Trauma & Airway Obstruction

Question 1

What needs to be ruled out in nasal fracture?

Answer 1

Septal haematoma (will move with palpation; pure broken nose should not move)

Question 2

Which investigations are necessary in nasal trauma?

Answer 2

None, usually a pure clinical diagnosis.

Question 3

When should nasal fracture be “reviewed” in ENT clinic?

Answer 3

5-7 days post injury

Question 4

How is nasal fracture treated?

Answer 4

Manipulation under Anaesthetic

Question 5

The nose receives blood supply from which major arteries?

Answer 5

Internal and external carotid

Question 6

What are the 3 anastamoses making up Little’s area?

Answer 6

Sphenopalatine, ethmoid, greater palatine

Question 7

How is epistaxis managed acutely?

Answer 7

1) Arrest flow (vasoconstrictor like adrenaline, ice-packing). Rapid-rhino pack.
2) Remove clots if present
3) Cautery

Question 8

A fracture of the cribiform plate gives a risk to what fluid leaking from nose

Answer 8

CSF - any potential fractures need prophylactic antibiotics for 10 days

Question 9

How is pinna haematoma treated?

Answer 9

Aspiration and drainage, with pressure dressing

Question 10

How is ear laceration treated?

Answer 10

Debride infected tissue, reattach ear.

Do NOT use adrenaline local.

Question 11

Temporal bone fractures will most commonly present at which site

Answer 11

Pterion

Question 12

“Battle sign” on the ear is indicative of what

Answer 12

Temporal fracutre

Question 13

In temporal bone fracture, the status of which nerve must be assessed?

Answer 13

CN VII

Question 14

What is more common: longitudinal or transverse temporal bone fracture?

Answer 14

Longitudinal (blow to the side of the head)

Can also cause conductive hearing loss, CSF otorrhoea.

Question 15

Which injury represents a higher chance of injury to facial nerve; longitudinal or transverse fracture?

Answer 15

Transverse (also SNHL, vertigo)

Question 16

TM perforation causes what type of hearing loss

Answer 16

Conductive

Question 17

Stapes fixation/ “otosclerosis” causes what type of hearing loss

Answer 17

Conductive

Question 18

Does otosclerosis follow trauma?

Answer 18

No

Question 19

How is otosclerosis diagnosed?

Answer 19

CT

Question 20

How are most CSF leakages repaired?

Answer 20

Usually self-healing

Question 21

What constitutes a “zone 1” neck injury?

Answer 21

Any injury to: trachea, oesophagus, thoracic duct, thyroid or the great vessels.

Question 22

What constitutes a “zone 2” neck injury?

Answer 22

Any injury to the: larynx, hypopharynx, CN X, CN XI, CN XII, or vessels of the neck (i.e. carotid, internal jugular)

Question 23

What constitutes a “zone 3” neck injury?

Answer 23

Any injury to the: pharynx

Question 24

What are some indications for urgent surgical exploration in neck trauma?

Answer 24

Hypovolaemic shock, airway obstruction, blood in aerodigestive tract

Question 25

"Tear drop sign" is a buzz-word for what

Answer 25

Medial wall of orbit blow-out fracture

Question 26

What physics principle determines resistance to airflow

Answer 26

Poisueille's Equation (a reduction of radius size will give a ^4 increase in airflow resistance, i.e. 2mm radius reduced by 1mm will give 16x resistance in increase)

Question 27

What is stridor

Answer 27

High pitched sound on expiration

Question 28

What is stertor

Answer 28

Low pitched on inspiration

Question 29

Commonest organism causing acute epiglossitis in children

Answer 29

H. influenzae type B

Question 30

A foreign body will likely lodge itself where

Answer 30

Right lung (bronchus straight c.f. to left which is angled).

Question 31

Recurrent intubation can lead to what glottus change?

Answer 31

Sub-glottic stenosis

Question 32

What is mentoplasty

Answer 32

Chin implants

Question 33

Blepharoplasty should be considered after what 2 other anti-ageing procedures

Answer 33

Botox injections | Fillers

Question 34

What is healing by second intention?

Answer 34

Healing over a scar

Question 35

What is healing by third intention?

Answer 35

Healing with a wide-scar

Question 36

What is first intention healing?

Answer 36

Hairline scar

Question 37

Should a deep wound be sutured immediately?

Answer 37

No, may need debridement and cleaning

Question 38

Skin graft donor site

Answer 38

Anterior ear

Question 39

An SCC is removed from the lateral aspect of a patient's nose (on the ala). Which cosmetic surgery should be used?

Answer 39

Skin flaps

Question 40

Barium swallows are useful in what suspected conditions (3)

Answer 40

1) Pharyngeal pouch 2) Oesophageal dysmotility 3) Strictures

Question 41

First-line investigation in a neck lump

Answer 41

USS

Question 42

Benign lymph nodes tend to have what

Answer 42

Elliptical shape, obvious central fatty hilum, organised vasculature supply.

Question 43

As a rule of thumb, which modality is used to image sensineural deafness?

Answer 43

MRI

Question 44

As a rule of thumb, which imaging modality is used to investigate conductive deafness?

Answer 44

CT

Question 45

Vestibular schwannoma leads to what hearing loss? What is the investigation of choice?

Answer 45

Sensineural. | MRI

Question 46

Foramen rotundum transmits which CN

Answer 46

CN V2

Question 47

Dental abscesses can invade which space? What CN is in this space?

Answer 47

Masticator space. | CN V