Brainscape's Knowledge GenomeTM

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


See full index

SEMESTRE 7 > Otorrino ordinario > Flashcards

Otorrino ordinario Flashcards

1
Q

Nasal epithelium

A

ciliated, pseudostratified columnar

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

a donde drena el nasolacrimal duct

A

al inferior meatus

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

a donde drenan los frontal, maxillary and anterior sinues

A

al ostheomeatal complex

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

a donde drena el posterior ethmoid sinus

A

al superior meatus

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

a donde drena el anterior ethmoid sinus

A

middle meatus

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

a donde drena el sphenoid sinus ostia

A

to the superior turbinate

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

the vasculatiry its given by..

A

Internal carotid –> ophthalmic–> anterior and posterior ethmoid arteries

External carotid –> sphenopalatine artery

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

the venois drainage its by…

A

pterygoid and ophtalmic plexuses

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

Principales symptoms of rhinits

A

nasal obstruction, hypeirrtibility and hypersecretion

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

persistent rhinits

A

more then 4 days a week AND more the 4 weeks

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

intermitent rhinits

A

symptoms for less then 4 days a week or less then 4 weeks

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

mild vx moderate/severe rhinits

A

normal or abnormal sleep (moderate and severe)

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

symptons of NON allergic rhinitis

A

nasal obstruction, clear rhinorrhea,
not tha common: sneezing, itchy and watery eyes

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

viral non allergic rhinits

A

associated with other manifestations of viral illness: headache, malaise, body aches, cough.

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

occupational non allergic rhinits

A

pollutants like dust, ozone, garden sprays, etc. (irritant agents). Nasal dryness.

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

vasomotos non allergyc rhinits

A

symptons associated with changes of temperature, eating, alcohol use, etc.

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

non allergyc rhitis with eosinophilia

A

they have more severe exacerbations (eosinophilia >25%)

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

medicamentosa non allergic rhinits

A

because of the over-the-corner topical vasoconstrictive nasal sprays (Afrin most common drug that gives this)

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

pregnancy non allergic rhinits

A

rise of estrogen –> rise of hyaluronic acid –> rise of nasal edema and congestion

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

basic tx of non allergic rhinits

A

-Irritant avoidance
-Saline irrigation (for a clean nose, improves ciliary function)
-Topical Intranasal steroids (reduce eosinophil and neutrophil chemotaxis and inflammation) (don’t give IV, IM)
-a-adrenergic drugs (2 main familys: phenylamines [contraindicated in px with hypertension, coronary artery disease, etc] and imidazolines)
-Anticholinergics (ipratropium, azelastine, cromolyn, etc)

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

for mild intermittent/persistent non allergic rhinits TX

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

for moderate/severe intermittent non allergic rhinitis tx

A
  1. INAH
  2. INCS
  3. IN (AH & CS) o INAH + INCS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

for moderate/severe persisiten non alergic rhintis tx

A
  1. IN (AH & CS) o INAH+ INCS
  2. INAH
  3. INCS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

surgical measures for non allergic rhinits

A

septoplasty and turbinate surgery (inferior turbinate)
*for anatomical problems

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

pathogenesis de allergic rhintis

A

IgE- mediated inflammatory nasal condition resulting from allergen introduction (sensitazion fase) and early inflammation by mast cell that liberates histamine and then late inflammation caused by chemotaxis (2 phase) (type 1 hypersensitivity)

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

typical symptoms of allergic rhinits

A

sneezing, itching, rhinorrea and nasal congestion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

classification: season allergic rhinits

A

symptoms usually worst in the morning, aggravated by dry, windy conditions

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

classification: perennail allergic rhinits

A

only happens in specific moment or places, indoor inhalants like dust mites, animal dander, mold spores, etc. Most common sign its nasal congestion

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

FR de allergic rhinits

A

family history (atopias)

Male sex

Birth during the pollen season

1 born

Early use of antibiotics

Maternal smoking exposure

Exposure to allergens

Associated chronic conditions: asthma, otitis media with effusion

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

for intermittent mild allergic rhintis tx

A
  1. OAH o INAH
  2. OAH + PSE
  3. INCS
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

for intermittent moderate/severe allergic rhinits tx

A
  1. OAH o IANH
  2. INCS
  3. IN (AH & CS) o INAH + INCS
  4. OAH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

for persisiten mild allergic rhintis tx

A
  1. INCS
  2. OAH o INAH
  3. OAH + PSE
  4. Intranasal cromolyn sodium
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

for persistent moderate/severe allergic rhinits tx

A
  1. IN ( AH & CS) or INAH+ INCS
  2. INCS
  3. INAH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

dx for allergic rhinits

A

-Complete HC
-Physical examination
-Rhinoscopy: bluish, pale, boggy turbinates, wet and swollen mucosa, nasal congestion (predominant sign in perennial allergies), anatomic abnormalities
-Conjunctivitis, eczema, asthmatic wheezing, nasal salute, OME
-Allergy testing
-Skin testing (skin-prick test SPT most common, (gold standard)
-ID testing
-In vitro testing

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

Etiología rhinosinusitis

A

90% viral (sintomas < 10 dias y no empeoran)
sintomas que te orientan a bacteriano: purulent rhinorrhea, facial pain/pressure, and nasal obstruction., fever >38°, unilateral

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

bacterias mas comunes en ARS

A

Streptococcus pneumoniae, Haemophilus influenzae, M. catarrhalis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

bacterias más comunes en CRS

A

S. auerus. P. auriginos, H. influenzae, Anaerobios

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

acute rhinosinusits ARS generalidades

A

incia como un resfriado, normalmente es vrial ( adenovirus, rhinovirus, respiratory virus)

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

acute rhinosinusitis ARS dx

A

2 o mas sintomas, 1 a fuerzas nasal congestion o nasal discharge y el otro facial pain, reduction or loss of smell de > 4 semanas

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

subacute rhinosinusitis

A

4-12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

recurretn acute rhinosinusists

A

4 or more episodes in 1 year, with complete resolution between episodes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

CRS

A

2 or more symptoms, one of which should be either nasal blockage/congestion or nasal discharge, and facial pan/pressure, reduction or loss of smell for > 12 weeks

