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ENT > larynx > Flashcards

larynx Flashcards

1
Q

development of larynx starts and completes at

A

4wk to 3rd mnth of intrauterine life

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2
Q

wrisberg cartilage is ??

A

cuneiform cartilage

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3
Q

cartilage of santorini is ??

A

corniculate cartilage

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4
Q

angle bw lamina of thyroid is ?

A

male 90

female 120

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5
Q

oblique line over thyroid lamina gives attachment to ??

A

thryohyoid
sternohyoid
inferior constrictor

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6
Q

largest laryngeal cartilage

A

thyroid cartilage

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7
Q

only complete cartilaginous ring is ??

A

cricoid cartilage

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8
Q

wht is pachydermia laryngitis

A

due to faulty production of vocal process of arytenoid rub against each other leads to an area of heaped up mucosa on one vocal process which fits into ulcer like depression on side

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9
Q

which part of vocal fold is affected by pacydrermia laryngitis

A

posterior 1/3

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10
Q

is contact ulcer malignant ??

A

no they r not malignant

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11
Q

cause of contact ulcers is ??

A

vocal abuse

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12
Q

TB affects which part of vocal cord

A

posterior

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13
Q

first sign of laryngeal tb is ??

A

hyperemia and ulceration of unilateral vocal cord with impairment of abduction

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14
Q

mouse nibbled appearence is seen in ??

A

tubercular laryngits

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15
Q

turban epiglottis is ??

A

pseudoedema of epiglottis seen in laryngeal tb

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16
Q

lupus of larynx is seen in which part of larynx

A

anterior

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17
Q

syphilis effects which part of larynx

A

anterior

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18
Q

leprosy effects which part of larynx

A

anterior

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19
Q

lesions of leprosy r ?

A

dull in color of epiglottis is destroyed and gives appearance of hook over a buttonhole

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20
Q

wht is reinke edema

A

b/l symmetrical swelling of

vocal cord giving appearance of hook over a button hole

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21
Q

kind of voice in reinke s edema

A

pt uses false cords therefore voice is low pitched and rough

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22
Q

b/w which layers of vocalcord

lies the reinke edema

A

b/w superficial lamina propria and intermediate lamina propria

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23
Q

dysphonia plica ventricularis is ??

A

voice production by false cord

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24
Q

treatment of dysphonia plica ventricularis is ??

A

psychological counselling if functional cause

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25
Q

key hole appearence of glottis is seen in ??

A

phonosthenia

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26
Q

cause of keyhole appearance

A

elliptical space bw the cords is due to paralysis of thyroartenoid and triangular gap is due to weakness of interarytenoid

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27
Q

cause of rhinolalia clausa

A

nasal allergy
polyp
adenoids nasopharyngeal mass

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28
Q

cause of rhinolalia aperta

A

velopharyngeal insufficiecy

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29
Q

gutzman test is positive in ?

A

puberphonia

thyroid prominece is pressed backwards and downwards

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30
Q

muscle responsible for falsetto voice of puberphonia

A

cricothyroid main tensor

there is hyperkinetic function and spasm of this muscle

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31
Q

intubation granuloma is most commonly found on??

A

posterior third of vocal cord

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32
Q

glottic cancer is found where

A

free edge and upper surface of ant 1/3 of true vocal cord

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33
Q

wht is mogiphonia

A

phonic spasm occurs in professional voice users

initially voice is normal but soon vocal cords get adducted and person cannot speak

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34
Q

lesions of leprosy are ?

A

dull grey in color

epiglottis idestrgives

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35
Q

most common site affected in pacydermia laryngis

A

arytenoid cartilage

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36
Q 
true abt reinke edema is ?
1usually unilateral 
2 common in smoker 
3 corticosteroids is mainstay of treatment 
4 patient has low pitch voice
5 involves membrnous part of vocal cord
A

ans
common in smoker
involves whole vocal cord
pt has low pitched voice

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37
Q

wht is functional aphonia

A

seen in emotionally labile females in age grp 16-30 yrs
laryngoscopy shows vocal cords in abducted position and fails to adduct on phonation however adduction is seen on coughing
indiacting normal adductor function

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38
Q

treatment of functional aphonia

A

reassurances and psychotherapy

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39
Q

wht is typ1 thyroplasty

A

medialisation of vocal cord

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40
Q

wht is type 2 thyroplasty

A

lateralisation of vocal cord

indications spasmodic dysphonia

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41
Q

type 3 thyroplasty

A

relaxation of vocal cord or shortening of vocal cord

as in puberphonia to lower pitch

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42
Q

type 4 thyroplasty

A

lengthening of vocal cord

ie in androphonia to elevate the pitch

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43
Q

muscle responsible for change of pitch of voice

A

cricothyroid

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44
Q

ortners syndrome is ??

