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ENT > Larynx > Flashcards

Larynx Flashcards

1
Q

Cervical position of larynx

A

C3 - C6

C2 - C3 in children

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2
Q

3 processes of arytenoid

A

Muscular
Vocal
Apical

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3
Q

Ligaments of the larynx

A

Thyroepiglottic
True vocal cords
False vocal cords

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4
Q

Which compartment can you find the false vocal cords

A

Supraglottis

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5
Q

Which compartment can you find the true vocal cords

A

Glottis

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6
Q

arterial supply of larynx

A

branch of superior and inferior thyroid arteries

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7
Q

distinguishing features of larynx of a child

A
  1. Positioned higher than an adult larynx. Reaches the soft palate when swallowing
  2. Laryngeal cartilages are soft and collapse easily. Epiglottis
    is omega shaped
  3. Thyroid cartilage in an infant is flat.
  4. Infant’s larynx is small and conical. The diameter of cricoid
    cartilage is smaller than the size of glottis
  5. Submucosal tissues of infant’s larynx are comparatively loose and easily undergo oedematous change with trauma or inflammation leading to obstruction.
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8
Q

landmarks of trachea

A

bifurcates at t5
commences at C6
10cm in length
bifurcation at t6 in full inspiration

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9
Q

laryngeal symptoms

A 
Hoarseness
Stridor
Dyspnea
Cough
Hemoptysis
Dysphagia
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10
Q

mechanism of hoarseness

A

loss of approximation
size of the cord
stiffness

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11
Q

Common cause of hoarseness of acute onset

A

local inflammation of the larynx. e.g. acute laryngitis

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12
Q

Other causes of acute hoarseness

A

bacteria

brieft periods of vocal overuse

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13
Q

time duration of chronic onset of hoarseness

A

longer than 2 weeks

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14
Q

cause of chronic hoarseness

A

Pharyngeal reflux ,Benign polyps, Vocal cords nodules, Laryngeal papillomatosis, malignancy, Neurological disorders, or Chronic inflammation secondary to Smoking or voice abuse.

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15
Q

systemic diseases that cause hoarseness

A
  • Hypothyroidism
    • Multiple sclerosis
    • Rheumatoid arthritis
    • Parkinson’s dx.
    • Systemic lupus
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16
Q

where are vocal nodules usually seen

A

free edge of the anterior 3rd of the VC

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17
Q

How are vocal nodules formed

A

Pathologically, trauma to the vocal cord in the form of vocal abuse or misuse causes oedema and haemorrhage in the submucosal space.
This undergoes hyalinization and fibrosis. The overlying epithelium also undergoes hyperplasia forming a nodule

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18
Q

in which of the pathologies is referred otalgia seen

A

vocal cord nodules

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19
Q

Stridor

A

Noisy respiration produced by turbulent airflow through a partially obstructed airway.

20
Q

causative organism of juvenille papillomatosis

A

hpv 6 11

21
Q

which of the hpvs have high risk of malignancy

A

11

22
Q

Classic triad of juvenile papiloomatosis

A

being firstborn
vaginal delivery
having a mother younger than 20 years

23
Q

differential for JP

A

asthma

acute laryngitis

24
Q

imaging for JP

Diagnosis

A

soft tissue lateral neck xray

flexible fibreoptic laryngoscopy

25
Q

treatment for JP

A

repeated surgical debulking via microlaryngoscopy and CO2 laser excision avoiding injury to vocal ligament

In the absence of CO2 laser, tumour can be removed under microscope with cup forceps or a debrider

26
Q

adjuvant therapy in JP

A

Intralesional injxn of cidofovir
Indole-3-carbinol
Vaccination with a quadrivalent vaccine. Protects against HPV 6, 11, 16 and 18

27
Q

Cause of acute laryngitis

A

infectious more of viral origin

non - infectious..more of alcohol, trauma, etc.

28
Q

significant negative in laryngitis

A

dyspnea

29
Q

Age range of acute epiglottitis

A

2-7 years

30
Q

causative organism in acute epiglottitis

A

H. influenza type B

Strept species

31
Q

significant negative in epiglottitis

A

no hoarseness

32
Q

mnemonic for epiglottis

A

A - airway obstruction
I - increased pulse
R - Restlessness

R - Retractions
A - Anxiety increased
I - Inspiratory stridor
D - drooling

33
Q

which radiological sign is seen in epiglottis

A

thumb sign

34
Q

Most common cause of upper airway obstruction in infants and young children aged 6mo to 6yrs.

A

Croup or acute LTB

35
Q

Causative organism in ALTB

A

parainfluenza type 1 & 2

influenza virus

36
Q

which radiological sign is seen in LTB

A

steeple sign

37
Q

name of manoeuvre in fb aspiration

A

heimelich manuvre

38
Q

narrowest portion of upper airway in children and aldults

A

subglottic region

glottic region

39
Q

indications of cricothyroidectomy

A
  • Emergency situations.
    • Palliative respiratory hygiene in the terminally ill.
    • In the presence of anatomic variations.
40
Q

indications of Tracheostomy

A

Bypass an UAO
Bronchial toileting
Assisted respiration.

41
Q

disadvantages of tracheostomy

A 
Anosmia
Aphonia
Inability to lift heavy weights
Inability to swim
Inability to perform strenuous exercises
Risk of aspiration if a cuffed tube is not used
42
Q

types of tracheostomyh

A 
1. TIMING
Emergency/Elective tracheostomy
2. PURPOSE
Permanent/ Temporary tracheostomy
3. POSITION
High/Mid/Low tracheostomy
43
Q

borders of jackson’s safety triangle

A

Base: Lower end of thyroid cartilage
Apex: Suprasternal notch
Sides: Inner edges of sternocleidomastoid muscle

44
Q

Significance of Jackson’s safety triangle

A

So named as this marks the area through which safe dissection can be done for tracheostomy
Also represents the area into which infiltration anesthesia is given during tracheostomy under local anesthesia

45
Q

Immediate complication of tracheostomy

A 
Haemorrhage
Air embolism
Apnoea
Cardiac arrest
Damage to local structures
False passage of the tracheostomy tube 
Puncture of the posterior tracheal wall  
Premature extubation during the procedure and loss of the  airway
46
Q

early complication of tracheostomy

A 
Dislodgement
Surgical emphysema
Pneumothorax/pneumomediastinum
Scabs and crusts
Infection- Tracheitis, cellulitis
Tracheal necrosis
Tracheoarterial fistula
Dysphagia
Early bleeding: Increased  blood pressure as the patient emerges from  anesthesia and begins to cough
47
Q

late complications of tracheostomy

A 
Scarring
Stenosis
Difficult decannulation
Bleeding - tracheoinnominate fistula
Tracheoesophageal fistula
Tracheo cutaneous fistula

ENT (9 decks)

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