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

classification of CRS

A

-primary CSR: unilateral o bilateral
-secundary CSR: localize o diffuse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

dx rhinosinusists

A

2 o mas major factors + 1 minos

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

mayor factors RS

A

facial pain/pressure
nasal obstruction/blocakege
nasal dishcarge/ postnasal drainage
hyposmia
purulance
fever

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

minor factors RS

A

headache
fever
halitosis
fatgiue
dental pain
cough
ear pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

caldweel RX

A

for ethomoidal and frontal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

water rx

A

maxillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

lateral rx

A

Sphenoid, Frontal, ethmoidsandmaxillary

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

lund mackey system

A

del 0 al 2(obstruccion total) y en ostiomeatal complex es 0 o 2 , se califica cada lado, de 0-6 es leve, 6-10 moderado y >10 severo

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

que sinues califica lund mackey system

A

-frontal
-anterior ethmoidal
-posterior ethmaidal
-maxillary
-esphenoid
-osteomeatal complex

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

pathogenesis the RS

A

Mucosal swelling (allergy, infection, enviorment, etc)–> obstruction of sinus ostia –> mucus stasis –> infecion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

TX ARS

A

Saline irrigation

Nasal steroids

Antibiotics (for bacterial): amoxicillin with clavunate

Antihistamine

Systemic steroids

Decongestant (like Afrin: oxymetazoline)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

tx CRS

A

Antibiotics

Nasal steroids

Saline irrigation

Leukotriene antagonist

Oral steroids

Antihistamine

Monoclonal bodies (omalizumab [ige] or mepolizumab [IL5]

Antifungal

fuctional endsocpic sinus surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

tx for CRS with polips

A

dupilamab

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

tx fungal infectio RS (common in no control DM)

A

Anfortemince B

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
57
Q

alarma symptoms in RS (inmediate referral)

A

-periorbital edema/erythema
-displaced globe
-dobule vision
-ophtalmoplejia
-reduced visual acuity
-severe headche
-frontal swelling
-signs of sepsis
-signs of meningitis
-neurologicla signs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
58
Q

chandler complicatiosn of SR

A

1 inflammatory edema: no visual lost ni ophtalmoplejia

2 Orbital cellulitis: pain, proptosis, chemosis, little ophthalmoplejia, edema of extra vascular muscles and mild disminución of agudeza visual tx: intravenous antibiotic

3 Subperiosteal abscess: operative drainage

4 Orbital abscess: proptosis, chemosis, ophtalmoplejia, visual lost operative drainage

5 Cavernous sinus thrombosis: tromboflebitis, 3,4,5 NC affected, life threatening, IV antibiotic + OR drainage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
59
Q

most common emergency 60% in otorrino

A

epistaxis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
60
Q

causes epistaxis

A

1° idiopathic
2° traumatic
3 iatrogenic

leucemia (common in children)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
61
Q

irrigation of nasal cavity
EXTERNAL CAROTID

A

-facil artery (anterior nasal septum)
-internal maxillary artery
-sphenopalatine artery
(septal y conchal brand)
-descendign palatine
artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
62
Q

irrigation of nasal cavitiy
INTERNAL CAROTIDE

A

-ophtalmic artery
-anterior ethomoid artery
-posterior ethomoid artery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
63
Q

el 90% de anterior epistaxis viene de

A

Kieselbach plexus or littles area

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
64
Q

la anterior y posterior (dificl de controlar la bleeding) epistaxisi se divide por el

A

ostium of the maxillary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
65
Q

cuantos ml es lo habitual de epistaxisis

A

700-900 ml

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
66
Q

manegement epistaxis

A

-initial assesment (HC, EF, BH, future crossmatching)
-headlamp examination (local anestesia)
-nasal endoscopy (mostly in posterior)

  1. identify site de sangrado
  2. buscar patolgoia desecadenante
  3. digital pressure on alar cartilages fot 20 min
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
67
Q

most common source of bleedign in children

A

from a vessel in the mucocutaneous junction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
68
Q

5-10% of epistaxisis in children its cause

A

of an undiagnosed von willbrand disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
69
Q

tx epistaxis

A

-topical silver nitrate
-petroleum jelly (Best method)
-cautery in OR (NEVER bilateral)
-nasal packign with antibiotic (gauze, bilateral,) (never in children)

*if after packing sigue sangrado, suele ser posterior, y se manda al otrorrino para poner foley catheter

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
70
Q

every posterior epistaxis belongs in the hospital

A

true

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
71
Q

tx posterior epistaxis

A

-nasal packing
-gold standar: cauterization (endoscopic sphenopalatin artery ligation)
-maxillary a., external carotid a. ligation
-embolization

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
72
Q

donde es mas comun una neoplasia paranasal de sinus

A

en el maxilary sinus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
73
Q

sintomas que sugieren proceso neoplasico

A

unilateral swelling, pain, and epistaxis.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
74
Q

que es lo primero que pido ante un tumor

A

CT scan WITH constras and RM (T1 liquod negro, T2 liquido blanco)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
75
Q

inverted papilloma “scheinderian tumor”

A

Most common benignal tumor, HPV has 75% grade of malignization, usually men, usually on maxilary sinus, pale, multiboluted, dx CT with contrast and MR
-TX: surgical resection +adyuvant RT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
76
Q

osteoma

A

slow growth, benignal, 2-5° decade of life, males, msot common place: anterior ethomidal, the frontal then maxillary then sphenoidal
-tx: watchfull waiting, open approach

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
77
Q

juvenile angiofibroma

A

vascular tumor, adolscent boys, usually in the pterigomaxilar fosse. has holamn miller sign (tumor psuhes the posterior bone of maxillary sinus)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
78
Q

juvenile angiofibroma manifestations, and tx

A

-common manifestation: recurrent epistaxis, nasal voice, eustachian tube dysfunction
-tx: surgical resection after embolization preop
AVOID BIOPSY

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
79
Q

Lobular capillary hemangioma

A

caused by Nasal trauma

Microscopic AVM

Veryyy small and can grow sooo much

beingn

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
80
Q

fibrous dysplasia

A

-tumor on the bone medula
-loose teeth, numbness, facr assymetry
-tx: observation, embolization 1°, cx (quitan todo el hueso, queda el hueco) 2°,

