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Upper Respiratory System Flashcards

1
Q

What are the 4 sinuses?

A

Frontal - Don’t develop till 8-10 yrs.
Ethmoid
Maxillary
Sphenoid

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2
Q

What are the 5 steps for performing a thorough oral examination?

A
  1. Use gloves
  2. Establish good view oral mucosa & gingiva
  3. Palpate the oral mucosa & gingiva
  4. Check ventral aspect of tongue
  5. Grip tongue with gauze - check lateral borders
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3
Q

Is pharyngitis always strep?

A

NO!

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4
Q

What is pharyngitis? Most likely infectious causes?

A

Inflammation of the pharynx with resulting sore throat.

Causes:

  • Viral (Adenovirus, Rhinovirus, Coronavirus, Enterovirus, etc.
  • Bacterial (GABHS, Chlamydia Pneumoniae)
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5
Q

What are common symptoms of viral pharyngitis?

A 
Coryza - inflamed mucus membrane
Conjunctivitis 
Malaise / Fatigue
Hoarseness
Low grade fever
Nausea
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6
Q

Why might patients report nausea with pharyngitis?

A

Pharynx next to intra abdominal organs on homunculus.

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7
Q

What would increase the likelihood of GABHS (Group A Beta Hemolytic Streptococci)?

A
  1. Children age 5-15
  2. Winter or early Spring
  3. Absence of cough
  4. Tender anterior cervical lymphadenopathy
  5. Tonsillar exudates
  6. Fever
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8
Q

What is the Centor Score System?

A

Used to assess testing/treatment for GABHS Pharyngitis.

  • With score 2-3, perform Rapid Test; IF sibling is sick, start on empiric antibiotics.
  • With score > 4, consider treatment with empiric antibiotics.
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9
Q

What is assessed with the Rapid Strep Antigen Test?

A

Presence of Group A Streptococcal

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10
Q

How is a throat culture obtained?

A

Obtain specimen from posterior tonsillopharyngeal area & inoculate onto agar plate.

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11
Q

What is a monospot test?

A

Rapid slide agglutination test for Mononucleosis by looking at Epstein-Barr Virus.

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12
Q

What causes acute otitis media?

A

Inflammation caused by bacteria or viruses.

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13
Q

What is acute suppurative otitis media?

A

Acute otitis media WITH purulent material in middle ear.

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14
Q

What is otitis media with effusion (serous otitis media)?

A

Inflammation and fluid build up WITH NO infection.

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15
Q

What is chronic otitis media with effusion?

A

Fluid remains in middle ear MORE THAN 6 WEEKS.

Makes children susceptible to new ear infections.

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16
Q

What is chronic suppurative otitis media?

A

Persistent ear infection results in tearing or perforation of eardrum.

17
Q

With otitis media, what happens to the mobility of the tympanic membrane (TM)?

A

TM Mobility is reduced when using a pneumotic otoscope.

18
Q

What may cause otitis externa?

Associated symptoms?

A

Bacteria entering small break in skin

Associated Symptoms:
Report drainage from ear
Pain upon touching external ear

19
Q

What is otosclerosis? What are the 2 types?

A

Progressive hearing loss beginning age 10-30. Marked hearing loss during middle age.

Two types:
Conductive - ossicle sclerosis into single immovable mass.
Sensory - otic capsule sclerosis.

20
Q

What is rhinosinusitis/sinusitis?

What are the signs & symptoms?

A

Mucosal lining paranasal sinuses/nasal cavity inflamed.

Signs/Symptoms:
Nasal discharge
Cough
Sneezing
Nasal Decongestant
Fever
Headache
Pain
Facial Pressure
21
Q

What are the symptomatic treatments of sinusitis?

A

Analgesics, intranasal corticosteroid, nasal saline irrigation, decongestants, and antihistamines.

22
Q

What are the signs/symptoms of bacterial sinusitis?

A

Double sickening, purulent rhinorrhea, elevated ESR

Suspicion of acute bacterial sinusitis

23
Q

What is croup? What are causes?

Signs/Symptoms? Treatment?

A

Croup (Laryngotracheitis)
- Swelling of the larynx, trachea, bronchi causing inspiratory stridor & barking cough in children age 6 months to 3 years.

Causes: Parainfluenza virus, influenza, respiratory syncytial virus

Signs/Symptoms: Fever, nasal flaring, respiratory retractions, stridor

Treatment: O2 and Nebulized Epinephrine

24
Q

What is Epiglottitis?

History?
Presentation?
Treatment?

A

Inflammation of the epiglottis.

History: Rapid onset symptoms, sore throat, muffled voice, drooling
Presentation: High grade fever, toxic appearance, child sitting/leaning forward
Treatment: Protect airway, broad spec antibiotics

25
Q

In which ears would you assess conductive and sensorineural loss with the Weber Test?

A

Weber Test

  • Conductive Loss - lateralizes to AFFECTED side.
  • Sensorineural Loss - lateralizes to side opposite affected ear.
26
Q

What are causes of Conductive hearing loss?

A 
Cerumen impaction
Middle ear fluid
Lack of movement of the ossicles
Trauma
Other obstructions
27
Q

What are causes of Sensorineural hearing loss?

A 
Hereditary
Meniere Disease
Multiple Sclerosis
Trauma
Ototoxic drugs
Barotrauma
28
Q

How would you indicate a normal vs. abnormal Rinne Test?

A

Normal: AC > BC

Abnormal: BC > AC

29
Q

What is the Whisper Test?

A

Initial assessment for hearing loss.

Doctor stands behind patient. Patient occludes one ear. Doctor whispers combo of numbers/letters. Doctor repeats different sequence if patient responds incorrectly.

Normal: Patient correctly repeats or after 2 sequences, can identify 3 of 6.
Abnormal: Patient incorrectly identifies 4 of 6.

OR Place hand near both ears then rub fingers one near at a time. Allow patient to say which ear the sound was near.

30
Q

What is BPPV?

What are the two methods of diagnosing?

What is the one method of treatment?

A

Benign Paroxysmal Positional Vertigo (BPPV)

Two methods of diagnosing:
Dix-Hallpike Maneuver
Epley Maneuver

One method of treatment:
Epley Maneuver

31
Q

Which cranial nerves (CN) control the soft palate? What occurs during paralysis?

A

Soft Palate controlled by CN IX & X

Paralysis: Uvula deviates to OPPOSITE side and soft palate does not rise with saying “ah”!

32
Q

Define the following 4 oral conditions:

Aphthous Ulcers
Cheilitis
Gingivitis
Torus Palatinus

A

Aphthous Ulcer - canker sore
Cheilitis - B12 or iron deficiency, red cracks at corners of mouth
Gingivitis - swelling or ulcerations of gums
Torus Palatinus - benign lump on hard palate

33
Q

What is Vestibular Neuritis (neuronitis)?

A

inflammation of the nerve branch associated with balance, resulting in dizziness or vertigo but no change in hearing

34
Q

What are the differences between Canalithesis vs Cupulolitheseis?

A

Both are otoconial debris (stones) associated with BPPV
Canal: free floating; most common
Cuplo: not free floating; not common

35
Q

In terms of mucosa, what do the following indicate:

  1. Red, edema
  2. Pale, bluish or red
  3. Cocaine or meth use, trauma or surgery
A
  1. Red, edema - Viral rhinitis
  2. Pale, bluish or red - Allergic Rxn
  3. Cocaine or meth use, trauma or surgery - Septal perforation

PCM Final (5 decks)

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