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GM Phys Di > Unit 5 - ENT > Flashcards

Unit 5 - ENT Flashcards

1
Q

What are the external structures of the ear

A

Auricle and external auditory canal

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2
Q

What are the external functions of the ear

A

Protective and helps gather/channel sound

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3
Q

What are the middle ear structures

A

Ossicles (malleolus, incus, stapes) and the tympanic membrane

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4
Q

What are the functions of the middle ear

A

Ossicles transmit sound from tympanic membrane to inner ear and the tympanic membrane separates middle from external ear

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5
Q

What are the structures of the inner ear

A

Vestibule, semicircular canals, and chochlea

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6
Q

What are the functions of the inner ear

A

Cochlea transmits sound to CN VIII and semicircular canals involved in vestibular function

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7
Q

Sound is also transmitted by ____ directly to the inner ear

A

By bone

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8
Q

What has the function of odor identifying, passage for inspire/expire air, humidifying and warmth, resonance of laryngeal sounds

A

Nose, nasopharynx and sinuses

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9
Q

What is the structure of the external nose

A

Bone/cartilage and nares

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10
Q

What is the kiesselbach plexus

A

Convergence of small fragile arteries and veins within the nose, nasopharynx, and sinus

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11
Q

What are the only sinuses accessible for physical examination

A

Only the maxillary and frontal sinuses

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12
Q

What is the nasal floor is formed by what

A

The hard and soft palate

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13
Q

What is the nasal roof formed by

A

The frontal and sphenoid bone

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14
Q

Where are do the adenoids lie

A

On the posterior wall of the nasopharynx

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15
Q

What has the function of emission of air for vocalization and expiration, passage for material, initiation of digestion, and identify taste

A

Mouth and oropharynx

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16
Q

The oral cavity is divided into the ____ and the _____

A

Mouth and the vestibule

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17
Q

The ____ houses the tongue teeth, gums and anterior opening of the oropharynx

A

The mouth

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18
Q

The _________ of the hard palate and the fibrous soft palate form the roof of the mouth

A

The bony arch

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19
Q

Loose mobile tissue covering the mandibular bone forms the ______

A

Floor of the mouth

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20
Q

The tongue is anchored to the floor of the mouth by what

A

The frenulum

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21
Q

The roots of the teeth are anchored to the ________ of the maxilla and mandible

A

Alveolar ridges

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22
Q

The oropharynx is continuous but inferior to what

A

The nasopharynx

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23
Q

What separates the oropharynx from the mouth

A

Separated from the mouth by bilateral anterior and posterior tonsillar pillars

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24
Q

The tonsils lie in the cavity between waht

A

The anterior and posterior tonsilar pillars

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25
Q

When does the inner ear develop

A

In first trimester

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26
Q

When is salivation increases in infants

A

By 3 months

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27
Q

What is different about the eustachian tube in infants than adults

A

Its wider shorter and more horizontal

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28
Q

When do the frontal and sphenoid sinuses begin to develop

A

About 3 years of age completing development in late adolescents

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29
Q

Permanent teeth begin forming in the jaw by what age

A

6 months

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30
Q

When doe eruption of permanent teeth begin and when is it completed

A

Begins at 6 and completed around 14/15 years

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31
Q

In what cases can tooth eruption being delayed

A

In cases of poor nutritional status and chronic conditions

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32
Q

What does the elevated levels of estrogen cause in a womens respiratory tract

A

Causes increased vascularity of upper rspiratory tract

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33
Q

What does the increased vascularity in the upper respiratory tract of pregnant women cause

A

Capilllaries in nose, pharynx, and ears engorge as well as laryngeal changes

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34
Q

Nearly a third of older adults over age ____ have hearing loss

A

65 years

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35
Q

What can be associated with age related hearing loss

A

Degeneration of hair cells in organ of corti, loss of cortical and organ of corti auditory neurons, degeneration of cochlear conductive membrane, decreased vascularization of cochlear

