questions ! Flashcards
what is the umbo?
most inwardly depressed part of the tympanic membrane, marks the point of attachement of the handle of the malleus to tympanic membrane
what is the pars tensa?
thick part of tympanic membrane, inferior ish
pars flaccida = thinnest part, located superiorly
what muscle is attached to the malleus + chorda tympani passes over?
tensor tympani muscle (CN V3)
how often are taste receptor cells + olfactory receptors replaced respectively? what are they replaced by?
taste receptor cells = 10days
olfactory receptors = every 2 month
basal cells
what part of the brain does the olfactory tract take olfactory bulb neurons to?
temporal lobe + olfactory areas
the vagus nerve passes out the cranial cavity via which foramen?
jugular
what is the first + most superior branch of vagus nerve?
superior laryngeal
most likely diagnosis for vertigo lasting days-weeks
labyrinthitis AND vestibular neuronitis
most likely diagnosis for vertigo lasting 20 minutes to several hours
menieres disease
most likely diagnosis for vertigo lasting seconds to minutes
BPPV
–> triggered by positional changes
second line treatment of child with persistent otitis media with effusion
adenoidectomy + repeat grommet insertion
Adenoidectomy may be considered at first if child has nasal symptoms
other than antibiotics, what other treatment may be given in severe tonsilitis?
steroid
what kind of neck lump is most commonly seen in older men?
pharyngeal pouch
what kind of neck lump moves upwards on swallowing?
goitre
what kind of neck lump usually present in the first 2 years of life?
cystic hygroma
benign congenital lymphatic lesion, most commonly located in left posterior triangle of neck
what kind of neck lump is the most common cause of neck swellings?
reactive lymphadenopathy
what kind of neck lump will rarely cause pain when drinking alcohol?
hodgkins disease (lymphoma)
RARE
what kind of neck lump is usually located between isthmus of thyroid + hyoid bone?
thyroglossal cyst
pulsatile lateral neck lump
carotid aneurysm
most common bacterial cause of a sore throat?
streptococcus pyogenes (group A strep)
organism that produces potent exotoxin
corynebacterium diptheriae
commonest cause of otitis externa
staph aureus
commonest cause of otitis media
haemophilus influenzae
At what vertebral level is the thyroid and hyoid cartilage located respectively?
thyroid cartilage = C4/5/6
hyoid cartilage = C3
cricoid cartilage = C6
4 features of labyrinthitis?
episodes of vertigo lasting days to weeks
may be associated with a viral infection
associated hearing loss or tinnitus
ay experience tinnitus on affected side
what strains does the HPV vaccine protect against?
6, 11, 16 + 18
what strains does the HPV vaccine protect against?
6, 11, 16 + 18
which salivary gland is most likely to be affected by a tumour?
parotid - biggest gland, most likely benign
smaller glands more likely to be malignant
why do head + neck patients experience more pain than in other cancers?
more nerve innervations, lots of referred pain
at what stage of the WHO pain ladder are opiates considered
stage 2
which medication is give to combat neuropathic pain?
amitriptyline (tricyclic antidepressant)
most common site for head + neck cancer
larynx
viral cause of respiratory papillomatous disease
HPV
which virus plays a significant role in head + neck cancers?
HPV (16) - esp oropharyngeal
in an emergency airway algorithm, what counts as a definitive airway?
tracheal intubation
tracheostomy
what makes up Waldeyer’s ring?
tonsils, adenoids, lingual tonsil
what are the symptoms in the CENTOR criteria?
history of fever
tonsillar exudates
absence of cough
tener anterior lymphadenopathy
primary management of moderate to severe obstructive sleep apnoea in children caused by large tonsils?
surgery
changes to skin over time
decrease in collagen tunover as well as elastin
volume of subcutaneous fat diminishes
skin thins
melanocytes decrease
initial management of OME (glue ear) if first ENT clinic?
watch + wait, review in 3 months
contraindication to rhinoplasty in scotland
recent changes to mental health
what age would most people be considered for otoplasty (pinning ears)
from 6yrs old
what antibiotics should be avoided when treating tonsilitis or glandular fever?
ampicillin
amoxicillin
co-amoxiclav
main risk of tonsillectomy
bleeding
when should nasal fracture be assessed to see if local manipulation is indicated
7-14days post injury
36y/o 3 day history of stridor + fever, inital management?
start oxygen
RTA, presents with battles sign
temporal bone fracture
most important foreign body to rule out
battery
percentage of acute rhinosinusitis thats viral
> 90%
virus related to nasopharyngeal carcinoma
epstein barr virus
anatimical cause of prominent pinna
lack/underdeveloped antihelical fold
prominent concha
protruding lobe
nervee responsible for referred otalgia from oropharynx
glossopharyngeal nerve
most useful investigation for neck mass of unknown origin
US fine needle aspirate
most likely cause of parotid swelling mass
pleomorphic adenoma
patient not improving after 3 days with otitis externa + conservative measures, next management?
topical sofradex
type of hearing loss seen in patients with presbycusis
high frequency sensorineural hearing loss
patient has a rinnes test that is positive on the right + negative on the left, with a webers going to the left. what is the likely hearing loss?
conductive on the left
vertigo lasting minutes-hours, hx of migraines, management?
lifestyle + trigger avoidance
if not = triptans
recurrent vertigo lasts for 3hrs to a day, assoc vomiting + aural fullness. audiogram shows low frequency hearing loss
meneires
47 y/o man, 5 day hx of dizziness, N+V
vestibular neuritis (no hearing loss)
67y/o right sided facial nerve palsy, grade 4 wealness but can still move forehead, what must be ruled out?
CVE - stroke
tympanogram shows flat trace with high canal volume, what is this likely to indicate?
perforation
8y/o with otorrhea + hearing loss, white keratin tissue seen on otoscope
cholesteatoma
treatment for viral cause of hyposmia
smell retraining + support
most common blood vessel in the nose that can be ligated in the surgical management of epistaxis?
sphenopalatine
recurrent ear infections, on going discharge despite treatment with drops + tablets
cholesteatoma
tendernesss + swelling behind ear, bulging tympanic membrane
mastoiditis
