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DOOS 2 > HEENTradiology-Table 1 > Flashcards

HEENTradiology-Table 1 Flashcards

1
Q

When would you get plain views for HEENT

A

Adequate for upper airway compromise, routine sinus problems and initial work up of facial trauma

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2
Q

When do you do endoscopy in evaluation of HEENT?

A

Preferable where direct visualization and Biopsy are possible. Laryngoscopy and nasopharyngoscopy

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3
Q

Cold nodules indicate what in thyroid nuclear scan?

A

Cancer

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4
Q

Barium swallow is good for detecting what diseases?

A

Dysphagia, strokes, ALS, myasthenia, aspiration pneumonia and esophageal diverticula (Zenkers)

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5
Q

Reasons for ordering ENT studies

A

Atypical presentation, progressive symptoms or signs, determine the extent of a disease process, treatment failures, determine the need for referral to ENT, to define surgical options

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6
Q

ENT red flags

A

Chronic hoarseness in a smoker, neck masses, retroauricular pain and swelling, stridor, difficulty swallowing liquids, weight loss, unexplained fevers, sinus pain, antibiotic failures, clear rhinorrhea post-trauma, retrotympanic mass, unilateral hearing loss, tinnitus, loss of balance, facial weakness, facial trauma with palpable deformity, focal bone tenderness with fever and septic source, refractory sinus infection, pulsatile tinnitus and focal cranial nerve abnormalities

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7
Q

What are AP and Lateral views used for

A

Soft tissue detail for evaluation of the overall contour of the soft tissues of the neck

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8
Q

What views are required to view the odontoid process?

A

AP, lateral, right anterior oblique, left anterior oblique and open mouth AP

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9
Q

What sinuses does the lateral view evaluate?

A

Frontal, maxillary and sphenoid sinuses

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10
Q

What does the Waters view evaluate

A

Maxillary and frontal sinuses, anterior ethmoid air cells and orbital floors

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11
Q

What structures does the Caldwell view evaluate

A

Frontal sinuses and posterior ethmoid air cells

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12
Q

When might you get a head CT with contrast?

A

If you are looking for a tumor that might be vascular. Contrast enhances the images

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13
Q

What should you think of with pulsatile tinnitus

A

Glomus tumor- rare, slow-growing, hypervascular tumors that arise within the jugular foramen of the temporal bone

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14
Q

In what patients are MRIs contraindicated

A

Cardiac pacemaker (ferromagnetic), cochlear implants (aneurysm clips), and women in 1st trimester (avoid if possible)

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15
Q

What imaging study would you get to evaluate bone erosion associated with squamous/basal cell cancer with local invasion?

A

CT scan- high resolution

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16
Q

What imaging study would you get to evaluate soft tissue mass delineation associated with squamous/basal cell cancer with local invasion?

A

MRI

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17
Q

What causes exostoses?

A

Exposure to cold water

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18
Q

Who are at risk for developing malignant otitis externa? What are you concerned about with this? What imaging should you get for it?

A

Elderly, diabetic (increased risk of pseudomonas), osteomyelitis of outer petrous bone. Ct scan

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19
Q

What structures are considered external ear?

A

Auricle/pinna, External ear canal

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20
Q

What structures are considered middle ear?

A

TM, ossicles, middle ear cleft (chamber)

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21
Q

What is chronic suppuritive OM, and what is a complication that can occur with this? What is the Tx?

A

Perforated TM with persistent drainage from middle ear (lasting >6-12 weeks), can cause a cholesteatoma. Tx always includes tympanomastoid surgery

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22
Q

What imagine study would you use to evaluate chronic suppuritive OM, why?

A

CT- concerned for bone destruction by cholesteatoma

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23
Q

What is otosclerosis? What are the two types? What imaging study would you getto evaluate?

A

Hardening of the bony tissue in the ear caused by abnormal bone remodeling in the middle ear. Fenestral and restrofenestral. CT scan –high resolution

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24
Q

What is Fenestral otosclerosis

A

Stapes foot plate fused to oval window

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25
Q

What is restrofenestral otosclerosis

A

Osteoporosis of the bone surrounding the cochlea and labyrinth

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26
Q

What is venous sinus thrombosis? What imaging study should you get? Complications?

A

Thrombosis due to sepsis extension into posterior wall of mastoid and lateral venous sinus. CT scan or MRI. Extradural empyema, subdural empyema, cerebral abscess

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27
Q

What structures are considered inner ear?

