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random ENT Flashcards

1
Q

what is contained in the membranous labryrinte

A

ENDOlymph

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2
Q

what is the bony labyrinth made up of

A

rigid bony outerwall of the inner ear made up of the vestibule, semicircular canals and cochlea

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3
Q

what are the otolith organs and where are they contained

A

utricle and saccule which are contained in the vestibule

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4
Q

what is the middle ear lined with

A

columnar mucosa

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5
Q

where is a vestibular schwannoma found most commonly

A

vestibular portion of CNVIII, in the cerebellopontine angle, between the pons and the cerebellum

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6
Q

what syndrome is a paraganglioma associated with

A

MEN 2

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7
Q

what are paramyxoviruses

A

family of virsus associated with mumps and bilateral parotitis

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8
Q

what is the most common type of parotid tumour

A

most common is pleiomorphic adenoma and second most common is warthins both benign

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9
Q

how are ear drops applied

A

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

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10
Q

when is there an increased risk of aminoglycosides

A

with a perforated tympanic membrane

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11
Q

what is an open hearing aid and what are its benefits

A

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

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12
Q

what may be helpful if the ear canal is oedematous

A

a wick

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13
Q

why can you get dizziness from ear drops

A

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

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14
Q

what si the only indication for a hearing aid

A

auditory difficulty and there is a demonstrable hearing loss

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15
Q

can a hearing aid be used for cochlear, retrococohlear or neural hearing loss

A

sound can become very distorted so most commonly no

may make distortion worse and impair understnaiding of speech

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16
Q

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

A

no give hearing therapy

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17
Q

what is a telecoil and why is it useful

A

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

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18
Q

what are the problmes with hearing aids

A

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

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19
Q

what is osler weber rendu

A

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

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20
Q

what bone is the carotid canal in and what does it carry

A

the temporal bone and the internal carotid artery

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21
Q

what bone does the infraorbital foramen go through and what does it supply

A

maxilla and infraorbital nerve V2 and infraorbital artery-branch of maxillary nerve

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22
Q

what is the function of hair cells

A

to convert mechanical stimuli into electrical impulse

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23
Q

when does depolarisation occur

A

when deflected towards the longest

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24
Q

wht are clusters of hair cells called

A

maculae

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25
Q

what are the longitudinal muscles of the larynx supplied by

A

CNX

except for stylopharygeus which is supplied by CNI IX

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26
Q

the glossopharyngeal nerve supplies motor innervation to what muscle only

A

sytlopharygeus

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27
Q

how is air and bone conduction affected in sensorineural hearing loss

A

both air and bone conduction are decreased

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28
Q

when assessing a nasal trauma what should you make sure you do

A

assess eye movements
look in nose for a possible haematoma
refer to ENT clinic for 5-7 days time

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29
Q

what is the most common type of fracture to the temporal bone

A

longitudinal fracture

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30
Q

symptoms of a longitudinal fracture of the temporal bone

A

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

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31
Q

how do you get a transverse fracture of the temporal bone

A

frontal blows

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32
Q

what type of hearing loss is caused by a transverse fracture of temporal bone

A

sensorineural as the fracture can cross the internal acoustic meatus causing damage to CN VIII

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33
Q

where is otolith material most commonly deposited

A

in the posterior semi circular canal

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34
Q

how is a newborns hearing screened for

A

automated otoacoustic emission test

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35
Q

how does an automated optoacoustic emission test work

A

a computer generated click is played through a small earpiece, presence of a soft echo indicates a healthy cochlea

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36
Q

over what age can you do a PTA

A

pure tone audionometry over the age of 3

37
Q

what drains into the spenothmoidal recess

A

the sphenoid sinus

38
Q

what drains into the inferior meatus

A

the nasolacrimal duct

39
Q

what drains into the ethmoidal bulla

A

the middle ethmoidal air cells

40
Q

what drains into the semilunar hiatus

A

the anterior ethmoidal, frontal and maxillary sinus

41
Q

what is another name for maxillary sinus

A

antrum

42
Q

what are the semilunar hiatus and ethmoidal bulla part of

A

the middle meatus

43
Q

where do the posterior ethmoidal air cells drain

A

into the superior meatus

44
Q

what is sinusitis

A

inflammation of the mucosa

45
Q

why can sinusitis be dangerous

A

increased pressure in ethmoid and break the medial wall of the orbit and impact the eye/spread of infection to optic nerve

