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BHP Exam 3 > Sinonasal & Upper Aerodigestive Tract > Flashcards

Sinonasal & Upper Aerodigestive Tract Flashcards

1
Q

paranasal sinuses

A 
1 right frontal sinus
2 left frontal sinus
3 ethmoidal cells
4 sphenoidal sinus
5 maxillary sinus
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2
Q

pharynx

A

1 nasopharynx
2 oropharynx
3 hypopharynx

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3
Q

internal pharynx

A 
1 palatine glands
2 pharyngeal tonsil
3 tubal tonsils
4 palatine tonsil
5 lingual follicles of lingual tonsil
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4
Q

UV on skin of the nose

A

1 solar (Actinic) keratosis
2 basal cell carcinoma
3 squamous cell carcinoma

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5
Q

Inflammation on skin of nose

A

1 rosacea= chronic vascular follicular dilation of the nose and cheeks; telangiectasias

2 rhinophyma= form of rosacea, hypertrophy, follicular dilation, hyperplasia of sebaceous glands, fibrosis; increased vascularity

3 lupus erythematosus

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6
Q

nasal Polyps

A

1 Nasal Polyps Rhinitis (“runny, blocked”) precedes
2 smooth surfaced
3 creamy, semi-translucent
4 ovoid masses
5 histology: immense edema, scattered CICI (mainly plasma cells but if allergic the many eosinophils)

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7
Q

Epistaxis

A

nosebleeds

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8
Q

Etiology of nosebleeds

A 
1 trauma
2 H.H.T (hereditary Hemorrhagic Telangiectasia)
3 Hypertension
4 THombocytopenia
5 Nasopharyngeal angiofibroma
6 Sarcoidosis
7 Wegener's Granulomatosis
8 Hemangioma
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9
Q

Acute Maxillary Sinusitis

A

1 Thickened, acutely inflamed sinus membranes
2 Blockage of sinus drainage at ostia
3 persistent stasis of maxillary secretions
4 secondary bacteria infections
5 retained maxillary fluid becomes purulent
6 severe infections: ehtmoid and frontal sinuses; meninges of the brain

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10
Q

Factors of chronic maxillary sinusitis

A

1 cigarette smoke or allergies
2 deviated nasal septum
3 presence of nasal polyps

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11
Q

squamous papilloma (benign tumor of nose and paranasal sinus)

A

1 nasal vestibule
2 surface epithelium
3 warty nature

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12
Q

nasopharyngeal angiofibroma (benign tumors of nose and paranasal sinuses)

A

1 adolescent and young adult males
2 epistaxis
3 may mimic malignancy

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13
Q

Paranasal sinuses

A

squamous cell carcinoma: causes erosion and maxillary sinus most often

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14
Q

Malignant tumor of the nasopharynx

A

1 MALToma (Mucosa Associated Lymphoid Tissue) type of lymphoma
2 * Nasopharyngeal Carcinoma
3 Squamous cell carcinoma

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15
Q

Nasopharyngeal carcinoma

A

1 Epstein-Barr virus origin
2 poorly differentiated
3 prevalent in China, Southeast Asia, and East Africa
4 Early metastasis, late detection
5 Obstruction-secretory otitis media, hearing loss, and tinnitus
6 Diplopia, nasal obstruction, epistaxis, serous nasal discharge

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16
Q

Waldeyer’s ring in the oropharynx

A

1 palatine tonsils
2 nasopharyngeal tonsils (Adenoids)
3 lingual tonsils
4 tubal tonsils

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17
Q

beta-hemolytic streptococcal pharyngitis (pathology of the oropharynx) is a possible precursor of

A

1 acute rheumatic fever

2 acute post-streptococcal glomerulonephritis

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18
Q

what is the most common cause of tonsillar enlargement?

A

reactive lymphoid hyperplasia

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19
Q

What is “Quinsy” (Abscess) or Ludwig’s angina (submandibular space)

A

acute tonsillitis

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20
Q

Tenacious Pseudomembrane produced results in

A

obstructive asphyxia

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21
Q

Production of exotoxin

A

affects heart and nerves

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22
Q

Tympanic membrane of the middle ear

A

eardrum

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23
Q

what are keloids

A

-reactive response to injury (acquired diseases of the pinna)

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24
Q

Where is the etiology of conductive deafness most often located?

A

in ear wax

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25
Q

otitis media with effusion (OME/EAR GLUE)

A

1 thick mucoid, gray/brown fluid
2 sterile, sticky, glue like
3 accumulates in middle ear of children following blocked Eustachian tube
4 Associated with conductive deafness with intermittent earache
5 Predisposes to acute suppurative otitis media
6 Tympanosclerosis: hyaline degernation of the eardrum mucosa associated with OME

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26
Q

What is the etiology of chronic suppurative otitis media?

A

persistent non-healing perforation of the tympanic membrane

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27
Q

What are the clinical manifestations of chronic suppurative otitis media?