A

Cochlea, semicircular system, CN8

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28
Q

How does an acoustic neuroma present?

A

Asymmetric sensorineural hearing loss, tinnitis

29
Q

What imaging study would you get to evaluate for acoustic neuroma?

A

MRI- high resolution with attention to the internal auditory canal (IAC)

30
Q

What is this an image of?

A

Acoustic neuroma

31
Q

True or false: Facial nerve palsy always needs immediate imaging

A

False- facial nerve palsy is usually not imaged

32
Q

What imaging study would you get for trauma concerning inner ear?

A

CT scan- high resolution

33
Q

Basal skull fractures may involve what bone? What is this associated with?

A

Petrous bone. Associated with CSF leak, facial nerve damage, ossicular chain disruption (loss of normal alignment between the three inner ear ossicles. The condition is a cause of conductive hearing loss)

34
Q

What imaging study would you get to evaluate for congenital malformations of the inner ear? What are some things evaluated by this imaging study?

A

CT scan- high resolution/MRI is complementary to CT.
Cochlea- basal turn structure, number of turns
vestibule- enlargement
Semicircular canals- absent or morphological abnormalities
Ossicles- fused or malformed
Oval and round window- position/orientation

35
Q

Water’s view magnifies what sinuses?

A

Maxillary/frontal

36
Q

What is this?

A

Left maxillary mucous retention cyst (mucocele)

37
Q

What is on the left , right in this. What imaging modality is this?

A

Left- mucocele

Right- polyp

38
Q

What is this image showing?

A

Maxillary sinusitis

39
Q

What is this image showing?

A

Frontal sinusitis

40
Q

What type of image is this, what is it showing

A

MRI- Ethmoid sinusitis with left extension into orbit

41
Q

List the areas of mandibular fracture from most common to least common

A 
Condyle- 30%
Angle 25%, Body 25%
Parasymphyseal/mental 15%
Ramus- 3%
Coronoid process- 2%
42
Q

What is this image showing?

A

Mandibular condylar fracture

43
Q

What is this?

A

Mandibular condylar fracture

44
Q

WHAT IS THIS?!?!?

A

Mandibular tumor

45
Q

What is this?

A

TMJ sclerosis

46
Q

What might you see on laryngoscopy of an opera singer?

A

Laryngeal polyps- frequently result from vocal use/misuse (excessive loudness in teacher, singing excessively with poor breath support in a singer).. these are benign

47
Q

What image would you get in a child with inspiratory stridor. What do you expect to see?

A

Neck Xray- expect to see the steeple sign, showing a tapering or narrowing of the airway below the vocal cords

48
Q

What is this?

A

Steeple sign, suggestive of croup or laryngotracheobronchitits

49
Q

What is this? What is it associated with? How is it treated?

A

Thumb sign, epiglottis , IV antibiotics

50
Q

What is this?

A

Laryngeal cancer

51
Q

What is this?

A

Retropharyngeal abscess

52
Q

What is this study? What is the finding?

A

Barium swallow, zenker’s diverticulum

53
Q

What is presbyesophagus?

A

Abnormal shape of the esophagus

54
Q

What is this?

A

Presbyesophagus

55
Q

When is US used in thyroid disease?

A

Used to differentiate solid vs cystic soft tissue lesions and thyroid nodules

56
Q

Technetium-99 is used in the evaluation of what?

A

Radionucleotide scan Salivary gland function in autoimmune disease, salivary obstruction, can be pathognomonic of certain tumors

57
Q

I-123 and I-131 are used to evaluate for what?

A

Thyroid imaging- uptake hot:cold nodules, thyroid ablation

58
Q

What is this?

A

Multinodular goiter

59
Q

What is this? What is this concerning for?


A

Cold nodule, thyroid 123-I

60
Q

What is this?

A

Sialolithiasis

Sialolithiasis

61
Q

What is this

A

Sialolithiasis

62
Q

What is this?

A

Sialgogram- used to diagnose a blocked salivary gland or duct

63
Q

What is this?

A

Parotid tumors

64
Q

What is this?

A

Tongue cancer with invasion into mandible

65
Q

What is this and what is it used for?


A

Useful for evaluating vascular compression and vessel encasement and patency, but full characterization of tumor vascularity and vascular malformations is suboptimal.

66
Q

What is gold standard for imaging vascular lesions

A

CT angiography

67
Q

What is this?

A

Carotid angiogram

68
Q

What is this?

A

AV malformation of the middle cerebral artery

DOOS 2 (14 decks)

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