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ENT > Imaging & Procedures > Flashcards

Imaging & Procedures Flashcards

1
Q

Purposes of X-ray

A

Detect sinusitis
Detect fluid in the sinuses
Detect polyps

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2
Q

Indications of X-ray

A

Pain/pressure in the face

Clinical symptoms need supportive evidence

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3
Q

Maxillary Sinus X-ray

A

Frontal view of the maxillary sinuses, orbits, nasal structures, zygomas
Permits direct comparison of sides

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4
Q

Waters View

A

Posterior/anterior radiographic view of the skull with an angle of 37 degrees from the plane of the film to show the orbits and maxillary sinuses

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5
Q

What disease has the thumbprint sign?

A

Epiglottitis

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6
Q

What disease has the steeple sign?

A

Croup

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7
Q

What is the imaging of choice for retropharyngeal abscess

A

CT of the neck

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8
Q

CT is preferable to MRI in these situations

A

Larynx for neck nodes
Tumor volume
Cartilage sclerosis & destruction

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9
Q

CT of Sinuses Useful for:

A 
Further info about tumors
Provide info about obstruction
Detect fluid in sinuses
Detect if membranes are thickened
Assist with diagnosis
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10
Q

Best Diagnostic Tool for Epiglottitis

A

Lateral Neck X-ray

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11
Q

Best Diagnostic Tool for Retropharyngeal Abscess

A

CT

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12
Q

Best Diagnostic Tool for Sinusitis

A

X-ray or CT

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13
Q

Best Diagnostic Tool for Trauma

A

CT

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14
Q

Best Diagnostic Tool for Ludwig’s Angina

A

CT

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15
Q

Best Diagnostic Tool for Peri-tonsillar Abscess

A

CT

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16
Q

Best Diagnostic Tool for Tumors

A

MRI

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17
Q

Most Radiation exposure between x-ray, CT, or MRI

A

CT

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18
Q

Indications for a Throat Swab or Culture

A

Sore throat
Fever of unknown origin
Chronic carriers with recurrent infection

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19
Q

Indications for a Nose Swab or Culture

A

Nasal or sinus infections

Carriers of pathogenic bacteria

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20
Q

When should cultures be performed?

A

Before antibiotic therapy is initiated

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21
Q

Main bugs on throat cultures

A

Bordatella pertussis
Streptococci (esp. B-hemolytic)
Meningococci
Corynebacterium diptheriae

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22
Q

Most common bugs on nasal swab

A

Staph aureus

MRSA

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23
Q

Most common bugs on a nasopharyngeal swab

A

H-flu
RSV
Influenza
Pertussis

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24
Q

How to perform a nasal swab

A 
Raise tip of nose
Insert swab into nare
Rotate swab
Remove swab
Place in appropriate tube
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25
Q

How to perform a nasopharyngeal swab

A 
Raise tip of nose
Insert FLEXIBLE swab into nare medially
Gently move to posterior pharynx
Rotate swab
Place in appropriate tube
26
Q

Where do you swab for a rapid strep?

A

Posterior pharynx

27
Q

Cerumen Disimpaction

A

Removal of cerumen via an ear curette

28
Q

Treatment of Epistaxis

A

Topical vasoconstrictor/analgesic
Direct pressure
Silver nitrate cautery

29
Q

Topical Vasoconstrictors

A

Inhaled Afrin

Cotton balls soaked in Epi & Lidocaine

30
Q

How Long to Apply Direct Pressure?

A

20 minutes

31
Q

When do you use nasal cautery

A

After 20 minutes of direct pressure

32
Q

How long can one hold silver nitrate to a bleeding site?

A

10 seconds

33
Q

Why does one not cauterize both sides of the nasal septum?

A

Risk of septal perforation

34
Q

Which type of nasal packing is more common?

A

Anterior nasal packing

35
Q

What items are used for anterior nasal packing?

A

Gauze-petroleum soaked
Rhino rocket
Mercel

36
Q

How long until follow up is required after nasal packing is placed?

A

Within 24 hours

37
Q

How long is the packing usually left in place?

A

48-72 hours

38
Q

Complications of Nasal Packing

A

Necrosis if too tight
Sinusitis
Otitis media
Toxic Shock Syndrome

39
Q

What is pneumatic otoscopy testing for?

A

Movement/mobility of the tympanic membrane

40
Q

Interpretation of Increased TM Mobility

A

Atrophy

Previous perforation or T-tube

41
Q

Interpretation of Absent or Decreased TM Mobility

A

Acute otitis media

Scarring

42
Q

Define Audiometry

A

Formal measurement of hearing

43
Q

What does audiometry involve?

A

Presentation of tones or speech to each ear testing frequencies

44
Q

Purpose of Weber/Rinne Testing

A

Determine whether the hearing loss is sensorineural or conductive

45
Q

How to Perform the Rinne Test

A

Place vibrating tuning for on mastoid process

Then move it in front of the ear canal

46
Q

Normal Result of Rinne Test

A

AC > BC

47
Q

What is the Rinne Test Looking For?

A

Conductive hearing loss

48
Q

If BC > AC there is what type of hearing loss?

A

Conductive hearing loss

49
Q

A normal Rinne is:

A

Positive

50
Q

An abnormal Rinne is:

A

Negative

51
Q

How to Perform a Weber Test

A

Place vibrating tuning fork on top of the head

Patient should hear equally in both ears

52
Q

What test must you use in addition to the Weber test to determine if the ear is normal or abnormal?

A

Rinne test

53
Q

If Rinne normal and Weber is lateralized, what kind of hearing loss is present?

A

Sensorineural hearing loss in the opposite ear of where Weber was lateralized

54
Q

If Rinne is abnormal in the ear that Weber lateralizes to, what kind of hearing loss is present?

A

Conduction hearing loss in that ear

55
Q

Define Tympanometry

A

Measurement of the impedance of the middle ear to sound

56
Q

What can tympanometry detect?

A 
Fluid in the middle ear
Negative middle ear pressure
Disruption of ossicles
Otosclerosis
Hypercompliant TM
57
Q

How is tympanometry performed

A

Soft probe placed into ear canal
Small amount of pressure applied
Instrument measures movement of TM with varying pressures

58
Q

What is vestibular caloric testing used for?

A

Test disorders of the ear or brainstem

59
Q

What disorders of the ear or brainstem does vestibular caloric testing test?

A

Benign positional vertigo
Perilymph fistula
Vestibular neuritis
Gentamycin ototoxicity

60
Q

What does cold water in the ear initiate?

A

Fast nystagmus

Eyes to move away from cold water

61
Q

What does warm water in the ear initiate?

A

Eyes move towards the warm water

62
Q

What can ice water caloric testing be used for in the ICU?

A

Determine brain function of a comatose patient

ENT (10 decks)

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