Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

EENT > Nose > Flashcards

Nose Flashcards

1
Q

what is rhinitis?

A

inflammation of the nasal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

etiologies of rhinitis

A

viral infection
allergic
acute bacteria infection
vasomotor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what is allergic rhinitis?

A

hay fever

seasonal allergic rhinitis is MOST common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Pathophysiology of allergic rhinitis

A

activation of humoral and cell mediated immune responses that lead to IgE mediated inflammatory response

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

allergic rhinitis nasal symptoms

A

rhinorrhea (clear)
sneezing
watery eyes
allergic shiners
Dennie’s lines (lines under eyes)
transverse nasal fold or “allergic salute”
throat discomfort
nasal congestion
hyposmia
malaise

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

allergic rhinitis eye symptoms

A

eye irritation
pruritus
conjunctival erythema
excessive tearing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

what is the triad of allergic rhinitis?

A

nasal congestion, sneezing, clear rhinorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what is associated with allergic rhinitis?

A

strong genetic component
asthma, nasal polyps, nasal speech, history of atopic dermatitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

testing for allergic rhinitis?

A

clinical diagnosis
nasal smear - elevated eosinophils
allergy skin tests or RAST tests often positive for specific allergens

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

treatment of allergic rhinitis

A

avoid allergens
corticosteroids - intranasal AND/OR oral or IM for severe cases
antihistamines
anticholinergic agents
antileukotrienes
immunotherapy for resistant cases

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

physical findings of allergic rhinitis

A

pale-bluish, edematous or boggy nasal mucosa
venous engorgement

AND

nasal polyps - yellow boggy masses of mucosa
associated with chronic allergic rhinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

what are nasal polyps?

A

benign lesions that arise from nasal mucosa caused by chronic inflammation
associated with asthma, CF, aspirin tolerance, allergic rhinitis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

what is viral rhinitis?

A

also known as the common cold, coryza

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

T/F: viral rhinitis most common adult infection

A

FALSE: most common pediatric infection
children < 5 years average 6-12 “colds” per year

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

testing for viral rhinitis?

A

diagnosis made by history
lab test unnecessary
complications may prolong illness (ear infection, pneumonia, pharyngitis, sinusitis)
*can trigger asthma attacks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

viral rhinitis symptoms

A

rhinorrhea (clear to opaque)
nasal congestion, headache
hyposmia
sneezing
malaise
throat discomfort
post nasal drip –> cough

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

T/F: only 1 virus is responsible for the viral rhinitis

A

FALSE: multiple. rhinovirus (majority), adenovirus, coronavirus, enterovirus, influenza, influenza, parainfluenza, RSV

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

physical findings of viral rhinitis

A

erythematous, edematous, engorged nasal mucosa
watery discharge - intranasal purulent discharge suggest bacterial cause

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

viral rhinitis treatment

A

self-limiting - no effective anti-viral therapies
zinc acetate lozenges
nasal irrigation
decongestants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

what is vasomotor rhinitis?

A

perennial non-allergic rhinitis associated with hyperactive nasal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Pathophysiology of vasomotor rhinitis

A

caused by increased sensitivity of the vidian nerve (passes through the pterygoid canal supplying the pterygopalatine ganglion)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

T/F: vasomotor rhinitis etiology is unknown

A

TRUE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

what is vasomotor rhinitis related to?

A

related to geriatric rhinitis and progressive degeneration of nasal mucosa

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

when and what is the onset of vasomotor rhinitis?

A

adults

presents with rapid onset of nasal congestion and postnasal drip

*No family history of allergies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

physical exam of vasomotor rhinitis

A

clear rhinorrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

triggers for vasomotor rhinitis

A
  • cold temperature,
  • inhaled irritants,
  • strong odors,
  • spicy foods,
  • other nonallergenic environmental stimuli
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

what is rhinitis medicamentosa

A
  • overuse of Decongestant nasal spray (limit use to <5 days)
  • Swollen, red mucous membranes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

what do the lab tests look like for vasomotor rhinitis

A

negative lab tests

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

treatment for vasomotor rhinitis

A

Inhaled decongestants or corticosteroids
Topical Ipratropium bromide (atrovent) - dries up drainage
Avoidance of triggers

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

how to differentiated between allergic, viral and vasomotor

A
  • Allergic Rhinitis – precipitated by allergen, nasal congestion, sneezing, clear rhinorrhea,
    • PE: Watery Rhinorrhea, Pale, boggy nasal mucosa
  • Viral Rhinitis – precipitated by virus, inflammation of nasal mucosa, <10 days
    • PE: erythematous mucosa, clear/yellow rhinorrhea
  • Vasomotor Rhinitis – precipitated by a trigger, hyperactive nasal mucosa, adults, no hx of allergies
    • PE: clear, constant rhinorrhea
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

function of nose

A
  • 80% Flavor of Food
  • Recognize thousands of smells
  • Smell affects our emotions
  • Helps block bacteria from entering
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

function of sinuses

A
  • Humidifying and warming inspired air
  • Regulation of intranasal pressure
  • Lightening the skull
  • Resonance
  • Absorbing shock
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

when is the frontal sinus present?