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36
Q

What does sensorineural hearing loss first occur with

A

High frequency sounds and progresses to low ones

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37
Q

Excess deposition of bone cells along the ossicle chain causes what

A

Fixation of stapes in the oval window resulting in conductive hearing loss

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38
Q

What can produce conductive hearing loss

A

Excess deposition of bone cells, cerumen impaction, sclerotic tympanic membrane

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39
Q

Deterioration of sense of smell results is from what

A

Loss of olfactory sensory neurons beginning at age 60 years

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40
Q

When does the sense of taste begin to deteriorate

A

By about 50 years

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41
Q

Why does taste sense deteriorate

A

As the number of papillae on the tongue and salivary gland secretion disease

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42
Q

Why do ears and nose get larger as we age

A

Continuing cartilage formation in ear and nose

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43
Q

What mouth soft tissues change in older adults

A

Cheeks more prominent

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44
Q

What happens to gingival tissues as we age

A

Less elastic and more vulnerable to trauma

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45
Q

What happens to the tongue in older adults that cause difficulty swallowing

A

Altered motor function of tongue

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46
Q

What can ear pain often be concurrent with

A

Upper respiratory infection, frequent swimming, and trauma to the head

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47
Q

What is a false sense of motion

A

Vertigo

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48
Q

What can be an indicator in infants and children regarding serum bilirubin

A

Serum bilirubin greater than 20 mg/100 mL

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49
Q

When doing an external exam on the external auditory canal what are you looking for

A

Discharge/odor

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50
Q

What should the consistency of the auricle be like for the external exam

A

Consistency should be firm and mobile and without nodules

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51
Q

What are the middle ear structures

A

Ossicles (malleus, incus, stapes) tympanic membrane

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52
Q

How do we compare air to bone conduction

A

Weber test and rinne test

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53
Q

What are 3 evaluations of auditory function

A

Response to questions directions, whispered voice test, finger rustle test

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54
Q

What do response to questions/directions, whispered voice test, and finger rustle test all have in common

A

They all are GROSS assessments with limited diagnostic accuracy

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55
Q

What are the two types of hearing loss

A

Sensorineural and conductive

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56
Q

What is the tool used in the weber test

A

512 hz tuning fork

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57
Q

During the weber test if patient hears well in both ears what is it labeled as

A

Normal = weber midline

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58
Q

During the weber test if a patient hears it better in the left or right ear what does it indicate and what is it labeled as

A

Abnormal = weber left or weber right respectively

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59
Q

Weber test interpretation that has sound lateralizing to one ear is what (2 options)

A

Ipsilateral conductive hearing loss or contralateral sensorineural hearing loss

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60
Q

What does the weber test interpretation assume

A

That the patient only has one form of hearing losse

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61
Q

What is the most common cause of hearing loss

A

Conductive hearing loss

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62
Q

When does conductive hearing loss usually take place

A

Usually under age of 40

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63
Q

During rinne test if air conduction (part 2) is ____ as long as the ____ (part 1)

A

2 times as long; bone conductive

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64
Q

What is a normal rinne test be labeled

A

Positive rinne ( air conduction 2x as long as bone conduction)

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65
Q

If bone conduction is better in a rinne test what is it labeled

A

Negative rinne = suggests conductive hearing loss

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66
Q

When does sensorineuronal hearing loss take place

A

Usually over age 40

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67
Q

What is the otoscopic exam used for

A

Used to inspect external auditory canal and middle ear

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68
Q

What findings are you looking for on the tympanic membrane during otoscopic exam

A

Landmarks, color, contour, perforation

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69
Q

What determines the mobility and compliance of tympanic membrane during otoscopic membrane

A

Using pneumatic attachment and evaluation

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70
Q

When should auditory canals be first examined

A

First few weeks of life

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71
Q

When does the TM become conical

A

After 1st months

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72
Q

How do you evaluate hearing of infant

A

Using sound stimuli

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73
Q

When do you perform an otoscopic/oral exam for children

A

At end of PE (maybe physical exam)

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74
Q

When do you do weber and rinne test in children

A

After age of 3

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75
Q

What should be performed on all newborns

A

Audiometry

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76
Q

What kinds of things should we examine in the ears and hearing of older adults

A

Irritation (if hearing aid), course hair on auricle, tm for sclerotic changes, presence of presbycusis/conductive loss, cerumen impaction

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77
Q

What are the external nose parts

A

Bone, cartilage, nares

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78
Q

What are the 4 sinuses

A

Maxillary, frontal, ethmoid, sphenoid

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79
Q

When should you perform palpation of the nose

A

With injury history

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80
Q

How do you evaluate the patency of the nares

A

Occlude one nostril while breathing in through the other

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81
Q

What sinuses should we palpate

A

Frontal and maxillary

82
Q

What are fordyce spots

A

Small yellowish white bodies on mouth/oropharynx that represent ectopic sebacceous glands

