (e.g., pointing to pictures)

222
Q

What is visual reinforcement audiometry (VRA)

A

Method of assessing hearing levels in children aged 6-24 months by employing lighted transparent toys to reinforced responses (head turn) to auditory stimuli.

223
Q

What is behavioral observation audiometry (BOA)

A

Method of assessing hearing levels in children less than 2 by observing reflexive/behavioral responses to sound stimuli at different frequencies.

224
Q

What 2 inner ear malformations are contraindications to cochlear implantation

A

Michel deformity and small internal auditory canal syndrome (

225
Q

Why are OAEs useful as a screening tool in infants

A

Nearly 100% of people demonstrate evoked OAEs; testing is non-invasive and inexpensive; test time is short; cochlear hearing loss exceeding 30 dB can be detected.

226
Q

If otoacoustic emissions are present, can retrocochlear pathology be ruled-out

A

No.

227
Q

What is a linear amplification system

A

One in which the amplitude output is directly proportional to the signal input until saturation is reached.

228
Q

A patient who recently had a cochlear implant placed complains of throat pain every time someone talks to him. What has happened

A

One of the electrodes of the cochlear implant is stimulating Jacobson’s nerve on the promontory.

229
Q

What psychological problems are contraindications to cochlear implantation

A

Organic brain dysfunction, mental retardation, psychosis, unrealistic expectations.

230
Q

What is the most common cause of an air-bone gap >50d8

A

Ossicular discontinuity.

231
Q

What is the most common cause of conductive hearing loss in people 15-50 years of age

A

Otosclerosis.

232
Q

Which cells emit otoacoustic emissions (OAEs)

A

Outer hair cells.

233
Q

What is the significance of speech discrimination scores

A

Patients with cochlear and retrocochlear pathology will have poor to very poor scores, respectively; those with only conductive hearing loss will have normal scores when the intensity level is sufficiently loud.

234
Q

How do linear amplification systems limit output

A

Peak clipping.

235
Q

How is speech discrimination testing performed

A

Phonetically balanced monosyllabic word lists (50) are administered at 30-50 dB above threshold and the % correct is identified.

236
Q

What are the criteria for cochlear implantation in adults

A

Postlingual, profound bilateral SNHL in excess of 95 dB PTA, no benefit from hearing aids (word discrimination

237
Q

How will a retrocochlear lesion affect the ABR

A

Prolongation of absolute wave V latency, 1-V latency, and interaural wave V latency.

238
Q

How can this be treated

A

Removal of the electrode(s) stimulating the nerve (probably 17 or 18).

239
Q

What does the finding of elevated acoustic reflex in the presence of normal hearing or mild SNHL and a normal tympanogram suggest

A

Retrocochlear pathology.

240
Q

What activities are contraindicated in patients with a cochlear implant

A

Scuba and skydiving.

241
Q

A patient with a SRT of 55 dB HL and a speech discrimination score of 64°/o at 75 dB HL has what kind of hearing loss

A

Sensorineural.

242
Q

What are the 3 types of evoked OAEs

A

SFOAE (stimulus frequency); TEAOE (transient evoked); DPOAE (distortion product).

243
Q

Which of these has no useful clinical application

A

SFOAE.

244
Q

What are the stimuli used to obtain a speech reception threshold (SRT)

A

Spondees.

245
Q

What do the peaks of the ABR represent

A

Synchronous neural discharge at various locations along the auditory pathway.

246
Q

What is the Stenger’s test

A

Test to see if the patient is malingering; appropriate to administer if there is >20dB difference between ears in voluntary thresholds.

247
Q

What does acoustic reflex delay measure

A

The ability of the stapedius muscle to maintain sustained contraction.

248
Q

What is crossover

A

The attained responses represent the performance of the non-test ear rather than the test ear due to a large sensitivity difference between the ears.

249
Q

Which part of the cochlea represents high frequency sounds

A

The basal end.

250
Q

Which part of the auditory system is assessed by air conduction tests

A

The entire auditory system.

251
Q

What is the frequency response of a hearing aid

A

The gain of the hearing aid across a range of frequencies.

252
Q

What is the spondee/speech reception threshold

A

The lowest hearing level at which half of the words are heard and repeated correctly, followed by at least 2 correct ascending steps.