A

at significant size at 3-4 yrs. old, sphenoid at 8yrs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

T/F: 3-4 liters of mucus produced per day

A

FALSE - One - Two Liters of mucus produced per day

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

common etiology of acute rhinosinusitis

A

VIRUS

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

how to manage acute rhinosinusitis

A
  • Symptomatic management for comfort
  • Does NOT decrease duration
    • Helps with symptoms
  • Self – limiting
    • Usually lasts 7 – 10 days
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

viral rhinosinusitis

A

Inflammation and swelling of the mucous membranes of the nose

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

how long does viral rhinosinusitis lasts

A

<10 days, self-limited

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

symptoms of viral rhinosinusitis

A
  • Clear/yellow rhinorrhea
    More mucoid in appearance after day 2
  • Erythematous Mucosa
  • Congestion
  • post-nasal drip
  • Cough
  • Low-grade fever
40
Q

treatment acute viral rhinosinusitis

A
  • Purpose: Relieve Nasal Obstruction and Rhinorrhea
  • Antiviral drugs not effective / Abx. not effective
  • Analgesic – Tylenol / Motrin
  • Hypertonic saline nasal rinses
  • Intranasal Glucocorticoids
  • Nasal Decongestant Spray (use < 5 days)
  • Antihistamines
  • Drying affect – could lead to further
  • Mucolytics (Guaifenesin)
41
Q

bacterial rhinosinusitis

A

Precipitated by viral rhinosinusitis

42
Q

how do you diagnose bacterial rhinosinusitis

A

Viral symptoms for > 10-14 days
Worsening of symptoms after 5-7 days

43
Q

what is sinuses involved with bacterial rhinosinusitis

A

Maxillary and ethmoid sinuses

44
Q

what are the cardinal signs of bacterial rhinosinusitis

A

Purlent Nasal discharge, nasal obstruction, facial pain

45
Q

pathogens involved with acute sinusitis

A

0-1 months

Strep pneumococcus
H. influenza
Moraxella catarrhalis

46
Q

pathogens involved with chronic sinusitis

A

> 3 months

Gram neg Staphylococcus
Staph aureus, including MRSA
Anaerobes

47
Q

sinusitis symptoms

A

Facial pain/pressure
Facial congestion
Nasal obstruction
Purulent PND
Inability to smell
Fever, malaise
Headache

48
Q

urgent sinusitis symptoms

A

Persistent Fevers > 102 F
Periorbital Edema / Erythema
Cranial Nerve Palsies
Proptosis
Visual Changes
Severe HA / AMS
Meningeal Signs

49
Q

sinusitis exam

A

Edema
Hyperemia
Purulence
Polyps
Pain to palpation over sinus
Inability to transilluminate
+/- swelling or erythema over a sinus
+/- fever in severe cases

50
Q

T/F: Plain radiography generally diagnostic

A

FALSE - NOT, Requires non-contrast CT Max/Face – use if complicating factors o/w not necessary

51
Q

treatment of sinusitis

A
  • Symptomatic treatment
    • 80% of patients will improve within 10 -14 days
    • Will Improve WITHOUT antibiotics
    • This tx plan must include appropriate follow-up
  • Antibiotics after trial with symptomatic tx. x 7 days with no improvement or presents with urgent symptoms.
52
Q

when to treat sinusitis

A

Lack of adequate follow-up
Worsening Symptoms during symptomatic tx
No improvement after 7 days

53
Q

Risk factors for a poor outcome sinusitis

A

Extremes of Age
Recent Hospitalization
Recent Abx use
Immunocompromised
Multiple Comorbidities
Severe Infection (Urgent Symptoms)

54
Q

sinusitis complications

A
  • Orbital cellulitis
  • Osteitis of frontal bone
  • Cheek cellulitis
  • Brain abscess
  • Osteomyelitis
  • Meningitis
55
Q

treatment of complications

A

surgical debridement and 4-6 weeks of ABO

56
Q

signs and symptoms of foreign body

A
  • Hx of FB insertion
  • Mucopurulent Nasal Discharge
  • Foul Odor
  • Epistaxis
  • Nasal Obstruction
  • Mouth Breathing
57
Q

are x-rays helpful for foreign bodies

A

NO, most FB are radiolucent

58
Q

complications of FB

A
  • Risk of Toxic Shock Syndrome
  • Pressure risk - tissue necrosis
  • Epistaxis
  • Obstruction can lead to acute sinusitis
  • Button Battery
  • Paired Disc Magnets
59
Q

when to refer FB

A

Posterior FB
Unable to Visualize
Impacted FB
Complications
Initial 1-2 attempts failed

60
Q

techniques of FB

A

Positive Pressure (soft or smooth FB that occlude the ant. nasal cavity)

Instrumentation (non-occlusive FB)