83
Q

What is the wharton duct

A

Duct of submandibular salivary gland opening near frenulum in mouth/oropharynx

84
Q

What should saying “ahh” do in the mouth/oropharrynx

A

Raises soft palate symmetrically, uvula in midline, and pharynx should constrict like a curtain

85
Q

How far should a tongue blade go

A

No more than 1/2 way bac

86
Q

What is the tongue blade used to assess

A

Tonsillar pillars and retropharyngeal wall

87
Q

What is menieres disease

A

Combo of vertigo and tinnitus

88
Q

What causes menieres disease

A

Dilation of fluid, chambers of the middle ear

89
Q

What evaluates equilibrium

A

Romberg test

90
Q

What test is performed if imabalance is detected

A

Nylen barany test (dix-hallpike test)

91
Q

Who has a higher incidence of rhinophyma

A

Rosacea and alcoholics

92
Q

What does the otoscope provide illumination for while examining the ear

A

Auditory canal and tympanic membrane

93
Q

What does a tympanometer or tympanometry examine

A

Assesses the functions of the ossicular chain, eustachian tube, tympanic membrane, and interrelation of these parts

94
Q

The amount of energy transmitted from tympanometer is directly related to what

A

The compliance of the system

95
Q

What is compliance of tympanometer measured in

A

Mm or cubic cm of equivalent volume

96
Q

What does compliance indicate

A

Mobility in the middle ear

97
Q

Low compliance measurement indicates what

A

More energy returned to probe with less transmitted to middle ear

98
Q

High compliance reading indicates what from tympanometer

A

Flaccid or highly mobile system

99
Q

What is a graphic representation of the change in compliance of the middle ear system as air pressure is varied

A

Tympanogram

100
Q

What can be visualized by a nasal speculum

A

The lower and middle turbinates of the nose

101
Q

What instrument is used in a Screening tests for auditory function for vibratory sensations as part of the neurological exam

A

A tuning fork

102
Q

What does a tuning fork vibrate at

A

512 Hz (512 cycles per second) (can use 500-1000)

103
Q

Tuning forks with a frequency lower than 500 cause what

A

To overestimate bone condution and can be felt as vibration as well as hearsd

104
Q

For vibratory sensation what frequency fork will i use

A

Lower frequency

105
Q

The greatest sensitivity to vibration occurs when the fork is vibrating between what

A

100-400 hz

106
Q

What is a sensory organ that identifies, localizes, and interprets sound and helps maintain balance

A

The ear

107
Q

The middle ear mucosa produces a small amount of mucus that is rapidly cleared by ciliary action of the ______

A

Eustachian tube (passageway between nasopharynx and middle ear)

108
Q

The eustachian tube drains into what

A

Posterior aspect of the inferior turbinate of the nose

109
Q

The cochlea is a coiled structure containing the _______ and transmits sound impulses to the ______

A

Organ of corti; CN 8

110
Q

Equilibrium receptors of semicircular canals and vestibule of inner ear send signals to where

A

The cerebellum to maintain balance

111
Q

How are vibrations passed through the ear

A

Tm to malleus, incus, stapes, to oval window of inner ear, causing cochlear endolymph motion to round window where it is dissipated

112
Q

Impulses of CN 8. Are sent to what lobe for interpretation of sound

A

Temporal lobe

113
Q

What bones form the nasal bridge

A

Frontal and maxillary bones

114
Q

Mucus collects and carries debris and bacteria from the inspired air in the nose to the ____ for _____

A

Nasopharynx; swallow/exportation

115
Q

What does the mucus of the nose contain to fight infection

A

Immunoglobulins and enzymes

116
Q

Receptors for smell are located where

A

In the olfactory epithelium

117
Q

The internal nose is divided by the septum into what

A

Two anterior cavities = the vestibules

118
Q

What houses the sensory endings of the olfactory nerve

A

The cribriform plate

119
Q

What is a small convergence of small fragile arties and veins in the nose and where specifically is it located

A

Kiesselbach plexus located on anterior/superior portion of the septum

120
Q

What are parallel curved bony structures covered by vascular mucous membranes in the nose

