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Otorhinolaryngology > ORL Must Knows > Flashcards

ORL Must Knows Flashcards

1
Q

Left-sided enlargement of a supraclavicular node is suggestive of:

A

Abdominal malignancy

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2
Q

Right-sided enlargement of a supraclavicular node may

indicate

A

malignancy of the mediastinum, lungs, or esophagus

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3
Q

Occipital and/or posterior auricular node enlargement may indicate

A

rubella

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4
Q

Functions of Facial Nerve

A

“Ears, Tears, Face, Taste”

Ears- stapedius muscle
Tears -lacrimation (lacrimal gland) and
salivation (parotid)
Face - muscles of facial expression
Taste - sensory anterior 2/3 of tongue
(via chorda tympani)
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5
Q

Drainage into Nasal Cavity

Superior meatus: ____

A

sphenoid (via sphenodethmoidal recess), posterior ethmoid sinuses

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6
Q

Drainage into Nasal Cavity

Middle meatus: ____

A

frontal, maxillary, anterior ethmoid sinuses

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7
Q

Drainage into Nasal Cavity

Inferior meatus: ____

A

nasolacrimal duct

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8
Q

Borders of the nasopharynx, oropharynx, and laryngopharynx

A

Nasopharynx: skull base to soft palate
Oropharynx: soft palate to hyoid bone
Laryngopharynx: hyoid bone to inferior
cricoid cartilage

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9
Q

Boundaries of the anterior triangle of the neck

A

anterior border of SCM
midline of neck
lower border of mandible

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10
Q

Boundaries of the submental triangle

A

bounded by both anterior bellies of digastric and hyoid bone

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11
Q

Digastric triangle boundaries

A

anterior and posterior bellies of digastric

inferior border of mandible

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12
Q

Carotid triangle boundaries

A

sternocleidomastoid
anterior belly of omohyoid
posterior belly of digastric

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13
Q

The carotid triangle contains which structures?

A

tail of parotid, submandibular gland, hypoglossal nerve, carotid bifurcation, and lymph nodes

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14
Q

The posterior triangle is bounded by:

A

posterior border of sternocleidomastoid
anterior border of trapezius
middle third of clavicle

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15
Q

Left lower level IV supraclavicular node

A

Virchow node

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16
Q

True or False.

True nystagmus and vertigo caused by a peripheral lesion will never last longer than a couple of weeks because of compensation. Central lesions do not compensate, hence nystagmus and vertigo will persist.

A

True

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17
Q

5 D’s of Vertebrobasilar Insufficiency

A 
Drop attacks
Diplopia
Dysarthria
Dizziness
Dysphagia
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18
Q

Tinnitus is most commonly associated with conductive or sensorineural HL?

A

SNHL

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19
Q

Signs and Symptoms of

Glomus Tympanicum/Jugulare Tumour

A
  • Pulsatile tinnitus
  • Hearing loss
  • Blue mass behind TM
  • Brown’s sign (blanching of the TM with pneumatic otoscopy)
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20
Q

Most common cause of vocal cord paralysis

A

lung malignancy

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21
Q

Two types of tinnitus

A

Subjective and objective

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22
Q

Order of the Neural Pathway (with corresponding waves on ABR)

A 
E COLI
Eighth cranial nerve (I- II)
Cochlear nucleus (Ill)
Superior Olivary nucleus
Lateralleminiscus (IV- V)
Inferior colliculus
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23
Q 
Normal hearing physiology
Conductive pathway (external auditory canal to cochlea)
A

Air conduction of sound energy down the EAC -> vibration of the tympanic membrane (area effect) -> sequential vibration of the middle ear ossicles: malleus, incus, stapes (lever effect) -> transmission of amplified vibrations from the stapes footplate in the middle ear to the oval window of the cochlea in the inner ear -> pressure differential on cochlear fluid creates movement along the basilar membrane within the cochlea from base to apex

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24
Q 
Normal hearing physiology
Neural pathway (nerve to brain)
A

basilar membrane vibration stimulates overlying hair cells
in the organ of Corti -> stimulation of bipolar neurons in the spiral ganglion of the cochlear division of CN VIII -> cochlear nucleus -> superior olivary nucleus -> lateral lemniscus -> inferior colliculus -> Sylvian fissure of temporal lobe