253
Q

What is the definition of auditory threshold

A

The lowest level at which the patient can detect a sound 50% of the time.

254
Q

What is the acoustic reflex threshold

A

The lowest stimulus level that elicits the stapedial reflex.

255
Q

What is the plateau method in clinical masking

A

The non-test ear is masked by progressively greater amounts of sound until the threshold of the test ear does not continue to increase.

256
Q

What is a nonlinear amplification system

A

The ratio of input to output is

257
Q

What is interaural attenuation

A

The reduction of sound when it crosses from one ear to another.

258
Q

What does the interwave latency reflect

A

The time necessary for neural information to travel between places in the auditory pathway; any pathology which interferes with this transmission will prolong the latency.

259
Q

Which patients benefit most from nonlinear amplification systems

A

Those with a small range between their threshold for hearing and their loudness discomfort level (LDL).

260
Q

How do prelingually deafened children with cochlear implants compare to those with multichannel tactile aids in open-set word recognition skills

A

Those with cochlear implants do better.

261
Q

What is the basic function of assisted listening devices

A

To improve the signal-to-noise ratio at ear level by 15 - 20 dB in moderate noise and reverberation.

262
Q

How is ABR most commonly used

A

To test newborns, difficult to test children, and malingerers.

263
Q

What is fatigue

A

Tone decay or adaptation where continued acoustic stimulation changes the auditory threshold… suggestive of a lesion of the VI lith nerve or brainstem.

264
Q

T/F: lnteraural attenuation values tend to be smaller for lower frequencies than higher frequencies

A

True.

265
Q

T/F: The acoustic reflex threshold is absent in patients with middle ear disease

A

True.

266
Q

T/F: Brainstem lesions may abolish the acoustic reflex without affecting the pure tone thresholds

A

True.

267
Q

T/F: The ABR is unaffected by state of sleep or medications

A

True.

268
Q

T/F: Females are twice as likely as males to demonstrate spontaneous OAEs

A

True.

269
Q

T/F: ASSEP has little predictive value in for hearing levels in children with auditory neuropathy

A

True.

270
Q

T/F: ASSEP cannot distinguish between cochlear and retrocochlear hearing loss

A

True.

271
Q

T/F: Speech perception of prelingually deafened children who have had cochlear implants for 5 years is likely to be equal to or better than postlingually deafened patients

A

True.

272
Q

T/F: The electrode of the cochlear implant is normally placed into the scala tympani

A

True.

273
Q

T/F: Results of cochlear implantation in children with congenital inner ear malformations are comparable to those without malformations

A

True.

274
Q

When is the interaural latency difference of wave V important

A

Used to document retrocochlear pathology when wave I is absent.

275
Q

Which of the waves is the largest and most consistent

A

V.

276
Q

What would the tympanogram look like in an ear with an interrupted ossicular chain

A

Very steep amplitude, high peak (type Ad).

277
Q

What are the neural pathways of the acoustic reflex

A

VIII to the ipsilateral ventral cochlear nucleus to the trapezoid body to the motor nucleus of VII to VII to the ipsilateral stapedius. VIII to the ipsilateral ventral cochlear nucleus to the trapezoid body to the ipsilateral medial superior olive to the motor nucleus of VII to VII to the ipsilateral stapedius. VII I to the ipsilateral ventral cochlear nucleus to the medial superior olive to the contralateral motor nucleus of VII to the contralateral VII to the contralateral stapedius.

278
Q

How is hearing threshold estimation performed using ABR

A

Wave V is tracked with decreasing sound intensity until it can no longer be observed.

279
Q

When is wave I absent

A

When hearing loss exceeds 40 - 45 dB at higher frequencies.

280
Q

What is the “half-gain rule?”

A

When programming a hearing aid, the gain for each frequency is determined by multiplying the patient’s hearing threshold at each frequency by 0.5.

281
Q

When are interoctave frequencies tested (750, 1500, and 6000 Hz)

A

When successive octave thresholds differ by more than 20 dB.

282
Q

When should masking be used

A

When the air conduction threshold of the test ear exceeds the bone conduction threshold of the non-test ear by a value greater than interaural attenuation.

283
Q

Which of these is most appropriate for patients with substantially reduced dynamic ranges

A

Wide dynamic range compression.

** Basic & Applied Science ENT Topics (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions