Otorhinolaryngic surgery test on 9/30 Flashcards
Acous/p
hearing
audi/o
hearing
aur/o
ear
auricle/o
auricle
cochle/o
cochlea
mastoid/o
mastoid
myring/o
tympanic membrane
eardrum
ossicul/o
ossicle
ot/o
ear
staped/o
stapes
tympan/o
tympanic membrane
-cusis
hearing
-otia
ear condition
laryng/o
larynx
nas/o
nasal
ot/o
ear
parathyroid/o
parathyroid
pharyng/o
pharnyx
phren/o
mind
brain
phrenic nerve
rhin/o
nose
thyr/o
thyroid
Thyroid/o
thyroid
What structures are in the outer ear? where does it stop?
tragus
auricle
stops at tympanic membrane
What structures are in the middle ear?
eustachian tube
mastoid sinus
ossicles (malleus, incus, stapes)
oval window
round window
What structures are in the internal ear?
semicircular canals
cochlea- organ of corti
labryinth
What is the vestibulocochlear nerve? and what # nerve?
balance and hearing
# 8
What are the ways of physiology of hearing?
bone conduction
fluid conduction
nerve conduction
sound wave reception
What is the physiology of balance/equilibrium?
semicircular canals and vestibule (endolymph-fluid)
vestibular nerve
What structures are in the nose?
nares
nasal cavity (choanae)
nasal conchae (turbinate’s)
What is the purpose of sinuses?
make the head lighter?
What 3 areas make up the pharynx?
nose to esophagus
nasopharynx
oropharynx
laryngopharynx
What is the primary function of a thyroid gland?
iodine metabolism
normal growth and metabolism
How many lobes does the thyroid gland have?
2 connected by the isthmus near base of neck (anterior only)
Where are the parathyroid glands located? How many are there?
on posterior side of the thyroid gland
4 glands
What is the function of the parathyroid glands? What does it release?
regulation and maintenance of blood calcium concentration
releases parathormone for metabolism of calcium
Where does the blood supply to the thyroid/parathyroid glands come from?
inferior and superior thyroid arteries
When removing thyroid/ parathyroid, what should you never do?
through anything away
can be reattached
What is otitis externa?
“Swimmers ear”
infection or abscess to ear canal
What is otitis media?
inflammation/infection of the middle ear
caused by blockage or accumulation of fluid in eustachian tube- drain into nasopharynx
What is otosclerosis?
bony overgrowth on stapes
What is mastoiditis?
complication of acute otitis media (pain and purulent discharge)
If mastoiditis is untreated what can occur?
meningitis or encephalitis
What is deafness?
reduction in hearing
What are 7 types of deafness??
conduction deafness
central deafness
mixed-type deafness
functional deafness
congenital deafness
neonatal deafness
sensorineural deafness
Explain what conduction deafness is. Caused by? Is it permanent?
interference in soundwaves from external ear to middle ear
disease, infection, or trauma
possibly restored
Explain what central deafness is.
involves the cerebral cortex- brain
Explain what mixed-type deafness is.
involves conduction and the nervous system
Explain what functional deafness is.
psychogenic in nature
Explain what congenital deafness is.
present at time of birth
hereditary
Explain what neonatal deafness is.
occurs at birth
prematurity, trauma, Rh incompatibility
Explain what sensorineural deafness is.
“nerve deafness”
defect in cochlear or cochlear division of the nerve
What is Meniere’s disease?
disorder of the membranous labyrinth
dilation of the endolymphatic space
What structures can Meniere’s disease affect?
cochlea and/or vestibule
What can Meniere’s disease cause?
progressive deafness
vertigo
What is tinnitus?
“ringing of the ear”
possibly from damage to inner ear
What can cause tinnitus?
noise exposure
hearing loss
medications
earwax
ear infection
head and neck injuries
What can cause a ruptured tympanic membrane?
external trauma (q-tip)
pressure from middle ear
What are signs and symptoms of a ruptured tympanic mambrane?
pain
hearing loss
drainage
dizziness/ vertigo
What are signs and symptoms of vertigo?
sensation of spinning room
loss of balance
What are two types of vertigo?
peripheral
central
What is peripheral vertigo?
issue with inner ear that controls balance
What is central vertigo?
issue in the brain
What is cholesteatoma?
benign cyst or tumor
erodes mastoid cells
can damage ossicles
nerve 7 possibly damaged
What is epistaxis?
nosebleed
What are common causes of epistaxis?
trauma
drying of nasal mucosa
over blowing
hypertension
chronic inflammation
What are nose polyps? When are they common?
mass originating in mucous membrane
allergic rhinitis
What is sinusitis?
inflammation of mucosal lining of paranasal sinuses
serious if chronic or forming pus
What is choanal atresia?
congenital failure of nasopharyngeal septum to rupture during development
(blocked because baby doesn’t need to breathe but should rupture after birth so can breathe.)
