Trauma & Airway Obstruction Flashcards
What needs to be ruled out in nasal fracture?
Septal haematoma (will move with palpation; pure broken nose should not move)
Which investigations are necessary in nasal trauma?
None, usually a pure clinical diagnosis.
When should nasal fracture be “reviewed” in ENT clinic?
5-7 days post injury
How is nasal fracture treated?
Manipulation under Anaesthetic
The nose receives blood supply from which major arteries?
Internal and external carotid
What are the 3 anastamoses making up Little’s area?
Sphenopalatine, ethmoid, greater palatine
How is epistaxis managed acutely?
1) Arrest flow (vasoconstrictor like adrenaline, ice-packing). Rapid-rhino pack.
2) Remove clots if present
3) Cautery
A fracture of the cribiform plate gives a risk to what fluid leaking from nose
CSF - any potential fractures need prophylactic antibiotics for 10 days
How is pinna haematoma treated?
Aspiration and drainage, with pressure dressing
How is ear laceration treated?
Debride infected tissue, reattach ear.
Do NOT use adrenaline local.
Temporal bone fractures will most commonly present at which site
Pterion
“Battle sign” on the ear is indicative of what
Temporal fracutre
In temporal bone fracture, the status of which nerve must be assessed?
CN VII
What is more common: longitudinal or transverse temporal bone fracture?
Longitudinal (blow to the side of the head)
Can also cause conductive hearing loss, CSF otorrhoea.
Which injury represents a higher chance of injury to facial nerve; longitudinal or transverse fracture?
Transverse (also SNHL, vertigo)
TM perforation causes what type of hearing loss
Conductive
Stapes fixation/ “otosclerosis” causes what type of hearing loss
Conductive
Does otosclerosis follow trauma?
No
How is otosclerosis diagnosed?
CT
How are most CSF leakages repaired?
Usually self-healing
What constitutes a “zone 1” neck injury?
Any injury to: trachea, oesophagus, thoracic duct, thyroid or the great vessels.
What constitutes a “zone 2” neck injury?
Any injury to the: larynx, hypopharynx, CN X, CN XI, CN XII, or vessels of the neck (i.e. carotid, internal jugular)
What constitutes a “zone 3” neck injury?
Any injury to the: pharynx
What are some indications for urgent surgical exploration in neck trauma?
Hypovolaemic shock, airway obstruction, blood in aerodigestive tract
“Tear drop sign” is a buzz-word for what
Medial wall of orbit blow-out fracture
What physics principle determines resistance to airflow
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)
What is stridor
High pitched sound on expiration
What is stertor
Low pitched on inspiration
Commonest organism causing acute epiglossitis in children
H. influenzae type B
A foreign body will likely lodge itself where
Right lung (bronchus straight c.f. to left which is angled).
Recurrent intubation can lead to what glottus change?
Sub-glottic stenosis
What is mentoplasty
Chin implants
Blepharoplasty should be considered after what 2 other anti-ageing procedures
Botox injections
Fillers
What is healing by second intention?
Healing over a scar
What is healing by third intention?
Healing with a wide-scar
What is first intention healing?
Hairline scar
Should a deep wound be sutured immediately?
No, may need debridement and cleaning
Skin graft donor site
Anterior ear
An SCC is removed from the lateral aspect of a patient’s nose (on the ala). Which cosmetic surgery should be used?
Skin flaps
Barium swallows are useful in what suspected conditions (3)
1) Pharyngeal pouch
2) Oesophageal dysmotility
3) Strictures
First-line investigation in a neck lump
USS
Benign lymph nodes tend to have what
Elliptical shape, obvious central fatty hilum, organised vasculature supply.
As a rule of thumb, which modality is used to image sensineural deafness?
MRI
As a rule of thumb, which imaging modality is used to investigate conductive deafness?
CT
Vestibular schwannoma leads to what hearing loss? What is the investigation of choice?
Sensineural.
MRI
Foramen rotundum transmits which CN
CN V2
Dental abscesses can invade which space? What CN is in this space?
Masticator space.
CN V
