Throat Conditions Flashcards
Pharyngeal pouch, also referred to as Zenker’s diverticulum, is a sac or pocket which can develop between the lower part of the throat (cricopharyngeus) and the upper part of the gullet or food pipe (oesophagus/thyropharyngeus). What is the incidence of this?
1 - 1 : 100/000
2 - 10 : 100/000
3 - 100 : 100/000
4 - 1000 : 100/000
1 - 1 : 100/000
Killian’s dehiscence is a triangular area in the wall of the pharynx between the thyropharyngeus and cricopharyngeus muscles.
Pharyngeal pouch is a sac or pocket which can develop between the lower part of the throat (cricopharyngeus) and the upper part of the gullet or food pipe (oesophagus/thyropharyngeus). Is this more common in elderly or younger populations?
- elderly
5:1 more common in men
Occurs due to a weakness in the muscles of the throat
Which of the following is NOT a typical symptom a patient with a pharyngeal pouch?
1 - dysphagia
2 - regurgitation
3 - sialorrhea
4 - aspiration/recurrent chest infections
5 - neck swelling which gurgles on palpation
6 - halitosis (bad breathe)
3 - sialorrhea
Medical term for drooling
What is the gold standard for diagnosing a patient with a suspected pharyngeal pouch?
1 - endoscopy
2 - chest X-ray
3 - MRI
4 - barium swallow test
4 - barium swallow test
Water soluble contrast swallow
Which of the following is NOT a suitable treatment for a patient with suspected pharyngeal pouch?
1 - SALT input (assess swallow and diet)
2 - tracheotomy
3 - antibiotics for infections
4 - endoscopic stapling/excision of pouch)
2 - tracheotomy
Laryngopharyngeal reflux (LPR) is a condition caused by gastro-oesophageal acid reflux resulting in inflammatory changes to the larynx/hypopharynx mucosa. What % of ENT referrals is this observed in?
1 - 0.1%
2 - 1%
3 - 10%
4 - 40%
3 - 10%
Laryngopharyngeal reflux (LPR) is a condition caused by gastro-oesophageal acid reflux resulting in inflammatory changes to the larynx/hypopharynx mucosa. This can cause all of the following symptoms, EXCEPT which one?
1 - catarrh (mucus build up in throat)
2 - dysphagia
3 - repetitive throat clearing
4 - voice changes
5 - globus pharyngeus
6 - chronic cough.
2 - dysphagia
All of these symptoms are vague and non-specific
Laryngopharyngeal reflux (LPR) is a condition caused by gastro-oesophageal acid reflux resulting in inflammatory changes to the larynx/hypopharynx mucosa. Erythema and oedema can be seen when scoping the patient. Which of the following is the gold standard for diagnosis?
1 - endoscopy
2 - pH manometry
3 - MRI
4 - water soluble contrast swallow
2 - pH manometry
Which of the following is NOT a conservative management approach for Laryngopharyngeal reflux (LPR)?
1 - dietary/lifestyle change
2 - quit smoking/alcohol reduction
3 - SALT input
4 - steroids
Laryngopharyngeal reflux (LPR)
Which 2 medications can be used as a treatment for Laryngopharyngeal reflux (LPR)?
1 - ondansetron
2 - omeprazole
3 - cyclizine
4 - gaviscon
2 - omeprazole
Proton pump inhibitor
4 - gaviscon
Which of the following can the vocal cords be found?
1 - epiglottis
2 - glottis
3 - subglottis
4 - supraglottis
2 - glottis
The vocal cords can be found at the level of the glottis. What level of vertebrae is this?
1 - C1-C4
2 - C2-C8
3 - C4-C6
4 - C5-T2
3 - C4-C6
This changes as we grow from a child to an adult
What is dysphonia?
1 - abnormal voice
2 - difficulty swallowing
3 - drooling
4 - difficulty in generating speech
1 - abnormal voice
Does vocal cord paralysis cause just an abnormal voice?
- No
Can affect breathing as well as below this is the trachea
If adducted during paralysis, then this is a medical emergency
Match what the vocal cord does in relation to the activity:
- breathing and speaking
- adduction and abduction
- breathing = abduction
- speaking = adduction
Vocal cords adduct to help with vibrations and thus make sound
The recurrent laryngeal nerves innervate the vocal cords. Which cranial nerve are the recurrent laryngeal nerves a branch of?
1 - facial nerve (CN7)
2 - hypoglossal nerve (CN12)
3 - vagus nerve (CN10)
4 - glossopharyngeal nerve (CN8)
3 - vagus nerve (CN10)
Left is more likely to be damaged due to its course going under the arch of the aorta
Stridor is a high pitched noice causes by restriction of air flow. A lesion at which of the following would cause an inspiratory stridor?
1 - Oropharynx
2 - Glottis/supraglottis
3 - Subglottic
4 - Tracheal
2 - Glottis/supraglottis
Stridor is a high pitched noice causes by restriction of air flow. A lesion at which of the following would cause an expiratory stridor?
1 - Oropharynx
2 - Glottis/supraglottis
3 - Subglottic
4 - Tracheal
4 - Tracheal
Often described as a wheeze
Stridor is a high pitched noice causes by restriction of air flow. A lesion at which of the following would cause a biphasic stridor?
1 - Oropharynx
2 - Glottis/supraglottis
3 - Subglottic
4 - Tracheal
3 - Subglottic
If a patient presents with stridor, it is important to do which of the following 1st?
1 - bloods
2 - call ENT and anaesthetics
3 - ABCDE assessment
4 - airway assessment
3 - ABCDE assessment
Include history if not distressing the patient
All others would also be done
If a patient presents with stridor, it is important to perform an ABCDE approach and seek help. We can also do all of the following, except which one?
1 - Intubate
2 - High flow oxygen 15L
3 - adrenaline nebuliser
4 - dexamethasone
5 - heliox (B2 agonist nebuliser)
6 - IV Antibiotics (if infective)
1 - Intubate
MUST only be performed by ENT or anaesthetist
Which of the following is NOT a red flag for suspected throat malignancy?
1 - horse voice for months
2 - dysphagia with solids for weeks
3 - dysphagia for liquid and solids since dysphagia began
4 - neck lumps present for weeks
5 - unintensional weight loss for months
3 - dysphagia for liquid and solids since dysphagia began
Malignancy would start with solids, before progressing to liquids