What are the 3 salivary glands?
parotid
submandibular
sublingual
Explain where the parotid salivary gland is. What is another name for it?
largest near cheek area
Stensens duct
Explain where the submandibular salivary glandis. What is another name for it?
second largest by back jaw
Wharton’s duct
Explain where the sublingual salivary gland is. What is another name for it?
below the tongue
ducts of rivinus
What is tonsillitis? which tonsils are they?
inflammation of the tonsils
palatine tonsils visible at back of mouth
What is adenoiditis? which tonsils are they?
inflammation of the adenoids
pharyngeal tonsils
visible with mirror- upwards
What are two types of sleep apnea?
obstructive
central sleep
What is obstructive sleep apnea?
problem in upper respiratory tract preventing movement of air through nose and mouth
What is central sleep apnea?
brain fails to signal muscles controlling respiration
What is subglottic stenosis?
narrowing of airway below vocal cords above the trachea
congenital diseases
What is laryngitis?
inflamed larynx
acute or chronic
What are some issues that can occur with the thyroid gland?
cancer
tumor/ growth
excessive secretion of hormones
What are some signs and symptoms of issues with the thyroid gland?
can feel a mass
difficulty breathing
loss of voice
swollen lymph nodes
tiredness, loss of appetite, weight loss
What is a goiter?
enlargement of the thyroid
irregular cellular growth
What is hyperthyroidism?
the thyroid speeds up the bodys metabolism
What are some signs and symptoms of hyperthyroidism?
weight loss
hand tremors
rapid/ irregular heartbeat
protrusion of eyeballs
What causes hyperthyroidism?
graves disease-autoimmune disorder
thyroid nodules
thyroiditis
too much iodine
What is hypothyroidism??
underactive thyroid
lead to high cholesterol and heart problems
What are signs and symptoms of hypothyroidism?
tiredness
dry skin
weight gain
muscle pain
What causes hypothyroidism?
Hashimoto’s disease- autoimmune
thyroid surgery
radiation therapy
thyroiditis
What is hyperparathyroidism?
PTH increases levels of calcium in the bloodstream
affects nerve and muscle function and bone health
What are signs and symptoms of hyperparathyroidism? What can it lead to?
tiredness/ weakness
weak bones
kidney stones
convulsions or death
What is hypoparathyroidism? What can it lead to?
low calcium in the blood stream
increased phosphorous levels
can lead to tetany
What are 6 diagnostic studies for the ear?
initial assessment
audiometry
otoscope
ct scan
tympanogram
electronystagmogram (ENG)
What is used in the initial assessment for an ear appointment?
tuning fork
called weber/ rhine
What is an audiometry test?
machine emits tones at different tones
determines damage to conduction system
determines hearing aid
What is an otoscope test?
instrument to view outer ear
What is a tympanogram test?
probe placed against tympanic membrane to measure vibrations of the ear drum
What is an electronystagmogram test? What is needed to perform this test?
(ENG)
tests balance of inner ear
cool then warm H2O in ear canal
stimulates eye movement
What are the 4 diagnostic studies for the nose?
direct visualization
indirect visualization
radiography
angiography
What is done in a direct study of the nose?
directly look at
headlight used
nasal speculum
What is used in an indirect visualization study of the nose? What can be seen?
mirror
nasopharynx and posterior cavity
What can be seen in an indirect visualization study of the nose?
posterior nares
turbinates
posterior vomer bone
outlet of maxillary sinus
What radiography tests are done for the nose? and why?
x-ray for fractures and occlusions
Walters, Caldwell, lateral, and submental- sinus cavities
ct scan for bony and soft tissues
What direction is the head when taking the Walters, caldwell, lateral, and submental xrays of the nose?
walters- head up 45 degrees
caldwell- head down 15-20 degrees
lateral- straight ahead
submento- xray taken from uner the chin
What 8 diagnostic studies are done on the throat?