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
81
Q

squamosu cell carcioma

A

-most common mallignat tumor
-cx + rt
-bado rpognosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
82
Q

olfatory neuroblastoma

A

-olfacory epithelium
-malignat
-extension to the orbit and anterior fossa
-kadish classification

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
83
Q

ESTHESIONEUROBLASTOMA

A

from the olfatory epitheluim
-anosmia, iposmia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
84
Q

larynx roles

A

-protection (epiglotis, vocal cords, cough
-respiration
-phonation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
85
Q

we divide the larynge in:

A

-supraglottic (suprahyoid and infrahyod epiglotis, ariepiglotic folds, aritenoids, vocal fols)
-glottis (vocal cords)
-subglottic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
86
Q

cartilages of the larynx

A

-Epiglottis
-Thyroid (biggest, protection of vocal cord)
-Cricoid (like an incomplete ring, attachment with the traquea)
-Cuneiform
-Arytenoid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
87
Q

muscles in the larynx are inerveted by the

A

-recurretn laryngeal nerve (branch of vagus)
-other ones: superior laryngeal nerve (external [moves cricothyroid msucle] and internal [gives the sensibility])

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
88
Q

vocal cords

A

-anterior view es donde se forma el pico de la V
-es un squamous stratified epitheluim
-most common cancer in cords: suqamosu cell carcinoma
-has tyroarithenoid muslce

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
89
Q

que divide larynge de hipofarigne?

A

the aryepiglothic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
90
Q

4 types of cords paralisis

A

-vagal bialteral
-vagal unialteral
vocal cords in intermediate position (cadaveric)

-recurrent laryngeal bilateral
-recurrent laryngeal unilateral
parameida position
*recurrent larygneal are more common
*leer its more common

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
91
Q

vagal bilaterla cord paralysis

A

idiopathic or neurological causes, CANT generate voice, hisotry of choking

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
92
Q

vagal unilateral cord paralysis

A

iatrogenic, neoplasia, brainstem infarction
-weak, breathy hoarseness
-history of aspiration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
93
Q

recurrent laryngeal cord paralysisi bilateral

A

-usually after a cx
-Stridor, problems breathing
-no dysphonia
-its an emergency

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
94
Q

tx of recurrent laryngeal cord paralysis

A

-lateralization of vocal cord (but wont be able to speak)
-or cordectomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
95
Q

recurrent laryngeal cord paralysisi unilateral

A

-causes: neoplasia, iatrogenic, trauma, anerurysm (left)
-hay disphonia
-bovine cough
-tx: vocal and speech therapy, hyalurnic acid or fat to the cord, or thyroplasty (impkan tpushes the cord to middle line)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
96
Q

bening laryngeal lesions

A

vocal cord nodules, polyps, intubation granuloma, reinke edema, laryngeal cyst, laryngocele, papillomatosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
97
Q

vocal cord nodules

A

-comunes en gente que usa mucho la voz
-nodulos no permiten que se toquen las cuerdas: dysphonia
-bilateral
-in the junction of the 1/3 anterior and 2/3 posterior
-tx: speehc therapy 3 meses, no se extirpan porque crecen back

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
98
Q

vocal cord polyps

A

-unilateral
-red and pednculated
-por reflujo o UN esfuerzo vocal grande
-tx: speech therapy 3 months, omprazol and cx (take out polyp)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
99
Q

intubation granuloma

A

-usually unilateral
-neer to the arythenoid process
-in posterior 1/3
-px with intubation hisotory
-tx: NO smoking or drinking, dietic control, speech therapy or cx (quitas tejido para adelgazar la cord)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
100
Q

reinke edema

A

-Bilateral in the lamina propia
- Diffuse polyposis of the vocal cord (like they have water inside)
- Risk factor: smoking
- Clinic: raspy voice (like alejandra guzman)
- Treatment
o Avoid smoking, food irritants and voice overuse
o Speech therapy
o If that doesn’t work: surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
101
Q

laryngeal cyst

A

-usually unilateral
-INSIDE the mucosa (full of mucosa and epithelial cells)
-big
-dysphonia
-tx: surgery 1°

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
102
Q

papillomatosis

A

-infection by VPH 6 and 11
-children
-lesiones verrugosas en larynx
-dysphonia
-tx: surgery (but they grow again)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
103
Q

malignant laryngela lesions donde es mas comun de las vocal cros

A

1 glotis 59%
2 supraglotis 40%
3 suglotis 1% (bad prognosis)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
104
Q

in stage 3 we never have vocal cord fixation

A

false, we ALWAYS haver cord fixation in a malingant laryngeal vocal cord tumor

105
Q

tx of malingant laryngeal vocal cord tumor

A

Early stage T1 or T2: take a biopsy, send it to the surgeon oncologist to see if they can resect the tumor, so they need RT or cordectomy (lo hace el otorrino)

Advance stage T3 y T4: dual modal therapy: surgery and adjuvant RT

dx: CT scan

106
Q

tonsils

A

-1 adenoid (biggest)
-2 tubal
-2 palatines (in the orofarin, we see them)
-1 lingual

107
Q

2 pillars delimitate the tonsillar fossa

A

-palatoglossal muscle (anterior pilar)
-palatopharyngeal muscle (posterior pilar)

108
Q

irrigation of tonsils

A

branches of the external carotid artery

109
Q

Most common complication if a tonsillectomy:

A

bleeding

110
Q

adenotonsil disease

A

-usually viral (adenovirus, rhinovirus, covid, influenza [aqui si se da ocetamivir], parainfluenza, syncytial)
-it looks red, hyperemia, edema (se da tx sintomatico, antihistamines, AINES, don’t give antiviral)

111
Q

coxsaquie

A

-presence of herpangia in the tonsils
-hay aftas
-very high fever for days
-tx sintoamtico NO antibiotics

112
Q

herpes

A

-VHZ por varicela
-vesicles in soft palete, tosnisl,
-history of varicela or vesicles in lips
-very painful, neuropatic pain
-tx: aciclovir, valaciclovir

113
Q

mononucleosis

A

-VEB
-linfaadenopaty
-white-grey exudate localized
-too much adenopaty, fever
-complication: hepatoesplenomegaly

