Upper Respiratory System Flashcards
When do frontal sinuses develop?
8-10 yrs of age
whisper test
softly whisper into each ear & then ask the patient to repeat what you whispered
ex: baseball, 99
OR
place hands near both ear, then rub fingers near the patient’s ears one at a time. Ask pt to say which ear the pt heard the sound
pneumatic otoscopy
blows small amount of air into the ear to determine the mobility of the pt’s tympanic membrane. Immobility may be due to fluid accumulation in the middle ear, a perforation, or tympanosclerosis
normal lymph nodes
pea size, soft & spongy, non-tender, and mobile
pharyngitis
Inflammation of the pharynx with sore throat
most likely causes: viral– adenovirus, rhinovirus, influenza A/B
or bacterial– Group A beta hemolytic streptococcus, chlamydia pneumoniae, & mycoplasma pneumoniae
Common symptoms of viral pharyngitis
coryza (inflamed mucus membranes), conjunctivitis, fatigue, hoarseness, and low grade fever
Why might a pt report nausea along with a pharyngitis?
pharynx is right next to intra-abdominal organs on the homunculus
Probably Group A-beta hemolytic strep (GABHS) if
child 5-15, winter & early spring season,
absence of cough, tender anterior cervical lymphadenopathy, tonsillar exudate, & fever
The Centor score
Clinical decision tool for management of sore throat.
Must get a score of 1-3 to perform throat culture. Score of 4 or greater– consider empiric treatment w/ antibiotics
Mainly based on expected symptoms of GABHS
Rapid antigen detection test
Detects presence of group A streptococcal
specimen obtained by swab of posterior tonsillopharyngeal
–inoculated onto agar plate for throat culture
Monospot test
Rapid slide agglutination test for mononucleosis (AKA Epstein-Barr virus)
Outer ear infection
Otitis externa (outer ear canal) Can be caused by bacteria entering a small break in the skin of canal. Pt may report drainage from ear. Usually associated with pain upon touching external ear structures.
Inner ear infection
Labyrinithitis
Middle ear
air filled space behind the eardrum
Acute Otitis Media
Inflammation of the middle ear that can be caused by bacteria and viruses. Often appears the TM is bulging, erythematous.
Acute suppurative OM
acute OM with purulent material in the middle ear
OM with effusion (serous OM)
inflammation and fluid buildup (effusion) in the middle ear without bacterial or viral infection. May occur because the fluid buildup persists after an ear infection has resolved.
Chronic OM with effusion
Occurs when fluid remains in the middle ear & continues to return without bacterial or viral infection. Children susceptible to new ear infections & may effect hearing.
Chronic suppurative otitis media
Persistent ear infection that often results in tearing or perforation of eardrum
Otosclerosis
Abnormal growth around stapes bone
Associated with progressive hearing loss beginning at the ages 10-30, marked hearing loss occurring during middle age
Otosclerosis types
- Conductive loss: Ossicle sclerosis into single immovable mass
- Sensory loss: Otic capsule sclerosis
Affects 10% of caucasians, females>males
Rhinosinusitis/sinusitis
Mucosal lining in the paranasal sinuses & nasal cavity becomes inflamed.
Infectious causes:
viral–rhinovirus, adenovirus, influenza virus
bacterial–streptococcus pneumoniae, haemophilus influenzae
–labs & imaging not typically needed
Signs & symptoms of rhinosinusitis
nasal discharge, cough, sneezing, nasal congestion, fever, HA, pain, & facial pressure
Symptomatic treatment of sinusitis
analgesics, intranasal corticosteriods, nasal saline irrigation, decongestants, atihistamine
Bacterial sinusitis
Double sickening (initially get slightly better then gets worse), purulent rhinorrhea (mucus along nasal cavities), elevated ESR
Indicated when signs & symptoms pf acute rhinosinusitis persist without evidence of improvement for at least 10 days
Treatment: amoxicillin, augmentin
Croup
AKA laryngotracheitis
Swelling of the larynx, trachea, bronchi causing inspiratory stridor & barking cough on children 6 mon-3 yrs.
Presentation: fever, nasal flaring, respiratory retractions, stridor
Typically viral
Treatment: oxygen, dexamethsone, nebulized epi
epiglottitis
Inflammation of the epiglottis & adjacent structures
Typical causes: Type B influenza, GABHS
Presentation: high grade fever, toxic appearance, child sitting or leaning forward
Get lateral neck XR, WBC
Treatment: Protect airway! broad spectrum antibiotics
Veritgo (dizziness)
Typical Causes:
eustachian tube dysfunction– tube gets inflammed & mucus/fluid builds up
benign paroxysmal positional vertigo–brief episodes of mild to intense dizziness. triggered by specific changes in the position of head
vesitibular neuritis–inflammation of nerve associated w/ balance.
labyrinthitis– inflammation of the labyrinth, affects both branches of the vestibulo-cochlear nerve
Meniere’s Disease
Disorder of inner ear that causes episodes of dizziness, fluctuating hearing loss with a progressive, permanent loss of hearing. Can also have ringing and pressure in ear.
typicall only affects one ear.