A
  • chronic earache and deafness

- persistent discharge from external auditory meatus

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28
Q

Most important primary disease of small bones of the middle ear

A

otosclerosis

29
Q

meniere’s disease

A

1 marked distention of the cochlear duct by excess fluid
2 vestibular membrane (of Reissner) (VM) buldges into Scala vestibuli m membrane ruptures with two fluids mixing??? (Slide 47 confusing)

30
Q

Hearing Loss

A

sounds waves NOT to inner ear

31
Q

etiology of hearing loss

A 
1 usually ear wax
2 otitis externa and otitis media
3 barotrauma
4 ear drum perforation
5 otosclerosis
6 congenital malformations
32
Q

Sensorineural hearing loss

A

Damage to inner ear or nerve tracts to brain

33
Q

Etiology of sensorineural hearing loss

A 
1 usually presbyacusis 
-degernative changes in cochlea
-very common in elderly
2 excessive noise
3 ototoxic drugs=ASA, Aminoglycosides, etc.
4 Post infective= Rubella, Cytomegalovirus, Toxoplasmosis, Meningitis
5 Acoustic neuroma
6 Head Injury
34
Q

Ear disease in Children temporary hearing loss

A

acute otitis media or OME

35
Q

Permanent hearing loss in children

A

usually sensorineural

36
Q

Angioedema

A

allergic and toxic damage

1 type I hypersensitivity; may be life-threatening

37
Q

Allergic and toxic damage of the larynx

A

1 angioedema
2 acute toxic laryngitis
3 chronic laryngitis

38
Q

Singer’s nodules

A

1 Benign Thickenings, nodules, and polyps
2 smooth, round, minute fibrous nodules
3 junction of anterior one third and posterior two thirds of the vocal cord

39
Q

Laryngeal Carcinoma usually occurs in

A

male, cigarette smokers, >40 yrs old

40
Q

Sites of laryngeal Carcinoma

A

1 glottis= most common; best prognosis
2 Supraglottis= more often mets. since more lymphatics
3 subglottis= rarest; poor prognosis with late onset of symptoms

41
Q

Some laryngeal carcinoma preceded by epithelial dysplasia

A

most are well-differentiated squamous cell carcinoma

42
Q

Verrucous carcinoma variant

A

1 pathology of the larynx
2 affects one or both true vocal cords
3 locally destructive
4 metastasis is rare unless irradiation treatment

43
Q

3 characteristic locations of esophageal diverticula

A

1 *Zenker Diverticulum = immediately above the upper esophageal spincter
2 near the midpoint of the esophagus
3 epiphrenic diverticulum= immediately above the lower esophageal spincter

44
Q

What causes Achalasia?

A

loss of ganglion cells of the myenteric plexus (muscular)

45
Q

Achalasia usually occurs in

A

middle aged adults

46
Q

What is a lack of coordinated muscle contraction (peristalsis) and constant contraction of the loewr esophageal spincter. Dilation of the esophagus, difficult swallowing and retention of food bolus?

A

achalasia

47
Q

Megaesophagus slowly evolves.

Predisposes to esophageal carcinoma

A

achalasia

48
Q

What increases width of esophagus except distal spastic segment?

A

achalasia

49
Q

Esophageal Varices

A

Esophageal submucosal venous channels enormously dilated secondary to portal hypertension (e.g. chronic liver disease, cirrhosis)

50
Q

What can protrude into the esophagus’s lumen?

A

Esophageal varices

51
Q

If this ruptures or overlying mucosa ulcerates, then torrential hemorrhage into esophagus and stomach with hematemesis leads to exanguination

A

esophageal varices

52
Q

Mallory-Weiss Tear (laceration)

A

1 lower esophagus
2 following vomitting with full stomach- severe retching
3 typically seen in alcoholism

53
Q

hiatal hernia

A

upper part of stomach moves through the diaphragmatic esophageal hiatus into the thoracic cavity

54
Q

symptoms of hiatal hernia

A

reflux, esophagitis, peptic ulcers in intrathoracic stomach and lower esophagus

55
Q

what is an important complication of hiatal hernia?

A

esophagitis

56
Q

two types of hiatal hernia

A

sliding and paraesophageal (rolling)

57
Q

Gastroesophageal reflux

A

most common clinical abnormality of the esophagus

58
Q

What leads to substernal pain (heartburn)

A

reflux of gastric acid contents into esophagus

59
Q

Predisposing factors of Gastroesophageal reflux

A

1 increase abdominal pressure (overeating, pregnancy, recumbent position)
2 lower esophageal spincter lax or incompetent
( hiatal hernia, excessive smoking, and alcohol ingestion , scleroderma)

60
Q

3 complications of GERD

A

esophagitis, erosive esophagitis, esophageal stricture

61
Q

Gastroesophageal reflux complications

A

1 reflux-acute inflammation (Esophagitis)
2 Peptic ulceration (Erosive): lower esophagus, small ulcers
3 stricture- lower esophagus, progressive fibrosis of ulceration
4 barrett esophagus

62
Q

barrett esophagus

A

persistent reflux results in columnar metaplasia of the lower esophageal squamous epithelial mucosa to glandular tall columnar epithelium and epithelial dysplasia. Eventually, adenocarcinoma may (3-10%) develop so monitor patients with endoscopy and biopsy

63
Q

What does Adenocarcinoma (malignant esophageal tumor) most often arise from?

A

aberrant (ectopic) gastric mucosa or Barrett Esophagus

64
Q

Where does Adenocarcinoma arise most frequently?

A

lower one third of esophagus

65
Q

Clinical Squamous Cell Carcinoma

A 
1 alcohol and tobacco use
2 seen more in men
3 affects loewr and middle thirds
4 dysplastic epithelium may precede
5 dysphagia occurs when tumor becomes large
66
Q

treatment of squamous sell carcinoma

A

surgery or irradiation

67
Q

Prognosis of Squamous cell carcinoma?

A

regional lymph node involvemnet early and common

-survival rate is POOR with 5 yr. survival

68
Q

Plummer Vinson Syndrome

A

1 severe iron deficiency anemia
2 middle aged and elderly women
3 more often Scandinavian origin
4 Squamous cell carcinoma at a rare esophageal site: posterior -cricoid area (upper 1/3)

BHP Exam 3 (7 decks)

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