46
Q

which sinuses is predisposed to infection and why

A

maxillary sinus

as the ostium of maxillary sinus is location superior in relation to its cavity so the cilia must work against gravity

47
Q

what are the vocal cords

A

free borders of mucosa covered connective tissue in the larynx

48
Q

what are the true vocal cords

A

vocal process of arytenoid cartilage to thyroid cartilage

49
Q

what are the false vocal cords

A

arytenoid cartilage to epiglottis

50
Q

where is the quadrangular membrane

A

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

51
Q

where is a laryngoscope placed

A

in the vallecular

52
Q

what is the aryepiglottic fold

A

the superior border of quadrangular membrane

53
Q

what does increasing tension do to pitch

A

increases pitch

54
Q

what does relaxation do to pitch

A

decrease in pitch

55
Q

what does adduction do to sound

A

it makes sound quieter

56
Q

what does Abduction do to sound

A

louder

57
Q

what types of muscles are the intrinsic muscles of the larynx

A

skeletal muscles

58
Q

what are the intrinsic muscles of the larynx innervated by

A

CN X

59
Q

describe the laryngeal muscles in normal respiration

A

they are in resting position

60
Q

what muscles of larynx are being used when there is forced respiration

A

posterior crico-arytenoids contract

61
Q

what happens during phonation

A

artyenoids contract

assist lateral cricoartenoids

62
Q

what happens in whispering

A

lateral crico-arytenoids contract

63
Q

how are oral sounds made

A

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

64
Q

how are nasal sounds produce

A

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

65
Q

what are the intrinsic muscles of the larynx nerve supply

A

all inferior laryngeal nerve apart from cricothyroid

cricothyroid supplied by external laryngeal nerve

66
Q

what is the mucosa above the fold supplied by

A

internal laryngeal nerve

67
Q

what is the mucosa below the fold supplied by

A

inferior laryngeal nerve

68
Q

what does the external laryngeal nerve supply

A

motor supply to cricothyroid

69
Q

what does the internal laryngeal nerve supply

A

sensory to mucosa above the vocal folds, vestibule, vestibular folds etc

70
Q

what is mucosa below the fold supplied by

A

the inferior laryngeal nerve

71
Q

what is the function of the strap muscles

A

accessory muscles of breathing

72
Q

what is the laryngopharynx

A

region of the pharynx from epiglottis to oesophagus

73
Q

which vertebral levels is the larynx between

A

C4-C6

74
Q

what is contained in the carotid sheath

A

internal jugular vein
common carotid artery
deep cervical lymph nodes
vagus nerve

75
Q

what is enclosed in the investing fascia

A

deep to superficial fascia

encloses all the other neck fascial compartments and the trapezius and sternocleidomastoid muscle

76
Q

where is the retropharyngeal space

A

between the pretracheal and prevertebral fascia

77
Q

what is contained in the prevertebral fascia

A

it is deep to the investing fascia, located posteriorly encloses the cervical vertebrae and the postural neck muscles

78
Q

what is the adams apple called anatomically

A

laryngeal prominence of thyroid cartilage

79
Q

where is the oral vestibule

A

located between the lips and teeth

80
Q

what is the sublinguinal caruncle

A

opening for submandibular glands

81
Q

how do you test CN XII

A

ask the patient to stick out their tongue, if it is in the midline then both CN XII are working

82
Q

if one CN XII is damaged what happens

A

points towards the side of the injured nerve

83
Q

where do the arteries of the tongue pass

A

medial to hypoglossus

84
Q

where do nerves of the tongue pass

A

lateral to hypoglossus

85
Q

which pharyngeal arch forms the malleus and incus

A

first pahrygeal arch

86
Q

what are regional nodes

A

the group of lymph nodes that first receive lymph

87
Q

what are the regional nodes for the tip of the tongue

A

submental nodes

88
Q

what are the regional nodes for the palatine tonsil

A

jugulo-digastric

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