114
Q

b-hemolytic

A

complete hemolysis

115
Q

a-hemolytic

A

partial hemolysis

116
Q

y-hemolysisi

A

no hemolysisi

117
Q

bacterian adenotonsil desease

A

-purulent exudate, inflammation, pus generalized
-give antibiotic
-most common bacteria: acute streptococco

118
Q

Acute Streptococcal Pharyngotonsillitis

A

-group A b-hemolityc (GABHS)
-most common cause of acute bacterial
dx: gold standar blood agar plate (BAP)
tx: 10-day course of penicillin V or amoxicilina

119
Q

no suppurative complications of adenotonsil desease

A

-scarlet fever: “strawberry tongue”, fever , rash
-rheumatic fever: can cause heart damage. (1-4 semanas desp)
-poststreptoccocal glomerulonephritis (1-2 semanas desp)
-Pediatric autoimmune neuropsychiatric disorder associated with group A streptococcal (PANDAS): in children with TOC

120
Q

tx para reumatic fever

A

peniciclian benzatina 1,200, 000 unit every 21 days for 3 months

121
Q

suppurative complications of adenotonsil desease

A

-peritonsillar abscess (abscess surrounding the capsule of the tonsil, que emuja la tonsil so se ve mas inflamado de one side, its bilateral, se da ceftriaxone, it’s a big infectiosn, sometimes they go to the hospital, hot potato voice/ muffled voice
-parapharyngeal space abscess (decreased neck range of motion)
-retropharyngeal bases (spread t lymph nodes, usually in childre)

122
Q

paradise criterio for tonsilectomy

A

-7 o mas epidosido en el año o 5 o mas epidosidos en cada año en 2 años, o 3 o mas episodios en cada año en 3 años
-fiebre >38.3 o lymphandeopati cervical (nodes > 2 cm) o exudado en las tonsil, cultivo positivo para a-hemolitico strepto
-tosnil cronicas sin respuesta a tx
-roncar y respirar por boca
-sleep-disordered breathing
-tonsialr diseas with dysphagia
-tosnila disases with craniofacil growth
-monucleosis with obstructive tonsilar hypertrofphy

123
Q

grades oftonsil obstruction

A

satge 1: <25%
stage 2: 25-50%
stage 3: 50-75%
stage 4: >75% (they are touching)

124
Q

centor criteria para ver si es bacteriana

A

fever 1
tosnilla exude 1
absent cough 1
anterior cervical Linphadenopaty 1
3- 14 años 1
15-44 años 0
>44 años -1

125
Q

centor score valores risk of infection

A

0: 1-2.5% risk
1: 5-10% risk
2: 11-17% risk
3: 28-35% risk
4 > 51-53% risk

*apartir de 3 puntos das antibiotico

126
Q

diphteria

A

membrane on the tonsil that blocks the airway

127
Q

chronicotonsillitis: cassium

A

se acumula food en la tonsil

128
Q

muscle that opens the vocal cord

A

posterior cricoarythenoid

129
Q

Behavioral audiologic measures

A

-pure tone air conduction
-pure tone bone conduction
-speech-recognitios threshold (STR)
-suprathreshold speech recognition socres

130
Q

Objetive physiological measures

A

-otoacousitc emissions
-acoustic admittance test battery
-tympanometry
-acoustic-reflex threshold (adaptation)

131
Q

objective auditory electrophysiologic measures

A
  • auditory evoked potentials testing/ electrocochleography (ECochG)
  • auditory brainstem response (ABR)
    -auditory middle latency response (AMLR)
    -auditory steady state response (ASSR)
    cortical auditory evoked potentials (CAEPs)
132
Q

puretone audiogram: air-conduction thresholds (AC)

A

-frequencies 250, 500, 1000, 2000, 4000, 8000 hertz
-we can block the none tested ear with masking noise

133
Q

puretone audogram: bone conduction thresholds (BC)

A

-frequencies: 250, 500, 1000, 2000, and 4000 Hz
-with a bone vibrator placed in the mastoid process of temporal bone.
-it shoul be in an isolated room

134
Q

Normal hearing audiogram

A

-10 to 25 db
-x its frequency (Hz)
-y its dB

135
Q

audiogram symbols

A

-red: right
-blue: left
-AC: circule (right) and X (left)
-BC: < (right) and > (left)
-AC masked: triangle (right) and square (left)
-BC masked: [ (right) and ] (left)
BC always arriba de AC

136
Q

que indica HL en AC and BC

A

-AC: heraign problem in the conductive and/or sensorineural
-BC: just sensorineural

137
Q

air bone GAP

A

difference of dB between AC and BC
-in normal hearign its < 10dB

138
Q

normal hearing

A

-AC: < 25
-BC: <25
-ABG: <10

139
Q

normal hearing with significant ABG

A

-AC: <25
-BC: <25
-ABG: >10

140
Q

conductive HL

A

-AC: >25
-BC: <25
-ABG: >10
-ej: otitis media or external, ear wax, tumor on middle or external ear, eustachian tube dysfunction, genetic HL like treacher collins sx

141
Q

sensorineural HL

A

-AC: >25
-BC: >25
-ABG: <10
-Ej: noise-induced HL, presbycusis, ototoxicity, meniere diseas, genetic HL like Connexian 26, Usher sx, acosutic neuroma, esclerosis multiple, sx caratgena, schwannoma

142
Q

PTA pure tone average

A

-para ver la magnitud de la HL
-vemos los db de 500, 1000 y 2000 hz, los sumas y dividimos entre 3
-solo los valores de AC

143
Q

mixed HL

A

-AC: >25
-BC: >25
-ABG: >10
-ej: otosesclerosis and presbycusis, uno y uno

144
Q

Normal PTA

A

<25

145
Q

mild PTA

A

25-40

146
Q

moderate PTA

A

40-55

147
Q

modeately severe PTA

A

55-70

148
Q

severe PTA

A

70-90

149
Q

profound PTA

A

> 90

150
Q

high frequencie audiometry

A

-test at 9000, 10000, 11,200, 12,500, 14.000, 16.000, 18.000 y 20.000 Hz
-nos dice sobre early ototoxic effects (gentamicen, amicasin), early presbycusis or early noise-induced HL

