Sore Throat Flashcards
What is the pharynx?
12cm flattened tube extending from the base of the skull to the oesophagus
Describe the mulsulature of the pharynx
- Inner longitudinal layer
- Outer circular layer composed of superior, middle and inferior constrictor muscles.
Describe the divisions of the pharynx
- Nasopharynx - base of skull to soft palate
- Oropharynx - soft palate to floor of vallecula
- Hypopharynx - floor of vallecula to oesophagus
What are the functions of the larynx?
- Protection of trachea and bronchi
- Assisting respiration
- Phonation
- Effort closure
What is the mainstream treatment for common sore throat?
- Fluids
- NSAIDs
- Rest
- Steroids (for extreme swelling)
Describe the clinical presentation of strep throat
- Red throat and tonsils
- Neck nodes
- Dysphagia (difficulty swallowing)
- Odynophagia (pain on swallowing)
- Caused by group B streptococcus
- Treat with penicillin
Describe the clinical presentation of tonsilitis
- Sore throat
- Dysphagia
- Fever
What is the treatment for tonsilitis?
- Reassurance
- Usually add in antibiotic - penicillin
What are the SIGN guidelines for tonsillectomy?
- 7 episodes in one year
- Bleeding and pain
What is quinsy?
- Peritonsillar abscess
- Complication of tonsillitis
- 2x is indication for tonsillectomy
What is the key sign of quinsy?
Trismus (patient can’t open mouth)
What action is required for a patient presenting with quinsy?
DRAIN IT
What is glandular fever?
- Infectious mononucleosis
- Epstein Barr virus
What is the clinical presentation of glandular fever?
- Large tonsils
- Greyish / white exudate
- Neck lymphadenopathy
- Monospot
Describe croup
- Laryngotracheobronchitis
- Occurs in babies 6m-3y
- Viral
- Gradual onset
Describe the onset and symptoms of croup
- Gradual onset
- URTI (upper respiratory tract infection)
- Barking cough
- Stridor (noise around larynx)
What are the treatment options for croup?
- Reassurance
- Opening airway with adrenaline nebuliser
- Intubation
What is supraglottitis?
- Bacterial infection of tissues in the larynx above the glottis
Describe the onset and symptoms of supraglottitis
- Rapid onset of symptoms
- Fever
- Odynophagia
- Drooling
- Difficulty breathing
What are the treatment options for supraglottitis?
- Antibiotics
- Nebulisers
- Intubation if necessary
Describe deep neck space infections
- Swelling with / without abscess in the neck
- Occurs often following tonsillits, dental abscess, trauma
- Needs to be imaged
- Can cause airway compromise
- Needs intubation and draining
What are the symptoms of diptheria?
- Looks like tonsillitis initially
- Grey membrane develops over pharynx
- Can cause airway compromise
What is the treatment for diptheria?
Antobiotics and antitoxin
Describe fungal sore throats
- Most commonly thrush
- Often chronic irritation rather than pain
- Occurs:
- after antibiotics
- after radiotherapy
- White patches in the throat
Why is stridor an important clinical indication?
It can be a sign of impending airway compromise
What are the symptoms of oropharyngeal cancer?
- Otalgia
- Neck lump
- Dysphagia
- Odynophagia
- Change in voice
- Lazy tongue (hypoglossal nerve palsy)
Describe pain associated with throat cancer
- Throat pain is rare
- Ear pain is common (otalgia)
- Referred pain from vagus nerve
What are the symptoms of laryngeal cancer?
- Hoarseness
- Neck node
- Late presentation is a problem
What is a laryngectomy?
Surgical resection of the larynx and separation of the airway from the GI tract.