A

cardiomegaly + paralysis of RLN

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45
Q

distance bw vocal cords in full abduction

A

19 mm

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46
Q

distance bw vocal cord as glottic chink

A

7 mm ie 3.5 mm from midline

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47
Q

which side of vagus is more prone to injury

A

left as it has longer

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48
Q

features of unilateral SLN paralysis

A

voice is not severly effected but pitch of voice cannot be raised
iosilateral cord is bowed and floppy,,increased in length,cords sag down in inspiration and bulge up during expiration
unilateral anaesthesia above the cord

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49
Q

treatment of unilateral

SLN paralysis

A

no treatment

50
Q

bilateral SLN PARALYSIS

A

voice is breathy and weak also there is high chances of aspiration as there is bilateral anaesthesia of supraglottic part

51
Q

treatment of bilateral SLN paralysis

A

tracheostomy may be required

epiglottopexy is close laryngeal inlet is done to protect from aspiration

52
Q

features of unilateral RLN paralysis

A

ie unilateral abductor paralysis affected cord is in paramedian position does not move laterally on inspiration
slight hoarseness which improves over days
voice tires on repeated use

53
Q

treatment of unilateral RLN paralysis

A

speech therapy

54
Q

features of bilateral RLN paralysis

A

both cords lie in median ot paramedian position due to unopposed action of cricothyroid muscle
voice is gud
dyspnea stridor may be present

55
Q

treatment for bilateral RLN

A

emergency tracheostomy or lateralise the cord

56
Q

position of cord i both RLN AND SLN paralysis

A

adductor paralysis causes vocal cord to be in cadaveric position

57
Q

muscular voice in female is treated by ?

A

thyroplasty type 4 used to lengthen the vocal cord and elevate the pitch

58
Q

voice in bilateral abductor paralysis

A

normal

59
Q

position of vocal cords in cadaver

A

intermediate

60
Q

most common cause of vocal cord palsy is

A

total thyroidectomy

61
Q

rht siided vocal cord pasy is seen in

A

rht RLN arises from vagus at the level of subclavian artery and hooks around it
it is seemin laryngeal carcinoma

62
Q

course of left RLN

A

arise from vagus in the mediastinum at level of arch of aorta loops around it and then ascends into neck

63
Q

treatmemt of unilateral vocal cord palsy

A

type 1 thryoplasty ie medialisation of vocal cord

64
Q

most common cause of vocal cord palsy

A

surgical due to surgery of thyroid , parathyroid carotid

65
Q

most common malignancy causing vocal cord palsy

A

bronchial 》esophagus 》nasopharyngeal 》thyroid

66
Q

most common cause of benign tumor

A

squamous papillomas

67
Q

cause of juvenile papillomatosis

A

HPV types 6,11

68
Q

treatment of infant hemangiona

A

involute spontaneously treated by CO2 laser

69
Q

treatment of adult hemangioma

A

most are cavernous

can be treated by steroids and radiation therapy

70
Q

mc type of laryngeal cancer

A

squamous cell carcinoma

71
Q

supraglottis and infraglottis drains inti

A

upper deep cervical

72
Q

vocal cord lymphatic drainage

A

no lymphatics

73
Q

mc site for laryngeal cancer

A

glottis

74
Q

worst prognosis of which laryngeal can er

A

subglottic

75
Q

best prognosis for which laryngeal cancer

A

glottic

76
Q

ackerman tumor treated by ??