151
Q

interaural attenuation

A

The reduction in intensity of a signal, such as a pure-tone signal, as it travels by BC from the TE to the NTE (where the masking goes)

152
Q

speech audiometry

A

–spondaic or speechrecognition threshold (SRT): based on spondaic words bisyllabic
-es a la intensidad mas baja a la que el px repite las palabras

153
Q

Retrochoclear lession

A

with more dB, they hear more distortion instead of hearing ir louder

154
Q

TPP tympanometric peak pressure

A

-unit: daPa
-its when the air pressure intriduced in to the external ear, equals de pressur ein the middle ear

155
Q

TPP typanometric peak pressure

A

low: < -50 daPa its not normal, suggestive of eustachian tube dysfunction
normal: >.35 daPa

156
Q

tympanometry

A

measures the movement of the tympanic membrane
-speaker at 225 hz

157
Q

peak-compensated static-acoustic admittance

A

in adultos: 0.35-1.30
-abajo de eso: rigidez
-arriba: ossicular discontinuity or tympanic perforation

158
Q

type A tympanometry

A

normal TPP
normal peak height
normal middle ear function

159
Q

type Ad

A

-TPP normal
-admitance higher peak height >1.30
-ej: ossicular discontinuity

160
Q

type As

A

-reduced height at the peak (admitance < .35)
-normal TPP
-stiffening middle ear, like otoesclerosis

161
Q

type B

A

flat tympanogram
-stiffening middle-ear pathology or tympanic membrane perforation (or a patent tympanostomy tube), ear wax, foreign body, air fluid levels

162
Q

type C

A

-negative TPP (<-50)
-eustachian tube-dysfunction

163
Q

little bones:

A

-malleus (pegado al timpano)
-incus (de enmedio)
-stapes (parece una Y)

164
Q

Acoustic reflex

A

-se oye un ruido fuerte en un oido, y se contraen los 2 musuclos
-primary muscle involved: stapedius, su origen es in the pyramidal eminene of the tympanic cavity, y se inerva por 1 branch of facial nerve
-at high intesities: the tensor tympani (inervado por trigeminal nerve

165
Q

pathway acoustic reflex

A

-ipsylateral: Coclea –> NC8 –> nucleo coclear–> facial nerve (7) –>stapiduis
-contralateral: coclea –> NC8 –> nucleo coclear–> contralteral meadlle supirior oliva nucleos –> facila nerve motor –> stapiduis (el contralateral)

166
Q

otoacustic emissions

A

-records the sound of the movement of the outer hair cells
-dx of hering disordes in infants

167
Q

Auditory brainstem responses (ABRs)/ brainstem auditory evoked potentials (BAEPs)

A

it evaluates all the auditory pathway

168
Q

anatomy of the external ear (pinna)

A

-24 mm length with 1-2 ml volume
-lateral 1/3 its fibrocartilage
-medial 2/3 it sbone
-junction de esos es narrowest poinr

169
Q

pinnas skin

A

-Stratified squamous epithelium
-subcutaneous layer: hair follicles, sabaceos glands and ceruminous glands, 1mm
-osseous canal: 0.2 mm

170
Q

Cerumen

A

-secreciones glandulares + epitelio desprendido
-hydrophobic
-acid pH
-antibacterial effects

171
Q

pinna innervation

A

-laterally, inferiorly, and posteriorly by the great auricular nerve (cervical plexus).
-Arnold’s nerve (a branch of the vagus nerve) innervates the inferior bony canal (concha and floor ear canal)
-posterosuperior bony EAC by branches of the facial nerve
-anterior (tragus and roof): auriculotemproal branch of V3 of the trigeminal nerve

172
Q

microtia

A

-malformaciones evidentes
Marx system:
-G1: deformidad leve el helix y antihelix
-G2: (atypical microtia): tissue deficiency and defromity
-G3: peanut ear
-G4: absence

173
Q

tx microtia

A

-observation
-protesis
-single stage reconstrutction with implant
-staged autologous costochondral reconstruction. (4 stages)

174
Q

atresia and stenosis

A

-la microtia esta asociada
-tienen conductive HL moderate severe
-risk of chloesteatoma
-CT scan para ver si es candidato a cx

175
Q

protruding ears (prominauris)

A
  • increase in the distance from the helical rim to the mastoid (due to a lack of the antihelical fold and prominence of the conchal bowl)
    -usually bilateral
    -normal Auriculocephalic angle 20-25° with Auriculomastoid distance 15-20 mm
    tx: otoplasty (esthetic)
176
Q

First branchial cleft anomalies

A

-10% de las BCA
-Fusion 1st and 2nd branchial arch por incomplete obliration of 1 BC
-hay infeccion, dolor, hinchazon, escurrimiento
-clasificacion Work: tipo 1 (duplicates the membranous EAC ) and tipo 2 (mas comun, duplicates both the membranous and cartilaginous EAC.)
tx: complete excision, no si esta infectada

177
Q

external ear trauma: hematoma auricular

A

-accumulation of blood in the subperichondrial space
-el cartilago depende de la vascularizacion del pericondrio via diffusion
-necrosis del cartilago, predispone a infecciones
-cauliflower ear
tx: quinolones, drainage and ferula

178
Q

auricular laceration

A

-trauma –> laceracion o avulsion
-reparacionn expedita y prevencion de infecciones
-tx: quinolones, vendaje, secondary reconstruction

179
Q

auricular burns

A

1st degree: superficial layer of epidermis, red, hurt. Most common junto con la 2)

2nd degree: epidermis and extension to dermis

3rd degree: full thickness of dermis

4th degree: affection of another tissue that’s not the skin (fat, muscle, etc)

Tx: moisturizing creams, silver sulfadiazine (antiseptic cream), debridement, antibiotic ointment

180
Q

otitis externa

A

-Usually by p. aeruginosa and s. aureus
-Chronic >3 m, acute <3 m
-Tx: topic, NO oral antibiotics, debridement of the EAC, analgesia (AINES), culture, otic drops (acetic and boric acid, gentian violet, thimerosal, alcohol, ofloxacine), avoid water exposure

