random ENT Flashcards
what is contained in the membranous labryrinte
ENDOlymph
what is the bony labyrinth made up of
rigid bony outerwall of the inner ear made up of the vestibule, semicircular canals and cochlea
what are the otolith organs and where are they contained
utricle and saccule which are contained in the vestibule
what is the middle ear lined with
columnar mucosa
where is a vestibular schwannoma found most commonly
vestibular portion of CNVIII, in the cerebellopontine angle, between the pons and the cerebellum
what syndrome is a paraganglioma associated with
MEN 2
what are paramyxoviruses
family of virsus associated with mumps and bilateral parotitis
what is the most common type of parotid tumour
most common is pleiomorphic adenoma and second most common is warthins both benign
how are ear drops applied
turn the recipients ear upwards
straighten the ear canal by pulling the pinna backawards and upwards
instil the drops
press the tragus repeatedly over the introitus of the ear canal to encourage the drops to pass down the canal
when is there an increased risk of aminoglycosides
with a perforated tympanic membrane
what is an open hearing aid and what are its benefits
doesn’t have an ear mould, this means that patients do not lose the natural sounds from blockage of the canal and their canals do not become moist due to occlusion
what may be helpful if the ear canal is oedematous
a wick
why can you get dizziness from ear drops
the drops are not close to body temperature, this is worse when there is an open mastoid cavity
as the lateral scc is stimulated by the difference in temp
what si the only indication for a hearing aid
auditory difficulty and there is a demonstrable hearing loss
can a hearing aid be used for cochlear, retrococohlear or neural hearing loss
sound can become very distorted so most commonly no
may make distortion worse and impair understnaiding of speech
if resent with hearing problems but no demonstrable hearing loss and find it difficult to hear with background noise do you give a hearing aid
no give hearing therapy
what is a telecoil and why is it useful
a loop system can be used in theatres, lectures etc, causes distortion of the magnetic field which is picked up by users hearing aid and converted back into sound.
disadvantage is that microphone is disabled
what are the problmes with hearing aids
feedback
whistling noise caused by amplified sound being picked up by the microphone, setting up a feedback loop
may be caused by, wax in external auditory meatus, ear mould not inserted correctly, ear mould not fitting properly, leakage of sound
what is osler weber rendu
autosomal dominant genetic disorder that leads to abnormal blood vessel formation in the skin, mucous membrane and often in the lungs, liver and brain
can cause epistaxis
what bone is the carotid canal in and what does it carry
the temporal bone and the internal carotid artery
what bone does the infraorbital foramen go through and what does it supply
maxilla and infraorbital nerve V2 and infraorbital artery-branch of maxillary nerve
what is the function of hair cells
to convert mechanical stimuli into electrical impulse
when does depolarisation occur
when deflected towards the longest
wht are clusters of hair cells called
maculae
what are the longitudinal muscles of the larynx supplied by
CNX
except for stylopharygeus which is supplied by CNI IX
the glossopharyngeal nerve supplies motor innervation to what muscle only
sytlopharygeus
how is air and bone conduction affected in sensorineural hearing loss
both air and bone conduction are decreased
when assessing a nasal trauma what should you make sure you do
assess eye movements
look in nose for a possible haematoma
refer to ENT clinic for 5-7 days time
what is the most common type of fracture to the temporal bone
longitudinal fracture
symptoms of a longitudinal fracture of the temporal bone
fracture line is paralle of the long axis of the petrous pyramid
bleeding from external canal due to laceration pf ksin and ear drum
haemotypnaum
ossicular chian disruption causing conductive deafness
facial palsy
CSF otorrhoea
how do you get a transverse fracture of the temporal bone
frontal blows
what type of hearing loss is caused by a transverse fracture of temporal bone
sensorineural as the fracture can cross the internal acoustic meatus causing damage to CN VIII
where is otolith material most commonly deposited
in the posterior semi circular canal
how is a newborns hearing screened for
automated otoacoustic emission test
how does an automated optoacoustic emission test work
a computer generated click is played through a small earpiece, presence of a soft echo indicates a healthy cochlea
over what age can you do a PTA
pure tone audionometry over the age of 3
