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ENT > Pharynx > Flashcards

Pharynx Flashcards

1
Q

What is pharynx

A

It is a fibromuscular tube from skull base to C6

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2
Q

3 muscles of pharynx

A

Superior
Middle
Inferior constrictors

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3
Q

Inferior constrictor consist of

A

Oblique fibres-thyropharyngeus

Circular fibres- cricopharyngeus

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4
Q

Killians dehiscence

A

No muscle,weak area between the 2 fibres of inferior constrictor

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5
Q

Complications that can occur from killians dehiscence

A

Zenckers dicerticulum

Perforation during rigid endoscopy

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6
Q

What is sinus of Morgagni

A

Space between skull base and superior constrictor

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7
Q

Structures passing through sinus of morgagni

A

ET
Tensor and levator veli palatini
Ascending palatine artery

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8
Q

Laryngopharynx aka

A

Hypopharynx

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9
Q

Hypopharynx consist of

A

Pyriform sinus
Post cricoid area
Posterior pharyngeal wall

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10
Q

Internal branch of superior laryngeal nerve/internal laryngeal nerve supplies

A

Supraglottis

Pyriform sinus

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11
Q

Most common site of hypopharyngeal malignancy

A

Pyriform sinus

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12
Q

What is laryngeal crepitus

A

Clicking sound felt when larynx is moved over the cervical vertebra

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13
Q

What is moure’s sign and where is it seen

A

It is the absence if laryngeal crepitus

Seen in post cricoid carcinoma,laryngeal fractures of thyroid,prevertebral abscess

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14
Q

2 important landmarks of nasopharynx

A

ET opening

Adenoid

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15
Q

Nasopharyngeal disease can lead to which middle ear disease

A

Glue ear

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16
Q

Site of adenoids

A

Junction of roof and posterior wall of nasopharynx

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17
Q

Nasopharyngeal tonsil aka

A

Adenoids

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18
Q

What gives a ‘bag of worms’feel

A

Adenoids

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19
Q

What are the things absent in adenoids as compared to other tonsils

A

No capsule
No crypt
No definite blood supply

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20
Q

When is the physiological maximum size of adenoids attained

A

At 6 years

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21
Q

When do adenoids completely disappear

A

20 yrs

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22
Q

Name a main cause of adenoid hyoertrophy

A

Recurrent URTI

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23
Q

Adenoid facies features

A 
Open mouth 
Pinched nose 
High palate 
Malocclusion of teeth 
Rhinolalia clausa
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24
Q

Position of patient in adenoidectomy

A

Rose position

Extension of neck on chest and of head on neck

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25
Q

Complication of rose position

A

Grisel syndrome

Atlantoaxial subluxation C1-C2

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26
Q

What curette used for adenoidectomy

A

St.Claire Thomson curette

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27
Q

Other methods of removing adenoids

A

Coblation
Suction diathermy
Microdebrider

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28
Q

Most common benign tumour of nasopharynx

A

Angiofibroma

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29
Q

Site of origin of angiofibroma

A

Sphenopalatine foremen

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30
Q

Characteristic feature of angiofibroma tumour

A

Highly vascular

Blood vessel do not have muscular layer and do not contract when cut

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31
Q

Presentation of angiofibroma

A

Adolescent boys
Nasal mass
Profused Epistaxis

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32
Q

Hollman miller sign/antral sign

A

Anterior bowing of posterior wall of maxilla

Angiofibroma

33
Q

Fisch staging of angiofibroma

A

Pls pls see if you don’t know

34
Q

Radkowski staging system

A

Pls check if you don’t know

35
Q

Surgical approach of angiofibroma

A

Pls check again

It’s too much for a flash card

36
Q

Angiofibroma further complication

A 
Invasive to nose 
Cheek 
Orbit-frog face deformity 
Brain 
Pterygomaxillary fossa
37
Q

Site of origin for NPx carcinoma

A

Fossa of rosenmuller

38
Q

Risk factors of nasopharyngeal carcinoma

A 
Burning incense 
Salted fish (nitrosamine)
Vitamin C deficit diet
39
Q

Why is NPx a hidden cancer

A

Most common presentation is secondary neck node=metastatic lymphadenopathy

40
Q

How does NPC enter the cranial cavity

A

Foremen lace rum

41
Q

What is trotters triad

A

NPC mnemonic
Neuralgic pain in tempo parietal area (5th nerve)
Palatial palsy (10th nerve)
CHL