181
Q

otomycosis

A

-Fungical 10%
-80% aspergillus
-FR:immunocompromised
tx: debridement of EAC, acifiyng EAC (alcohol), antifungical agents (gentian violetm thimerosal, clotrimazole, nystatin, ketoconazole), avoid water exposure

182
Q

Skull base osteomyelitis/ malignant otitis external

A

-inmunocomprometidos
-otitis ext que afecta hueso temporal, puede dar meningitis fata, sepsis ,muerte
-progreso: cellulitis, chondritis, osteitis, and osteomyelitis
-travels through: Haversian canals, fissures of Santorini, foramina, and vascularized spaces
-90% pseudomona aeruginosa
-Usually they have facial paralysis
-dx: VSG, PCR, elevadas, cultivo, CT, MRI

183
Q

tx skull base osteomielitis

A

-long term parenteral antibiotics (6 wks), antipseudomonal (pip-tz, cefepime, ceftazidime, ciprofloxacin, ofloxacin)
-Hyperglycemia control
-Surgical debridement
-Hyperbaric oxygen

184
Q

atopic dermatitis

A

-cronic, recurrent
-AHF de atopia
-niveles altos de linfocitos T TH2
-lesiones eritematosas y prurito
-> 1 mes
-tx: decloxizine, emollients, soaking baths, topical corticoesteroids, calccineurin inhibitars (tacrolimus, sirolimus)

185
Q

soriasis

A

-cronica, inflamatoria
-18% lo manifoestan en el oido externo
-triggers: AINE, BB, carbonato de lithium, antimalarial agents, infection, trauma, stress
-papulas eritematosas (sangran si se rasca: signo de Auspitz) roud salmon-pink plaques
-tx: topical nonfluorinated corticoesteroids (mometasone, hydrocortisone), warm water soaks, 1-5% coal tar, oral proralens

186
Q

contact dermatitis

A

-por concancto con allergents and irritants
-hipersensibilidad type 4
-eritematoso, mal delimitado
tx: pruebas cutaneas, evitar irritante, glucocorticoestoried topicos

187
Q

foreign bodies

A

-no es emergencia (si es bateria si)
-tx: removal atraumatic manner, oil or glycerin

188
Q

keratosis obturans

A

-acumulacion de restos descamados
-asociado a broquitis cronica y sinusitis
-diferential dx: cholesteatoma

189
Q

basal cell carcinoma

A

-maligna mas comunde la pinna 45%
-FR: expo cronica al sol
-mutacion en gen p53 y via de señalizacion Hedgehog
-lesion nodular, ulcerada, sangrante
-dx: biopsy
-tx: photodinamic therapy with aminolevulinic acid, Topical 5-fluorouracil, Imiquimod is a topical immunomodulator, RT, Electrodessications, cryosurgery, mohs micrographic surgery

190
Q

squamous cell carcinoma

A

-hombres mayores
-mayor riesgo de metastasis
-FR: rayos UV, de lesiones precursoras
-acumulacion de mutaciones p53, Wnt, Ras, p 16
-son placas
-tx: 5-fluoruoracilo, ablacion con laser, chemical peeles, RT, inhibidores de la tirosina quinasa, ocal excision and Mohs micrographic surgery (MMS).

191
Q

melanoma of the external ear

A

-la mayoria en el helix
-dx: biopsia, rx torax, niveles de lactato deshidrogensasa, TAC, RM
-tx: escicion qx,

192
Q

osteomas

A

-benigna
-pediculado, unilateral
-nucelo fibrovascular rodeado de hueso laminar

193
Q

otitis media

A

-principal FR: disfuncion en tormpa de eustaquio
-h. influenzae y s. penumoniae y m. catarrhalsi
inflamacion en la middle ear cleft. hay dos:
-AOM
-OME

194
Q

exostoses

A

-firme, osea, base ancha (borad-based), de hueso laminar
-lesiones multiples
-FR: agua fria

195
Q

otitis media with effusion OME

A

-inflamacion con presencia de effusion
-tiene air bubbles
-no sintomas agudos de infección
-cronica: derrame por > 3 meses
-usually after AOM no resuelta
-my be cancer, so hacer nasalendoscpy
-tx: antibiotic, tympanostomy tubes (en pox con >3 meses y HL) + adenoidectomy (en px mayores a 3 de edad)

196
Q

acute otitis media AOM

A

-rapida aparición de sintomas
-inflamacion secundaria a infeccion so hay fever, hyperemia, edema
-timpano red
-recurrent AOM: >3 en 6 meses o >4 en 12 meses con resolucion entre episodios
-tx: espontaneo, antibiotico (amoxi)

197
Q

complicaciones de OME

A

-conductive HL and speech delay
-atelectasis (timpano muy retraida)
-cholesteatoma (primario por atelectasia y secudnario por perforacion timpanica)

198
Q

complicaciones de AOM

A

-perforacion timpanica
-mastoiditis coalescente aguda
-petrous apicitis (retro-orbital pain, AOM, and ipsilateral abducens nerve paresis [Gradenigo syndrome])
-facial nerve paressi
-laberintitis (sudden sensorineural HL, vertigo and nistagmo, se forma un conducto entre perilymph and the cerebrospinal fluid)
-intracraneal complications

199
Q

Acute coalescent mastoiditis

A

-complicacion mas comun de AOM
-hay fevers, postauricular erythema tenderness, ear proptosis
-si la infeccion avanza al esternocelidomastoidea, se puede formar absceso profundo –> Bezold abscess
-citelli abscess: se expande al digastric muscle

200
Q

intracraneal complications of AOM

A

-Meningitis (fever, photofobia, fluctuating mental staus, rigidez de nuca, tx: myringotomy)
-Encephalitis
-Otitic hydrocephalus (letargo, papiledema)
-intracraneal abscess (s. aureus, s.pneumonaiea, h. influenzae)
-sigmoid sinus thrombosis ((picket fence fever, torticollis)

*mondid dysplasia (cochlea only 1.5 coils) : meningitis+ congenital senosrineural HL+vestibular symtoms