direct visualization
indirect visualization
laboratory tests
radiological tests
MRI
videostroboscopy
polysomnography
multiple sleep latency test (MSLT)
What can be seen in an indirect visualization of the throat?
nasopharynx and laryngopharynx with a mirror
What laboratory tests are done on the throat studies?
culture and sensitivity
blood count
What radiological exams are done for throat studies? Why?
xrays- pathology of larynx and trachea
ct scan- comparison of structures
Why is an MRI test done for a throat study?
view of soft tissue structures
Why is a videostroboscopy done for a throat study?
analysis of Endo laryngeal tissue during speech
movement of vocal cords
Why is a polysomnography study done for a throat test?
diagnose and determine severity of sleep apnea
Why is a multiple sleep latency test done for a throat study?
MSLT
measure time to fall asleep
avg time 10-20 min
less then 5 equals a disorder
What 3 positions are used in otorhinolaryngic surgeries?
supine-recumbent
might use a shoulder roll
semi-fowlers
What kind or surgical prep is used on the face?
Betadine
5% above the neck (blue bottle)
10% on the neck
or 50/50 saline and betadine
Are these surgeries considered sterile or clean procedures?
clean so not always draped
dr preference
What incisions are used?
median/ horizontal
post auricular
recurrent laryngeal nerve
What is a Caldwell-luc incision?
in oral mucouse membrane (in the gums)
What is an acoustic neurectomy? What kind of incision?
removal of tumor from schwann cells
near cochlear or vestibular nerve
post auricle incision through mastoid bone
What is a bone anchored hearing aid?
BaHa
implant behind ear directly into mastoid bone
What is a BaHa used to treat?
conductive or mixed hearing loss
single sided deafness
hearing loss from ear infections, Meniere’s disease, or neuroma
What is a cochlear implant? treatment of what?
prosthetic to replace cochlear portion of ear
sensorineural deafness
What structure of the ear must work in order to have a cochlear implant?
Organ of corti
What is a mastoidectomy?
removal of diseased mastoid bone
What is a mastoidectomy a treatment for?
mastoiditis
cholesteatoma
What nerve must be protected when doing a mastoidectomy?
cranial nerve 7 (facial nerve)
What are 3 types of mastoidectomies?
simple
modified radical
radical
What is a simple mastoidectomy? what incision is used?
removal of mastoid process air cells
postauricular incision
What is a modified radical mastoidectomy procedure?
removal of:
mastoid air cells
posterior & superior walls of external ear canal
will provide drainage from mastoid to canal
What is a radical mastoidectomy procedure?
removal of:
mastoid air cells
tympanic membrane
malleus
incus
What is usually preserved in a radical mastoidectomy? what is it covered with?
the stapes and facial nerve
temporalis fascia graft
What is an ossicular chain reconstruction?
placement of a prosthesis of one of the ossicles
What is a stapedectomy?
prosthesis of the stapes
total or partial
What can be used for a prosthesis for a stapedectomy?
vein graft
polyethylene tubing
What is a myringotomy?
incision into tympanic membrane to release fluid in middle ear
What does a myringotomy treat?
otitis media
How many types of procedures are there for myringoplasty/ tympanoplasty?
5
called type 1 to 5
What is damaged in a type 1 myringoplasty/ tympanoplasty? What is used as the graft?
damage limited to tympanic membrane
middle ear intact
soft tissue (auricle fascia) graft
What is damaged in a type 2 myringoplasty/ tympanoplasty? What is used as the graft?
damage includes malleus
remove part or all of malleus
tympanic graft directly against malleus or incus
What is damaged in a type 3 myringoplasty/ tympanoplasty? What is used as the graft?
malleus and incus damaged
replacement tympanum against stapes
What is damaged in a type 4 myringoplasty/ tympanoplasty? What is used as the graft?
all ossicle affected
graft sets on stapes footplate
reconstruct ossicle chain
What is damaged in a type 5 myringoplasty/ tympanoplasty? What is used as the graft?
all ossicles affected
stapes footplate fixed
tympanic graft seals middle ear and protects oval window
What is a FESS?
functional endoscopic sinus surgery
direct visualization of paranasal sinuses and walls
intranasal or external incisional approach
balloon sinuplasty
What is a FESS for?
polyps
remove diseased mucosa
remove tissue obstruction
restore drainage
What is a submucosa resection?