61
Q

what is epistaxis

A

Nose is a vascular organ with incredible heating/humidification requirements

Vasculature runs just under mucosa

62
Q

anterior bleeding

A

Occurs in younger patients
Usually septal or anterior ethmoid
Usually not severe

63
Q

posterior bleeding

A

Occurs in older patients
Usually from posterior ethmoid
Often severe

64
Q

epistaxis etiology

A
  • **Self-Induced
  • HTN
  • Coagulopathy
  • Dessication (Dryness)
  • Drug Use (Cocaine)
  • Trauma – Facial Fractures
  • Vascular malformations
  • Infection/Inflammation
  • Iatrogenic
  • Neoplasm
  • Foreign Bodies
  • Post- op
65
Q

coagulopathy causes

A
  • Thrombocytopenia (Leukemia, TTP, HELLP)
  • Platelet dysfunction (Systemic disease – Uremia and Drug-induced – Coumadin, Heparin, ASA)
  • Clotting Factor Deficiencies (Hemophilia, VonWillebrand’s disease, Hepatic failure)
66
Q

trauma causes

A

Nose picking
Nose blowing/sneezing
Nasal fracture
Nasal intubation
Trauma to sinuses, nose, orbits, middle ear, base of skull

67
Q

neoplasm causes

A

Benign nasopharyngeal tumors
Squamous cell carcinoma
Adenocarcinoma
Melanoma
Lymphoma

68
Q

desiccation (extreme dryness) causes

A

Temperature, Humidity
Nasal oxygen
Atrophic rhinitis
Septal perforation (Nasal sprays, cocaine)

69
Q

epistaxis management

A
  • Medical history/Medications
  • Vital signs
70
Q

non-surgical treatments of epistaxis

A
  • If direct pressure ineffective, suction to remove clots
  • Apply topical vasoconstrictors / anesthetic
  • Cautery with AgNO3 (Silver Nitrate) or Bovie
    NEVER both sides of septum
    Less than 10 seconds
  • Gelfoam
  • Surgicel
  • Topical Thrombin
  • Control hypertension
  • Correct coagulopathies if indicated
71
Q

anterior bleed treatment

A

Afrin+pressure
Cauterization
Gelfoam
Surgicel
Topical thrombin

72
Q

posterior bleed treatment

A

call ENT

coagulopathy

73
Q

surgery for epistaxis?

A
  • Continued bleeding despite nasal packing
  • Nasal anomaly precluding packing
  • Patient refusal/intolerance of packing
  • Failed medical mgmt after >72hrs
  • Many times can’t tell anterior or posterior until pack and bleeding persists = POSTERIOR
74
Q

septal perforation etiologies

A
  • Overuse of nasal steroid
  • Latrogenic
  • Nasal cautery
  • Post-operative complication
  • Cocaine/Ketamine
75
Q

nasal polyps

A

benign lesions that arise from nasal mucosa

76
Q

what are nasal polyps caused by

A

chronic inflammation

77
Q

nasal polyps are associated with

A

asthma, CF, aspirin intolerance, allergic rhinitis

78
Q

samter’s triad

A

nasal polyps

asthma

hypersensitivity to aspirin

nasal polyps + asthma = no ASA

79
Q

what is AERD

A

Aspirin Exacerbated Respiratory Disease

80
Q

how to treat nasal polyps

A

nasal or oral steroids

81
Q

how to diagnose nasal polyps

A

Diagnosed with nasal endoscopy CT/MRI

82
Q

can you give aspirin to someone with nasal polyps

A

NOOOO

83
Q

inverted papilloma

A

caused by HPV

treated with surgical resection

84
Q

most common broken bone in the body

A

nose

high incidence of LeFort fractures

85
Q

is imaging needed for nasal fractures?

A
  • no unless….
    • Septal hematoma
    • Orbital or facial nerve involvement
    • Tenderness is not limited to bridge of nose
    • Patient cannot breathe through both nares
    • Severe asymmetry suspecting comminuted fracture
86
Q

nasal fracture

A
  • Prior Injury?
  • Edematous, Painful, Epistax.
  • Eval for Hematoma
  • +/- imaging
  • Delayed repair
87
Q

septal hematoma

A
  • Septal cartilage lacks its own blood supply
  • Untreated hematoma can lead to destruction of septum
  • Must I&D (saddle or perf)
88
Q

what is charge syndome?

A
  • Coloboma – hole in one of the eye structures
  • Heart disease
  • Atresia of choanae - Posterior naris
  • Retarded growth
  • Genital hypoplasia
  • Ear anomalies
89
Q

choanal atersia

A

Congenital blockage of one or both nasal passages, usually by abnormal bony or soft tissue growth during fetal development

life threatening emergency

90
Q

signs and symptoms of choanal atersia

A

cyanosis during feeding

continuous nasal drainage

91
Q

how to diagnose choanal atresia

A

Inability to pass 6F catheter
CT sinus

92
Q

treatment of choanal atresia

A

Surgical drilling and stent placement

Often need multiple surgeries through adolescent years and adulthood

93
Q

lefort I

A

horizontal

edema, mobility of hard palate / teeth

94
Q

lefort II

A

pyramidal

edema, subconj hemorrhage, mobility at nasofrontal suture, epistax., CSF rhinorrhea

95
Q

lefort III

A

separation of all facial bones from cranium

massive edema, movement of all facial bones, epistaxis, CSF rhinorrhea

EENT (5 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions