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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
Complication of rose position
Grisel syndrome | Atlantoaxial subluxation C1-C2
26
What curette used for adenoidectomy
St.Claire Thomson curette
27
Other methods of removing adenoids
Coblation Suction diathermy Microdebrider
28
Most common benign tumour of nasopharynx
Angiofibroma
29
Site of origin of angiofibroma
Sphenopalatine foremen
30
Characteristic feature of angiofibroma tumour
Highly vascular | Blood vessel do not have muscular layer and do not contract when cut
31
Presentation of angiofibroma
Adolescent boys Nasal mass Profused Epistaxis
32
Hollman miller sign/antral sign
Anterior bowing of posterior wall of maxilla | Angiofibroma
33
Fisch staging of angiofibroma
Pls pls see if you don’t know
34
Radkowski staging system
Pls check if you don’t know
35
Surgical approach of angiofibroma
Pls check again | It’s too much for a flash card
36
Angiofibroma further complication
``` Invasive to nose Cheek Orbit-frog face deformity Brain Pterygomaxillary fossa ```
37
Site of origin for NPx carcinoma
Fossa of rosenmuller
38
Risk factors of nasopharyngeal carcinoma
``` Burning incense Salted fish (nitrosamine) Vitamin C deficit diet ```
39
Why is NPx a hidden cancer
Most common presentation is secondary neck node=metastatic lymphadenopathy
40
How does NPC enter the cranial cavity
Foremen lace rum
41
What is trotters triad
NPC mnemonic Neuralgic pain in tempo parietal area (5th nerve) Palatial palsy (10th nerve) CHL
42
Oropharynx consist of
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
Bed of tonsil by which muscle
Superior constrictor
44
2 structures lying in bed of tonsil
Styloid process | CN 9 -glossopharyngeal
45
Eagles syndrome
Stylagia involving 9th CN | Throat pain referred to ear
46
Largest crypt of tonsils
Crypta magna
47
Blood supply to tonsil
Tonsillar branch of facial artery
48
Methods of tonsillectomy
``` Dissection and snare Conflation Bipolar cautery Cryosurgery Radio frequency Harmonic scalpel Laser ```
49
Main source of bleeding in tonsillectomy
Peritonsillar vein
50
Types of haemorrhage in tonsillectomy
Primary Reactionary Secondary
51
What is primary haemorrhage in tonsillectomy
During surgery
52
What is reactionary haemorrhage in tonsillectomy
Within 24 hours of the surgery Due to slippage of ligature It is an emergency
53
Treatment of reactionary haemorrhage in tonsillectomy
Immediate re-exploration
54
What is secondary haemorrhage in tonsillectomy
After 5 days of surgery Due to infection of tonsillar fossa Mild bleeding
55
Treatment of secondary haemorrhage
IV antibiotic
56
Causes of whitish membrane on tonsil (7)
``` Acute membranous tonsillitis Infectious mononucleosis Diphtheria Candidiasis Vincent angina Leukaemia Malignancy ```
57
Waldeyer ring consist of
``` Adenoids Palatine tonsil Lingual tonsil Tubal tonsil Lymphoid follicles on posterior pharyngeal wall ```
58
What happens if lymphoid follicles on the posterior pharyngeal wall get hypertrophied (appearance)
Cobblestone appearance
59
What is a tonsillolith
Collection of keratin debris in tonsillar crypt which appears as a white hard mass
60
What is quinsy
Peritonsillar abscess | Pus between tonsil and its bed
61
Examination finding in peritonsillar abscess
Uvula is pushed to other side | Tonsils is pushed medically
62
Clinical picture of quinsy
Throat pain Dysphagia Hot potato voice =plummy voice Trismus (due to spasm of medial pterygoid muscle)
63
Treatment of quinsy
I & D Antibiotics Remove tonsil after 6 weeks
64
What is hot tonsillectomy
Some doctors remove tonsils at the time of surgery =abscess=hot tonsillectomy
65
Same history and examination findings as quinsy/peritonsillar abscess but outer neck swelling present then diagnosis is
Parapharyngeal abscess
66
What is quicke’s disease
Angioneurotic Edema of uvula
67
Do you know where the retro pharyngeal space is?? -.-
See the pic | Between buccopharyngeal and preverterbral fascia
68
Retro pharyngeal space divided into two halves called
Spaces of Gillette
69
What are the lymph nodes in the retro pharyngeal space called
Lymph node of rouveir
70
What is acute retro pharyngeal abscess
Infection of lymph nose of rouveir
71
Chief complaints of retro pharyngeal abscess
``` Respiratory distress Drooling of saliva Inspiratory stridor Hot potato voice Dysphagia ```
72
D/D of retro pharyngeal abscess
Acute epiglottitis
73
Examination finding of retro pharyngeal abscess
U/L bulge on PPW
74
Prevertebral abscess due to
TB of cervical spine
75
Examination finding of prevertebral fascia
Diffuse midline bulge on PPW | X-ray shows erosion of vertebral bodies
76
Chief complain of prevertebral abscess
Dysphagia Neck pain Low grade fever
77
What is ludwig’s angina
Infection of floor of mouth = submandibular space | Floor of mouth made by mylohyoid muscle
78
Etiology of ludwigs angina
Dental infection
79
Clinical features of ludwigs angina
Chin swelling Trismus +/- respiratory difficulty

ENT (34 decks)

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