hoarseness, dysphagia, airway obstruction

Question 1

what innervates the voice box

Answer 1

1. superior laryngeal

2. recurent laryngear

Question 2

what is def. of hoaseness

Answer 2

• abnormal vocal quality

Question 3

3 general cause sof hoarseness

Answer 3

1. inflammatory or irritant
   - trauma, allergies, infection
2. neoplastic
3. neuromusc. or psych

Question 4

4 things to ask on hoarseness Hx

Answer 4

1. OPQRST
2. pattern of voice use
   - job and env
3. assoc. Sx
   - cough, hemoptysis, burn
4. risk factors

Question 5

3 parts of Phx

Answer 5

1. complete head and neck
2. nodal and thyroid exam
3. if voice is breathy, do cranial nerve exam

Question 6

what to do for acute hoarsness

Answer 6

observe

• URTI
• vocal abuse
• reflux Sx

Question 7

what to do for >2 weeks

Answer 7

• or if risk of CA

- to ENT for laryngoscopy

Question 8

2 important possible findings on scope

Answer 8

1. nodules

2. papillomas

Question 9

what are vocal cord nodules

Answer 9

• benign masses along the vocal cords
• occur in yellers
• rest the voice

Question 10

what are laryngeal papllimas

Answer 10

warts on the cords

- HPV 6+11

Question 11

2 distinct types of dysphagia

Answer 11

1. oropharyngeal - voluntary

2. esophageal - involuntary

Question 12

3 parts of Hx for dysphagia

Answer 12

1. OPQRST
2. assoc. Sx
3. description of dysphagia can help

Question 13

2 general cats. of oro. dysphagias

Answer 13

1. neuromusc/neurodegen
   - stroke
   - parkinsons
   - brain stem tumor
2. obstructive
   - tumor
   - zenkers
   - esopahgeal webs

Question 14

3 parts of Phx

Answer 14

1. H+N exam
2. CN exam
3. scope

Question 15

3 investigations

Answer 15

1. barium swallow
2. video flouroscopy
3. scope

Question 16

what is zenkers

Answer 16

• diverticulum in mucosa of pharynx
• adults >60
• barium swallow

Question 17

def. airway obst.

Answer 17

any reversible or irreversible narrowing or airway preventing adequate vent

Question 18

*key question

Answer 18

is patient in resp. distress

Question 19

what are important part of Hx

Answer 19

• progression or regression of Sx
• precipitiatin events
• recent surg
• diff. with previous general anathsia
• sleep apnea
• C-spine abnormal

Question 20

key parts of PHx (4)

Answer 20

1. observe - stridor/voice
2. oral cavity
   - trismus
   - dentitiiton
3. oropharynx
   - malampati
   - swelling
   - masses
4. neck
   - scars
   - swelling

Question 21

what is important tool

Answer 21

fiberoptic nasolaryngoscope

Question 22

what is sertor

Answer 22

sounds like snoring-

- cavity obst.

Question 23

3 types of stridor and where they are localized

Answer 23

1. inspiritory- supraglottic
2. expiratory - trach/bronchi
3. biphasic - glottic/subglottic