201
Q

sensorineural HL

A

-por perdida de funcion de celulas ciliadas y afectacion del nervio coclear

causas:
-mas comun en adultos es presbycusis
-unilateral: tumor (schawannoma in cerebellum [ataxia, vertigo, HL], meningiomas, etc=
-infections
-TORCH

202
Q

que musuclo abre la estachian tube

A

tensor of the elevator palati
-en sanos esta cerrada
-causas de su obstruccion: adenoid hypertrophy, failure of the contraction of tensor veli palating (like in a palsy), cleft palete

203
Q

hair cells

A

-otoacustic emission: test that measure how the outer HC move
-we have 12, 000 outer HC, and 3,500 inner HC

204
Q

sensorineural HL dx with tuninf fork

A

-with diapason of 256 hz o 512 hz
-rinne y weber
-normal: AC better then BN

205
Q

rinne

A

-sensible para conductivas HL
-en el mastoid process
-sensorineural HL: escucha mas AC que BC
-conductive HL: escucha mas por BN que por AC
negativa indica que AC esta afectada
positiva indica que AC esta conservado

206
Q

weber

A

-se pone en la cabeza
-se pregunta si escucha en ambos o mejor uno que el otro, se evalua BN
-Conductive HL: se oye mas en el afectado
-sensorineural HL: oye mas el lado sano
*lateralization a cierto lado indica que escucha mas de ese lado

207
Q

presbycuisis

A

-causa mas comun de HL en adultos
-por perida de celulas ciliadas basales
-alelo GRM7

208
Q

etiology of sensorineural HL

A

-presbycuisis
-infections
teratogenic exposure
-hereditarias: 2/3 so sindormaticas, 1/3 sindromaticas
(genes: GJB2–> conexina 26, o 32delH y 167delT)

209
Q

TORCH

A

toxoplasmosis, otras [sífilis, varicela-zóster], rubéola, citomegalovirus, herpes

210
Q

prevencion HL sensorineural

A

-vacunacion contra H. influnzae B, meningitis, measles, mumps, and rubeolla
-evitar ruidos fuertes (earplugs)

211
Q

tx sensorineurla HL

A

-hearing aids (Lyric, for unilateral: CROS or BAHA)
-implantes cocleares (para sordera profunda)
-brainstem Auditory Implant (px con ambos NC8 por trauam o schawnomas)
-para el tinnitus (abnomral sounds as ringins): masking

212
Q

vertigo

A

-illusion of movement
-se quejan de dizziness
-presence of nystagmus
*podemos tener nystagmus sin vertigo, pero no vertifo sin nistagmus
-dx: GS videomistagmography (VOR and VER)

213
Q

2 types of vertigo

A

Peripheral (on the ear), its sudden, the nystagmus its unidirectional
-Benign positionla vertig, meniere diseasem vestibular neuronitits, etc
-Ask for drug use, family history, psychological factors,

Central (on the brain)
- its gradual, the nystagmus its pure vertical multidirectional

214
Q

benign paroxysmal positional vertigo

A

–1° causa de vertigo
-es repentino, dura seg, cuando giras la cabeza al lado afectado
-sin HL
-nistgmo latent, geotropic (descendete y rotatorio) and fatigable
-its cause a semicircular canal has debris either attached to the cupula or free floating in the endolymph
-semicircular mas afectado: posterior, then horizontal y leugo superior
-hay cupulolithiasis y canalolithiasis

215
Q

dx and tx of benign paroxysmal positional vertigo

A

-MRI a px que no responden a tx
dx: Dix-hallpike test (cabeza a 45° y luego lo bajas)
tx: epley and semontmaneuver

216
Q

miniere disease/ endolymphatic hydrops

A

-2° causa de vertigo
-vertigo episdoico de horas
-HL fluctuante y unilateral (de low frequencies)
-tinnitus
-plenitud otica
*traes el ataque, se sienten agotados por dias, y pueden tener vomito y nausea
-increased endolymphatic fluid owing to impaired reabsorption in the endolymphatic duct and sac.

217
Q

dx meniere

A

-audiometria (sensorineural HL de baja frequencia)
-FTA-ABS para descartar sifilis
-RM para descartar patologia retrococlear
-electronistagmografia
-VEMP
-electrocochleography (GS)

218
Q

tx miniere

A

-dieta restringida en sodio
-diureticos
-ataques: vestibular suppressants (meclizine and diazepam) and antiemetic (prochlorperazine)
-cx: mastoidectomy (open the endolymphatic sac), vestibular nerve section, labyrinthectomy

219
Q

VESTIBULAR NEURONITIS

A

-3° causa de vertigo
-vertigo agudo
-nistagmo lento: hacia oido lesionado
-nistagmo rapido: hacia oido opuesto
-inestabilidad psotural hacia el oido afectado
-etiology: infeccion viral (VHS1), oclusion vascular (superior vestibular nerve), inmune, brainstem or cerebellar stroke (princial de vertigo que drua varios dias)

220
Q

vestibular neuronitis tx

A

-vestibular suppressants and antiemetics

221
Q

superior semiciruclar canal dehiscence

A

-fenomeno de tullio (vertigo cuando ruidos fuertes)
-signo de hennebert (vertigo al valsalva)
-They have a piece of bone missing in the semicurlcar canal
-tienen autofonia (se escuchan a si mismos), inner-ear Conductive HL, no tinnitus
-dx: TAC con proyeccion Poschl

222
Q

facial nerve

A

-Gives the movement of the face
-eye protection, speech articulation, chewing, swallowing, emotional expression
-divide a las parotid glands
-pasa por el fallopian canal

223
Q

bells palsy

A

-inica con paralisis unilateral, aguda < 48 hrs
-asociado con disfucnion de V, VIII, IX, y X
-bell sign: cuando parpadea, un ojo no cierra y se va hacia arriba

224
Q

ramsay hunt sx, VHZ

A

-asocaida a otalgia y varicela
-se extiende a V, IX, y X y ramas cervicales 2, 3, 4
-mayor incidenai de disfucnión cocleosacular
-meatal foramen like “physiological bottleneck”

225
Q

House Brackman facial paralisis grading system

A
  1. normal
  2. complete eye closure easy
  3. complete eye closured with effort
  4. incomplet eye closure
  5. asymmetry at rest
  6. no movement
226
Q

tx paralisisi facial

A

-steroids: prednisone 1mg/kg/day
-antiviral: acyclovir (in ramsey give it the first hour)
-electrical estimulation, exercises in the mirrori, eye care
-surgery (decompresse the edema)