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25
Annular arrangement of lymphoid tissue in the pharynx
Waldeyer's ring
26
Tuning fork used in Weber and Rinne tests
512 Hz
27
What is a positive Rinne?
AC >BC
28
How do you report Weber's test?
``` heard centrally (Weber negative) lateralized to one side (Weber right, Weber left) ```
29
Weber Test Lateralization
ipsilateral conductive hearing loss or | contralateral sensorineural hearing loss
30
True or False. When conductive hearing loss is present, the Weber test is more sensitive in detecting the CHL than the Rinne test.
True
31
Interpretation of tuning fork tests: Weber central AC > BC ( +) bilaterally
Normal or bilateral sensorineural hearing loss
32
Interpretation of tuning fork tests: Weber Lateralizes to Right Rinne BC > AC (-) right
Right-sided conductive hearing loss, normal left ear
33
Interpretation of tuning fork tests: Weber Lateralizes to Left Rinne AC > BC ( +) bilaterally
Right-sided sensorineural hearing loss, normal left ear
34
Interpretation of tuning fork tests: Weber Lateralizes to Left Rinne BC > AC (-) right*
Right-sided severe sensorineural hearing loss or dead right ear, normal left ear *a vibrating tuning fork on the mastoid stimulates the cochlea bilaterally, therefore in this case, the left cochlea is stimulated by the Rinne test on the right, i.e. a false negative test. These tests are not valid if the ear canals are obstructed with cerumen (i.e. will create conductive loss)
35
Pure Tone Patterns in conductive hearing loss?
* BC in normal range * AC outside of normal range * gap between AC and BC thresholds > 10 dB (an air-bone gap)
36
Pure Tone Patterns in sensorineural hearing loss?
* both air and bone conduction thresholds below normal | * gap between AC and BC <10 dB (no air-bone gap)
37
Pure Tone Patterns in mixed hearing loss?
* both air and bone conduction thresholds below normal | * gap between AC and BC thresholds >10 dB (an air-bone gap)
38
Degrees of Hearing Loss?
``` Decibel loss / Degree of Hearing loss 0 to 20 dB Normal 21 to 40 dB Mild 41 to 55 dB Moderate 56 to 70 dB Moderate- Severe 71 to 90 dB Severe =/>91 dB Profound ```
39
Peripheral vs Central Vertigo Imbalance is usually more severe in which?
Central
40
Peripheral vs Central Vertigo Nausea and vomiting is usually more severe in which?
Peripheral
41
Peripheral vs Central Vertigo Auditory symptoms is usually more common in which?
Peripheral
42
Peripheral vs Central Vertigo Compensation is usually more rapid in which?
Peripheral
43
Characteristic of nystagmus in central vs peripheral vertigo
Peripheral - Horizontal, rotatory, unidirectional | Central - bidirectional, horizontal or vertical
44
Which semicircular canal is usually affected in BPPV?
Posterior
45
Most common cause of episodic vertigo.
BPPV
46
5 Signs of BPPV Seen with Dix-Hallpike Maneuver
* Geotropic rotatory nystagmus (nystagmus MUST be present for a positive test) * Fatigues with repeated maneuver * Reversal of nystagmus upon sitting up * Latency of -20 sec * Crescendo/decrescendo vertigo lasting 20 sec
47
Lenses that the patients can wear during the Dix-Hallpike | maneuver, which inhibit visual fixation and allow for better visualization of the eyes.
Frenzel's magnifying eyeglasses
48
How is the Dix-Hallpike Positional Testing performed?
* the patient is rapidly moved from a sitting position to a supine position with the head hanging over the end of the table, turned to one side at 45° holding the position for 20s * onset of vertigo is noted and the eyes are observed for nystagmus
49
Particle repositioning maneuvers in BPPV
* Epley maneuver (performed by MD) | * Brandt-Daroff exercises (performed by patient)
50
Other name for Meniere's Disease
Endolymphatic Hydrops
51
Etiology of BPPV
due to canalithiasis (migration of free floating otoliths within the endolymph of the semicircular canal) or cupulolithiasis (otolith attached to the cupula of the semicircular canal)
52
Definition of Meniere's
episodic attacks of tinnitus, hearing loss, aural fullness, and vertigo lasting minutes to hours
53
Proposed etiology of Meniere's
inadequate absorption of endolymph leads to endolymphatic hydrops (over accumulation) that distorts the membranous labyrinth
54
narrowest anterior air channel and is a common site of inflammation
Frontal recess
55
Muscles of mastication
Temporalis, Lateral and Medial Pterygoids,
56
Crescent shaped gap between uncinate and ethmoid bulla
Hiatus semilunaris
57
Demarcates from anterior versus posterior ethmoid air ce,lls
Basal lamella
58
Dividing line between anterior and posterior epistaxis
maxillary sinus ostium
59
Most common cause of vocal cord paralysis
Lung malignancy
60
Proper tuning fork fequency to be used in weber's and rinne's
512 Hz
61
Mild hearing loss
21-40 dB
62
Moderate hearing loss
41-55 dB
63
Moderate to severe hearing loss
56-70 dB
64
Severe hearing loss
71-90 dB
65
Profound hearing loss
more than or equal to 91 dB
66
Type C tympanogram is indicative of
Negative pressure peak Indicative of eustachian tube dysfunction Or early otitis media without effusion
67
Acoustic reflex threshold
70 to 100 dB greater than hearinh threshold
68
Most common cerebellopontine angle tumor
Acoustic neuroma

Otorhinolaryngology (1 decks)

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