A

verrucus carcinoma is Ackermantumor

treatment is always surgery

77
Q

structures removed in radical neck dissection

A 
lymph nodes 1-V
  \+
spinal accessory nerve
 \+
int jugular vein
\+
sternocleidomastoid
78
Q

modified radical neck dissection

A 
type 1 spinal accessory preserved
type2 
spinal accessory nerve +internal jugular vein
type3 
spinal accessory nerve +int jugular vein
79
Q

levels of neck nodes

A 
level 1 submental
1b submandibular 2 
upper jugular 
3
middle jugular 
4
lower jugular 
5 
posterior triangle 
6 
central 
7 
sup mediastinal
80
Q

premalignant conditions for laryngeal cancer

A

leukoplakia papillomas

chronic laryngitis

81
Q

which is more aggressive hpv 6 and 11

A

hpv 11

82
Q

mode of acquiring papillomas in a child

A

vertical transmissions at time of parturition

83
Q

most common initial symptoms of supraglottis cancer

A

pain on swallowing

84
Q

most common first sign

of supraglottis cancer

A

mass in neck

85
Q

treatment of choice for all stage 1 laryngeal cancer which neither impair mobility or invade cartilage or cervical nodes

A

radiotherapy

86
Q

TOC FOR stage T1 glottic carcinoma

A

radiotherapy

87
Q

treatment for stage T2 of glottic carcinoma with mobile vocal cords

A

radiotherapy

external bean radiation

88
Q

treatment of choice for vocal cords with impaired vocal cord mobility

A

laryngectomy

89
Q

laser used for laryngeal cancer

A

CO2 laser

90
Q

TOC in perichondritis larynx

A

total laryngectomy

91
Q

IOC in upper airway obstruction

A

fiberoptic endoscopies

92
Q

most definative managemet for upper airway obstruction

A

tracheostomy

93
Q

immediate methods for upper airway obstruction

A

heimlich and jaw thrust

94
Q

minitracheostomy is ?

A

cricothyrotomy

95
Q

site for tracheostomy is ??

A

2nd,3rd,4th tracheal ring which lie under isthmus of thyroid gland

96
Q

high tracheostomy disadv

A

perichondritis of cricoid cartilage can lead to subglottic stenosis

97
Q

low tracheostomy disadv

A

injuries to great vessel of neck and ap

98
Q

prefered material for tracheostomy tube in children

A

silicon as it is flexible and causes less trauma

99
Q

should we use cuffed tracheostomy tubes in child

A

no as it causes subglottic stenosis

100
Q

mc foreign body

A

vegetable foreign body

101
Q

site of impaction of foreign body in upper digestive tract

A

cricopharynx

102
Q

treatment for foreign body in larynx

A

heimlich maneuver

cricothyrotomy

103
Q

killian incision is for

A

smr

104
Q

weber freguson incision

A

total maxillectomy

105
Q

freers incision

A

septoplasty

106
Q

moures incision

A

lateral rhinotomy

107
Q

Which anaesthetic should be avoided in middle ear surgery

A

N2O as it can cause expansion of ear cavity

108
Q

High tracheostomy is indicated for ??

A

Carcinoma

109
Q

LAM is

A

Laser assisted myrigotomy

110
Q

What is brewer luckhardt reflex

A

Inspiratory closure of Glottis and tracheal adduction of vocal cords which is unresponsive to airways. Manoeuvres

111
Q

Commonest indication for myringostomy

A

Serious otitis media

112
Q

Most common indication for tracheostomy is

A

Foreign body aspiration

113
Q

Frequency of cuff deflation

A

Cuff should be deflated every 2 hrs for 5 min

114
Q

Structures which can be damaged by emergency tracheostomy

A

Ishtmus of thyroid and thyroidima artery

Inf thyroid vein

115
Q

Most common complications of tracheostomy

A

Hemorrage

116
Q

Commonest cause of bleeding during tracheostomy

A

Ant jugular vein

117
Q

Mc cause of laryngeal stenosis

A

Endotracheal incubation followed by tracheostomy

118
Q

Commonest site of aspiration of foreign body

A

Rht side
If pt is supine 》post segment of upper lobe
Or superior segment of lower lobe

If patient is upright and sitting
》basilar segment of lower lobe

119
Q

kashim operation is done for ?

A

cordotomy

120
Q

Gold std for OSA

A

Polysomnography

121
Q

Can we pt of osa will benefit from the surgery

A

Yes by Muller maneuver

122
Q

larynx cartilages r hyaline or elastic

A

thyroid cartilage

cricoid cartilage basal part of arytenoid are hyaline cartilage rest all are elastic cartilage

ENT (5 decks)

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