what drains into the spenothmoidal recess
the sphenoid sinus
what drains into the inferior meatus
the nasolacrimal duct
what drains into the ethmoidal bulla
the middle ethmoidal air cells
what drains into the semilunar hiatus
the anterior ethmoidal, frontal and maxillary sinus
what is another name for maxillary sinus
antrum
what are the semilunar hiatus and ethmoidal bulla part of
the middle meatus
where do the posterior ethmoidal air cells drain
into the superior meatus
what is sinusitis
inflammation of the mucosa
why can sinusitis be dangerous
increased pressure in ethmoid and break the medial wall of the orbit and impact the eye/spread of infection to optic nerve
which sinuses is predisposed to infection and why
maxillary sinus
as the ostium of maxillary sinus is location superior in relation to its cavity so the cilia must work against gravity
what are the vocal cords
free borders of mucosa covered connective tissue in the larynx
what are the true vocal cords
vocal process of arytenoid cartilage to thyroid cartilage
what are the false vocal cords
arytenoid cartilage to epiglottis
where is the quadrangular membrane
between vestibular ligament and epiglottis
it is the upper part of the fibroelastic membrane which lines the larynx
extends between the arytenoid cartilage and the epiglottis, its lower border is thickened to form the vestibular ligament
where is a laryngoscope placed
in the vallecular
what is the aryepiglottic fold
the superior border of quadrangular membrane
what does increasing tension do to pitch
increases pitch
what does relaxation do to pitch
decrease in pitch
what does adduction do to sound
it makes sound quieter
what does Abduction do to sound
louder
what types of muscles are the intrinsic muscles of the larynx
skeletal muscles
what are the intrinsic muscles of the larynx innervated by
CN X
describe the laryngeal muscles in normal respiration
they are in resting position
what muscles of larynx are being used when there is forced respiration
posterior crico-arytenoids contract
what happens during phonation
artyenoids contract
assist lateral cricoartenoids
what happens in whispering
lateral crico-arytenoids contract
how are oral sounds made
soft palate tenses CNV3 and elevates CNX to close off entrance into nasopharynx
directs stream of air through oral cavity
sound interrupted by the tongue CN XII and teeth/lips CN VII to produce most vowels and sounds
how are nasal sounds produce
soft palate tenses CN V3 and descends CNX to close off entrance into orpharynx
directs stream of air through nasal cavities
produces one of three sounds m,n, or ing depending on position of tongue CN XII teeth and lips CNVII
what are the intrinsic muscles of the larynx nerve supply
all inferior laryngeal nerve apart from cricothyroid
cricothyroid supplied by external laryngeal nerve
what is the mucosa above the fold supplied by
internal laryngeal nerve
what is the mucosa below the fold supplied by
inferior laryngeal nerve
what does the external laryngeal nerve supply
motor supply to cricothyroid
what does the internal laryngeal nerve supply
sensory to mucosa above the vocal folds, vestibule, vestibular folds etc
what is mucosa below the fold supplied by
the inferior laryngeal nerve
what is the function of the strap muscles
accessory muscles of breathing
what is the laryngopharynx
region of the pharynx from epiglottis to oesophagus
which vertebral levels is the larynx between
C4-C6
what is contained in the carotid sheath
internal jugular vein
common carotid artery
deep cervical lymph nodes
vagus nerve
what is enclosed in the investing fascia
deep to superficial fascia
encloses all the other neck fascial compartments and the trapezius and sternocleidomastoid muscle
where is the retropharyngeal space
between the pretracheal and prevertebral fascia
what is contained in the prevertebral fascia
it is deep to the investing fascia, located posteriorly encloses the cervical vertebrae and the postural neck muscles
what is the adams apple called anatomically
laryngeal prominence of thyroid cartilage
where is the oral vestibule
located between the lips and teeth
what is the sublinguinal caruncle
opening for submandibular glands
how do you test CN XII
ask the patient to stick out their tongue, if it is in the midline then both CN XII are working
if one CN XII is damaged what happens
points towards the side of the injured nerve
where do the arteries of the tongue pass
medial to hypoglossus
where do nerves of the tongue pass
lateral to hypoglossus
which pharyngeal arch forms the malleus and incus
first pahrygeal arch
what are regional nodes
the group of lymph nodes that first receive lymph
what are the regional nodes for the tip of the tongue
submental nodes
what are the regional nodes for the palatine tonsil
jugulo-digastric