42
Q

Oropharynx consist of

A

Soft palate
Uvula
Base of tongue
Lingual tonsil
Vallecula (space between base of tongue and epiglottis)
Anterior tonsillar pillar (palatoglossus)
Posterior tonsillar pillar (palatopharyngeus)
Palatine tonsil =tonsil
Posterior pharyngeal wall
(Pls read,I took a long time to type 😅)

43
Q

Bed of tonsil by which muscle

A

Superior constrictor

44
Q

2 structures lying in bed of tonsil

A

Styloid process

CN 9 -glossopharyngeal

45
Q

Eagles syndrome

A

Stylagia involving 9th CN

Throat pain referred to ear

46
Q

Largest crypt of tonsils

A

Crypta magna

47
Q

Blood supply to tonsil

A

Tonsillar branch of facial artery

48
Q

Methods of tonsillectomy

A 
Dissection and snare 
Conflation 
Bipolar cautery 
Cryosurgery
Radio frequency 
Harmonic scalpel 
Laser
49
Q

Main source of bleeding in tonsillectomy

A

Peritonsillar vein

50
Q

Types of haemorrhage in tonsillectomy

A

Primary
Reactionary
Secondary

51
Q

What is primary haemorrhage in tonsillectomy

A

During surgery

52
Q

What is reactionary haemorrhage in tonsillectomy

A

Within 24 hours of the surgery
Due to slippage of ligature
It is an emergency

53
Q

Treatment of reactionary haemorrhage in tonsillectomy

A

Immediate re-exploration

54
Q

What is secondary haemorrhage in tonsillectomy

A

After 5 days of surgery
Due to infection of tonsillar fossa
Mild bleeding

55
Q

Treatment of secondary haemorrhage

A

IV antibiotic

56
Q

Causes of whitish membrane on tonsil (7)

A 
Acute membranous tonsillitis 
Infectious mononucleosis 
Diphtheria 
Candidiasis 
Vincent angina 
Leukaemia 
Malignancy
57
Q

Waldeyer ring consist of

A 
Adenoids 
Palatine tonsil 
Lingual tonsil 
Tubal tonsil 
Lymphoid follicles on posterior pharyngeal wall
58
Q

What happens if lymphoid follicles on the posterior pharyngeal wall get hypertrophied (appearance)

A

Cobblestone appearance

59
Q

What is a tonsillolith

A

Collection of keratin debris in tonsillar crypt which appears as a white hard mass

60
Q

What is quinsy

A

Peritonsillar abscess

Pus between tonsil and its bed

61
Q

Examination finding in peritonsillar abscess

A

Uvula is pushed to other side

Tonsils is pushed medically

62
Q

Clinical picture of quinsy

A

Throat pain
Dysphagia
Hot potato voice =plummy voice
Trismus (due to spasm of medial pterygoid muscle)

63
Q

Treatment of quinsy

A

I & D
Antibiotics
Remove tonsil after 6 weeks

64
Q

What is hot tonsillectomy

A

Some doctors remove tonsils at the time of surgery =abscess=hot tonsillectomy

65
Q

Same history and examination findings as quinsy/peritonsillar abscess but outer neck swelling present then diagnosis is

A

Parapharyngeal abscess

66
Q

What is quicke’s disease

A

Angioneurotic Edema of uvula

67
Q

Do you know where the retro pharyngeal space is?? -.-

A

See the pic

Between buccopharyngeal and preverterbral fascia

68
Q

Retro pharyngeal space divided into two halves called

A

Spaces of Gillette

69
Q

What are the lymph nodes in the retro pharyngeal space called

A

Lymph node of rouveir

70
Q

What is acute retro pharyngeal abscess

A

Infection of lymph nose of rouveir

71
Q

Chief complaints of retro pharyngeal abscess

A 
Respiratory distress 
Drooling of saliva 
Inspiratory stridor 
Hot potato voice 
Dysphagia
72
Q

D/D of retro pharyngeal abscess

A

Acute epiglottitis

73
Q

Examination finding of retro pharyngeal abscess

A

U/L bulge on PPW

74
Q

Prevertebral abscess due to

A

TB of cervical spine

75
Q

Examination finding of prevertebral fascia

A

Diffuse midline bulge on PPW

X-ray shows erosion of vertebral bodies

76
Q

Chief complain of prevertebral abscess

A

Dysphagia
Neck pain
Low grade fever

77
Q

What is ludwig’s angina

A

Infection of floor of mouth = submandibular space

Floor of mouth made by mylohyoid muscle

78
Q

Etiology of ludwigs angina

A

Dental infection

79
Q

Clinical features of ludwigs angina

A

Chin swelling
Trismus
+/- respiratory difficulty

ENT (34 decks)

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