A

Turbinates

121
Q

What do turbinates of the nose form

A

Lateral walls of the nose protruding into nasal cavity

122
Q

A ___ below each turbinate is named for the turbinate above it

A

Meatus

123
Q

What is the purpose of the turbinates

A

Increase nasal surface area to warm, humidify, filter inspired air

124
Q

Where does the inferior meatus drain to

A

The nasolacrimal duct

125
Q

Where does the medial meatus drain into

A

The paranasal sinuses

126
Q

Where does the superior meatus drain into

A

The ethmoid sinuses

127
Q

What are air filled paired extensions of the nasal cavities within the bones of the skull

A

Paranasal sinuses

128
Q

Where do the ethmoid sinuses lie

A

Behind frontal sinuses near the superior portion of nasal cavity

129
Q

Where do the sphenoid sinuses lie

A

Deep in skull behind the ethmoid sinuses

130
Q

What are the taste receptors scattered throughout the filiform papillae of the tongue

A

Fungiform papillae

131
Q

How many teeth do adults have

A

32 permanent

132
Q

The oropharynx is separated from the mouth by what

A

Bilateral anterior and posterior tonsillar pillars

133
Q

What part of the tonsils collect cell debris and food

A

Crypts

134
Q

How does an infants eustachian tube differ to an adults and why is it different

A

Wider, shorter, and more horizontal = easier reflux of nasopharyngeal secretions

135
Q

As a child grows what happens to the estachian tube

A

Lengthens and its pharyngeal orifice moves inferiorly

136
Q

What can occlude the eustachian tube and interfere with aeration of the middle ear causing ear effusion

A

Growth of lymphatic tissue specifically adenoids

137
Q

When are the sphenoid sinuses present on a child

A

By 5 yrs old

138
Q

When do frontal sinuses begin to develop

A

7-8 years

139
Q

20 decidious teeth erupt between what age of infant

A

6-24 months

140
Q

Permanent teeth begin forming in the jaw by how old

A

6 months of age

141
Q

Eruption of permanent teeth begins when

A

About 6 years of age completing around 14-15 years

142
Q

Conductive hearing loss may result from what

A

Excess deposition of bone cells along the ossicle chain

143
Q

What could an instant onset of hearing loss inn one or both ears indicate

A

Vascular or autoimmune process

144
Q

What could the onset of hearing loss over a few hours or days indicate

A

Viral infection

145
Q

Is meniere disease genetic

A

Yes

146
Q

What is a false sense of motion

A

Vertigo

147
Q

What age is most at risk for oral cancer and oropharyngeal cancer

A

Older than age 55

148
Q

What nutritional impact can affect ENT

A

Excessive sugar intake

149
Q

When should a child start babbling

A

Before 6 months of age

150
Q

When should there be concern of hearing loss in regards to communicative speech and reliance on gestures

A

After 15 months of age

151
Q

What can cause a cauliflower ear

A

Blunt trauma or necrosis of underlying cartilage

152
Q

What can indicate gout along the peripheral margins of the auricles

A

Tophi crystals

153
Q

The auricle must be almost vertical with no more than a ____ degree lateral posterior angle

A

10

154
Q

When performing external auditory canal inspection a purulent fould smelling discharge can indicate what

A

Otitis externa, perforated acute otitis media, or foreign body

155
Q

What can a low set postition of the auricle or unusual angle indicate

A

Chromosomal aberrations or renal disorders

156
Q

The triad of hearing loss, tinnitus and vertigo constitutes as what

A

Meniere syndrome

157
Q

What is meniere disease

A

Usual symptoms plus another cause undetermined

158
Q

In the nose what is indicated by bilateral watery dishcharge and associated sneezing/nasal congestion

A

Allergy

159
Q

In the nose what is indicated by bloody discharge

A

Epistaxis or trauma

160
Q

In the nose what is indicated by bilateral mucoid or purulent discharge

A

Rhitiis or upper respiratory infection

161
Q

In the nose what is indicated by unilateral purulent, thick, greenish, malodorous discharge

A

Foreign body

162
Q

In the nose what is indicated by unilateral watery discharge occurring after head trauma

A

Cerbrospinal fluid leakage

163
Q

Placing a light against the medial aspect of each supraorbital rim illuminates what

