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Year 4 ENT > Otalgia > Flashcards

Otalgia Flashcards

1
Q

what are the types of otalgia

A

primary

secondary / referred

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2
Q

what is primary otalgia

A

pain coming from the ear itself e.g. pinna, external/middle/inner ear

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3
Q

what is secondary/referred otalgia

A

pain that arises from elsewhere that is supplied by the same nerves

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4
Q

external ear causes of otalgia

A 
otitis externa 
malignancy 
necrotising otitis externa 
perichondritis of the pinna
shingles
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5
Q

middle ear causes of otalgia

A 
acute otitis media 
malingering 
mastoiditis 
deep temporal bone erosion 
trauma
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6
Q

inner ear causes of otalgia

A

vestibular schwannoma

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7
Q

what is Jacobson’s nerve

A

Branch of CN IX in middle ear

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8
Q

What is Arnolds nerve

A

Branch of CN X in EAC

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9
Q

Which nerves can cause referred otlagia

A 
C2,3
CN V
CN VII
CN IX
CN X
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10
Q

causes of C2,3 referred otalgia

A

arthritis
spondylosis
soft tissue injury

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11
Q

causes of CN V (mandibular) referred otalgia

A

dental - caries, abscess, impaction
TMJ dysfunction
nasopharyngeal disease: viral, tumour

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12
Q

causes of CN IX referred otalgia

A

oropharyngeal
- infection: pharyngitis, tonsillitis, quinsy, post tonsillectomy
tongue base tumour

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13
Q

causes of CN VII referred otalgia

A

sphenoid sinus

palate

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14
Q

history taking for otalgia

A 
Pain - SOCRATES 
5 cardinal ear symptoms 
PMH 
SH - alcohol, smoking
FH
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15
Q

what are the 5 cardinal ear symptoms to ask anyone in an ear history

A 
otalgia 
discharge 
hearing loss 
tinnitus 
vertigo
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16
Q

what should you assess in otalgia

A

otoscopy and ear exam
TMJ - feel the joint as patient opens and closes mouth
oral cavity - teeth, tongue
oropharynx
neck - lymph nodes
CN exam - CN VII at least!!! should be full exam
flexible endoscopy - post nasal space, tongue base, pharynx and larynx

17
Q

management of dental otalgia

A

chronic pulpitis
tenderness to percusion
dentist / maxfax
NSAIDs, soft diet, dental guard

18
Q

otalgia associated with TMJ disorder rarely comes from the joint itself, true or false

A

true, it often comes from the muscles of mastication

19
Q

cardinal features of TMJ dysfunction

A

pain around TMJ
trismus
crepitus / cracking
tenderness over joint or associated muscles

20
Q

drug management of neuralgias

A

carbamazepine
gabapentin
amitriptyline

21
Q

list some ENT red flags

A

hoarse voice
severe pain
weight loss
smoking / alcohol history

22
Q

investigation for red flags

A

CT scan

MRI scan

23
Q

features of neuralgia

A

severe unilateral pain

Year 4 ENT (18 decks)

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