227
Q

dx facial paralisis

A

1° electromiography
2° electroneurography
>95% necesita descompresion

228
Q

other facila nerve disorders: facial nerve neoplasm

A

-facial nerve hemangioma: recurrent and progressive more severe unilateral facila palsy

229
Q

other facial nerve dissorders: lyme disease

A

-por borrelia burgdorferi
-rash adjacent to the site of the tick bite
-eritema migrants
-dx: ELISA para ver IgG y IgM
tx: tetracyclcine (No en niños, dar peniciline)

230
Q

other facial nerve disoirders: AOM and mastoiditis

A

-acute otitis media and mastoiditis
-chronic otitis media
-necrotizing otitis externa (pathognomonic signs: otoscopic evidence of ear canal inflammation or a breach of the external canal skin [granulation tissue]) (por p. aureiginosa)

231
Q

childohood facila palsy: congenital perinatal facial palsy

A

-malforaciones que afectan al 1 y 2 arco branquial
-sx de Möbius (dysgenesis at the brainstem) (bilateral, no movement, type 6 brackman) (gen HOX)
-

232
Q

salivary glands

A

Mayor Salivary Glands (6): 2 parotid glands, 2 submandibular glands, 2 principal sublingual glands
*each one has an acinus (produce saliva)

233
Q

parotid glands

A

-largest, 25 gr
-lateral an anterior to masseter muscle
-divide by the 7 NC
-Stensen duct pasa

234
Q

submanidbular glands

A

-2nd largest, 10-15 grs
-divided by the posterior edge of the mylohyoid
-wharton duct

235
Q

sublingual glands

A

-en la submucosa
-duct of rvinus are mutiple minor ducts
-ducts of bartholin: submandibular ducts + wharton duct

236
Q

Mumps

A

-most common viral causing parotitis
-bilateral swelling, pain, tenderness, malaise, trismus
-tx: autolimita, NSAIDS

237
Q

acute suppurative sialadenitis

A

-usually in parotid
-purulent discharge in the duct
-puede haber a la palpación induration and a doughlike consistency of the gland
–submandibular abscess can cause Ludwig
-tx: antibiotics (SARM coverage), sialogogues

238
Q

VIH of the parotid glands

A

-in the parotid due to presence of intraglandular lymph nodes
-bilateral parotid swelling, painless, no fever
dx: CT or USG reveal bilateral multiple cystic masess, serologic test for HIV
tx: drainage, sclerotherapy, gland excision

239
Q

chronic granulomatosis sialadenitis

A

-acute or chronic uni or bilateral salivary swelling
-minimal pain
-FR: tuberculosis

240
Q

sialolithiasis/ hydroxyapatite salivary calculi

A

-80-90% in submandibular gland
-swelling and pain exacerbated with eating
-hisotry of xerostomia, and sandlike sensation
-stone in the floor of the mouth
-tx: intraoral extration (if its on the anterior portion) or surgical excision (stone its too big)

241
Q

Chronic sialadenitis

A

-decreased production of saliva –> salivary stasis
-inflamacion dolorsa al comer, bilateral
-RF: smoking
-Tx: parotedectomy

242
Q

sjorgren syndrome

A

-parotid enlargment + xerostomia + keratoconjuntivitis sicca
-SS-A or SS-B autoantiboides
-dx: biopsy >1 focus/4mm^2
-lymphocitic inflitrate in acinars + epimoyoepithelial islands surrounde by lymphoid stroma
-dry eyes. mouth, vagina

243
Q

sialosis

A

-noninflamatory, enlargement of the parotid and submandibular (bilateral, diffuse)
-FR: alcohol
-dx: acinar enlargemnet

244
Q

parotyd cyst

A

-fluctuant swellign of the salivary glands
-congenital: (brachial cleft anomalies) type 1 (ectodermal) y type2 (mesodermal and ectodermal)
-adquired

245
Q

mucoceles/mocous retentions cyst

A

-trauma of minor salivary gland ducts
-acumulated mocus secretations
-plane, smooth, bluish
-simple ranula: true cyst
-plunign ranula: pseudocyst

246
Q

xerostomia

A

dry mouth, alterated taste

247
Q

ptyalism

A

-saliva hyperproduction
-tx: drying agents or cx of the chroda tympani nerve

248
Q

benign neoplasic disorders

A

-80% in th parotyd gland
-most common: epithelial tumors
-slow growing, painless, solitary
dx: fine needle aspiration
tx: surgical excision

249
Q

pleomorphic adenoma

A

-most common neoplasm of the salivory gland
-epithelia + myoepithelia +stroma elements
-isolated swelling

250
Q

warthin tumor

A

-FR: smoking
-only on th parotid gland
-males
-bilaterl and multicentricity
-well defined mass in the posterioinferior segmento del lobulo superior de la parotids
-oncocytes papilary structures

251
Q

stridors

A

inspiratory: obstruction at the larynx or above
expiratory: distal
biphasic: subglottic

252
Q

voice, donde esta la obstruccion

A

-muffle voice: supraglotic or epiglotis
-hoarse voice: laryngeal
-breathy/cry voice: vocal cord

253
Q

ororfaringeal and nasopharyngeal airways

A

px < 8 de glasgow

254
Q

tracheotomy

A

-trasnverse incision 2 anillos abajo de sternal notch. (vertical only in emergency)

255
Q

complicatiosn of tracheotomies

A

-early: infection, hemorragia, emfisema, penumomediastino, neumotorax, fistual traqueesofagal, RL nerve injury, tube dislacement
-delayed: traqueal innominate artery fistula
-tracheal estenosis
-delayed tracheoesophageal fistual, tracheocutaneo fistula

256
Q

Que musculos del ojo inerva el 3 par craneal

A

recto superior, inferior, interno, elevador del párpado, oblicuo inferior,

257
Q

que musculos del ojo inverva el 6 p y 4 ar craneal

A

6: recto externo
4: oblicuo sup

258
Q
A

SEMESTRE 7 (13 decks)

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