A

Frontal sinus

164
Q

Deep fissures at the corneers of the mouth (chielosis) can indicate what

A

Riboflavin deficiency or overclosure of mouth

165
Q

Lip pallor is associated with ____ and circumoral pallor is associated with ____

A

Anemia; scarlet fever

166
Q

What are round oval or irregular bluish gray macules on the lips and buccal mucosa are associated with what

A

Peutz jhegers syndrome

167
Q

Which malocclusion has the lower molars distally positioned

A

Class II

168
Q

What malocclusion has the lower molars mediallly positioned

A

Class III

169
Q

A red spot on the buccal mucosa at the opening of the stensens duct is associated with what

A

Parotitis

170
Q

What is a localized gingival enlargement or granuloma that is usually inflammatory rather than neoplastic change

A

Epulis

171
Q

The hard palate may have a bony protuberance at the midline called what

A

Torus palatinus

172
Q

Saying “ah” tests what

A

CN 9/10

173
Q

Deviation of the uvula to one side may indicate what

A

Vagus nerve paralysis or peritonsillar abcess

174
Q

A bifid uvula is associated with what

A

Loeys dietz syndrome

175
Q

A yellowish mucoid film in the pharynx is typical of what

A

Postnasal drip

176
Q

The tm does not become conical for several months in newborn and the light reflex may appear what

A

Diffuse

177
Q

A saddle shaped nose with a low bridge and broad base or a short small nose or large nose can suggest a what

A

Chromosomal disorger or congenital anomooly

178
Q

Macroglossia is associate with congenital anomalies such as what

A

Congenital hypothyroidism

179
Q

What are small whitish yellow masses at the juncture between the hard/soft palate and dissappear within a few weeks after birth

A

Epstein pearls

180
Q

How young can weber and rinne be performed

A

3/4 years

181
Q

When do maxillary sinuses form and are ready to palpate

A

At 4 years of age

182
Q

When are frontal sinuses developed and ready to be palpated

A

7 to 8 years

183
Q

Chalky white lines or speckles on the cutting edges of permanent incisors may result from what

A

Excessive flouride intake

184
Q

Multiple brown areas or caries on the upper/lower incisors can be result of what

A

Bedtime bottle of juice or milk

185
Q

Teeth with black or gray color may indicate what

A

Pulp decay or oral iron therapy

186
Q

Mottled or pitted teeth result from what

A

Tetracycline treatment during tooth development or enamel dysplasia

187
Q

Whit specks with a red base on the buccal mucosa opposit the first and second molars occuring in the prodromal phase of rubela are what

A

Koplik spots

188
Q

When do childs tonils reach peak size

A

6 years of age

189
Q

What is inflammation of middle ear resulting in collection of serous mucoid or purulent fluid (effusion) when tm is intact

A

Otitis media with effusion or acute otitis media

190
Q

What is inflammation of auditory canal and external surface of tympanic membrane

A

Otitis externa

191
Q

What is trapped epithelial tissue behind the tm that often is result of untreated or chronic recurrent otitis media

A

Cholesteatoma

192
Q

What is a reduced transmission of sound to middle ear

A

Conductive hearing loss

193
Q

What is a reduced transmission of sound in the inner ear

A

Sensorineural hearing loss

194
Q

What is a disorder of progressive hearing loss that in some cases is hereditary

A

Meniere disease (endolymphatic hydrops)

195
Q

What is the illusion of rotational movement by patient often due to disorder of the inner ear

A

Vertigo

196
Q

What is a bacterial infection of one or more of the paranasal sinuses

A

Sinusitis

197
Q

What is an iinfection of tonsils or posterior pharynx by microorganisms

A

Acute pharyngitis

198
Q

What is a deep infection in the space between the soft palate and tonisl

A

Peritonsilar abcess

199
Q

What is a life threatening infection in the lateral pharyngeal space that has the potential to occlude the airway and mostly occurs in children

A

Retropharyngeal abcess

200
Q

What is a cancer involving the oral cavity or related structures

A

Oral cancer

201
Q

What is a chronic infection of the gums, bones, and other tissues that surround and support teeth

A

Peridontal disease

202
Q

What is a craniofacial congenital malformation that is result of lip or palate failing to fuse during embryonic development prior to 12th week of gestation

A

Cleft lip/palate

GM Phys Di (3 decks)

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