incision of mucosa membrane
perichondrium or periosteum lifted
structures under mucosa removed to help breathe normal
What is a polypectomy?
removal of nasal polyp
common in allergic rhinitis
What is the Caldwell-Luc incision? Why?
type of antrostomy
incision above teeth line
removed disease portions, evacuate sinus contents, drainage through nose
What is a septoplasty?
repair of septum abormality
What are two types of septoplasties?
septal perforation
deviated septum
Explain what a septal perforation is.
caused by:
cancer, chemical exposure, drug use
whistling noise
Explain what a deviated nasal septum is?
septum is to one side
aging or trauma
What is a turbinectomy?
removal of turbinate’s
(usually inferior turbinate)
What does a turbinectomy treat?
chronic nasal congestion
deviated septum
snoring
chronic rhinitis
What is a valve reconstruction?
reshape and strengthens structural support of the nostrils
What does a valve reconstruction treat?
nasal valve collapse
What are the three types of valve reconstruction.
batten graft
spreader graft
rim graft
What is an internal maxillary artery ligation?
performed to control persistent nasal hemorrhage
reduces blood to the posterior portion of nose
What is an esophagoscopy?
examination of the esophagus with an EGD
What is a laryngoscopy?
visual of larynx
by esophagoscopy or bronchoscopy
obtain specimen for dx purpose
What is a laryngectomy? What does the procedure treat?
removal of larynx
cancer and severe damage
What are the 3 types of laryngectomies?
supraglottic
hemi
total
What is the supraglottic laryngectomy? What type of incision is used? What will the patients voice be like after?
removal of:
epiglottis
false vocal cords
hyoid bone
horizontal incision
normal voice
What is the hemi laryngectomy? What type of incision is used? What will the patients voice be like after?
removal of:
1 true vocal cord
1 false vocal cord
arytenoid
half thyroid cartilage
vertical incision
hoarse voice
What is the total laryngectomy? What will the patients voice be like after?
removal of:
entire larynx
epiglottis
true and false vocal cords
hyoid bone
cricoid cartilage
upper tracheal rings
loses voice- uses a stoma for breath
What is a glossectomy procedure?
partial or total removal of the tongue
possibly floor of the mouth
What does a glossectomy procedure treat?
oral cancer
What is a mandibulectomy procedure?
partial or total removal of lower jaw
possibly floor of mouth and tongue
What does a mandibulectomy procedure treat?
oral cancer extending into mandible
What is used for the reconstruction of a mandibulectomy?
composite graft
fibula
What is a parathyroidectomy procedure?
excision of the parathyroid glands
How many parathyroid glands can be removed/excised? Why?
3.5
avoid hypoparathyroidism and tetany
What is a parotidectomy procedure?
subtotal or total removal of parotid glands & tumors/lesions
majority of benign tumors
What is a complication of a parotidectomy procedure?
facial nerve paralysis
use nerve stimulator
What happens in a radical neck dissection procedure?
removal of
cervical lymph nodes
jugular vein
SCM sternocleidomastoid
What is a thyroidectomy procedure? What does it treat?
removal of thyroid
malignancy
What is a substernal or intrathoracic thyroidectomy procedure?
excision of enlarged goiter
may cause esophageal or tracheal compression
What are tonsillectomy and adenoidectomy procedures? What retractor is used?
removal of tonsils and adenoids
hurd retractor
Why are the tonsils and adenoids removed?
treat chronic tonsillitis or sleep apnea
What are tracheotomy and tracheostomy procedures?
insertion of device to provide patent airway
What is a uvulopalatopharyngoplasty procedure? What does it treat?
UPPP
resection of redundant tissue, tonsils, soft palate, and/or adenoids
corrects obstructive sleep apnea and snoring
What type of vasoconstrictors are used in ENT cases?
afrin
cocaine
epinephrine
When is nitrous oxide NOT used?
middle ear surgery- causes pressure
What is a coblator?
controlled ablation
low temp radiofrequency and electrically conductive saline to remove tissue
What laser is used in middle ear procedures?
argon
vaporizes/ cuts tissue
welds tissue
used in middle ear surgery
On what structure is a bur used? What is it for?
ear
remove small amounts of bone
spins
What blade is most often used in oropharyngeal surgery?
12 blade
Are ENT cases clean or sterile procedures?
mostly clean
