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ENT > Head & Neck > Flashcards

Head & Neck Flashcards

1
Q

DDx sore throat

A

Tonsillitis
Quinsey
Supraglottitis/Epiglottis
Deep neck infection
Pharyngitis, common cold, foreign body + dental infection

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2
Q

Tonsillitis spread

A

Inflammation of the pharyngeal tonsils
Usually spreads to the lingual tonsils and adenoids

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3
Q

Tonsillitis aetiology

A

Most commonly viral
15-30% are bacteria

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4
Q

Tonsillitis Hx

A

Fever, sore throat, galiotis halitosis (foul breath), dysphasia, odynophagia (painful swallowing), mild airway obstruction

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5
Q

Tonsillitis exam

A
  1. Degree of respiratory distress
  2. Full exam of oral cavity (tonsillitis erythema, oedema +/- exudate
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6
Q

Possible complications of strep pharyngotonsilitis

A

Non-suppurative: scarlet fever, rheumatic fever, post-streptococcal

Suppurative: Peritonsillar Abscess (Quinsy), deep neck space infection, cervical lymphadenitis

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7
Q

Peritonsillar abscess

A

Each tonsil is surrounded by a capsule. It is in the potential space (peritonsillar space) between the tonsil and capsule that the abscesses can form - a peritosillar abscess

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8
Q

Tonsillitis vs. Quinsy

A
  • Uvula deviated to controlateral side
  • inferior and medial tonsil displacement
  • swelling of supratonsillar fold/soft palate rather than the tonsil itself
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9
Q

Quinsy Hx

A

Same as tonsillitis
Plus
- neck pain
- throat pain, more severe on the affect3d side +/- referred ear pain
- trismus due to inflammation of chewing muscles
- voice changes, in PTA pharyngeal oedema and trismus can cause a “hot potato” voice

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10
Q

Aetiology peritonsillar abcess

A

Can progress to cellulitis and then via tissue necrosis and pus formation to a peritonsillar abscess or starts via an infection of minorsalivary glands

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11
Q

Investigations for tonsillitis and PTA

A

General
- FBC, U+E
- Monspoet test

PTA / suspicious of DNSI
- later Alice neck x-ray

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12
Q

Management PTA

A

ABCs
Incision and drainage

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13
Q

aetiology of supraglottitis/epiglottis

A

H.influenzae type b

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14
Q

Examination of supraglottitis/epiglottis

A
  • toxic appearance of patient
  • sitting or leaning forward
  • drooling/inability to handle secretions
  • irritability
  • stridor
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15
Q

supraglottitis/epiglottis investigation

A
  • lateral neck x-ray
  • flexible nasoendoscopy
  • blood cultures
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16
Q

supraglottitis/epiglottis Hx

A
  • sore throat
  • odynophagia/dysphasia
  • muffled voice/hot-potato
  • URTI
17
Q

supraglottitis/epiglottis Mangement

A

Airway
Minimise distress
Antibiotic (ceftriaxone)
Analgesia,anti-emetics, IV fluids

18
Q

Thumb sign

A

Sign on lateral chest X-ray that indicates epiglottis due to swelling of the epiglottis

19
Q

What are special compartments in the neck made of

A

Fascial planes

20
Q

What is the cause of spread of infection

A

Special compartments communicate with each other

21
Q

What is the danger space

A

Anterior to the prevertebral fascia is the dramatically named danger space.

It extends from the skull base to the diagram, meaning mediastinum is is possible complication of abscesses that spread into this space

22
Q

Types of DSNI

A
  1. PTA
  2. Retropharyngeal abcess
  3. Parapharyngeal abcess
  4. Prevertebral abcess
23
Q

Etiology of DSNI

A

Common complication of pharyngitis or dental infection

Sialadenitis, IV drug use, maligancy

24
Q

Hx of DSNI

A

Sore throat, dysphasia, odyndophagia, trismus, neck pain, painful neck mass sometimes

25
Q

Mangement DSNI

A

ABCs
Abx
Surgery (I+C)

26
Q

Exam findings DSNI

A

Posterior pharynx erythema + swelling retropharyngeal abscess
Medial displacement of tonsil and later Alice pharyngeal wall in paralhaeyfeal abcess
Torticollis
Tender lympathenopathy

27
Q

Investigations DSNI

A

CT neck
FBC, U+E
Blood cultur3s

ENT (4 decks)

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