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JL ENT > Week 1 > Flashcards

Week 1 Flashcards

1
Q

What is the tympanic membrane : oval window ratio?

A

18:1 (impedance matching air to liquid) - leads to pressure gain of x22

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2
Q

What two muscles open the resting state of the eustachian tube?

A
  1. Tensor veli palatini

2. Levator palatine

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3
Q

What does dysfunction of the eustachian tube lead to?

A

Middle ear negative pressure

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4
Q

What are the two openinsg of the chochlea to the middle ear?

A

Oval and round window

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5
Q

What do the oval and round windows permit?

A

Transmission of pressure wave in enclosed canal and vibration of teh basilar membrane

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6
Q

Give two features of the inner ear as a receiver and transducer?

A

Curved spiral lamina

2 half turns around central modiolus

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7
Q

What is scala media in the cochlea?

A

Endolymph

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8
Q

What is scala tympani and scala vestibuli?

A

Perilymph

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9
Q

Name the structure in the cochlea of the inner ear which produces nerve impulses in response to sound vibrations?

A

Organ of corgi (has hair cells)

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10
Q

What do the hair cells in the organ of corgi do?

A

Transduction - conversion of mechanical bending force into electrical impulse

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11
Q

In relation to hair cell function when does depolarisation occur?

A

When deflected towards longest

Hyperpolarisation occurs when deflected away

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12
Q

How is the cochlea organised?

A

Tonotopically

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13
Q

Where is the primary auditory cortex?

A

Superior temporal gyrus,

brodman areas 41/42

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14
Q

What do the superior canal and posterior canal of the labrynth connect to?

A

Common orus

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15
Q

What are the vestibular end organs?

A

Maculae of the utricle and saccule - otolith organs

Ampullae of lateral, posterior and superior semicircular canals

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16
Q

What do the maculae of utricle and saccule (otolith organs) have?

A

Stereocilia projecting upwards into a gelatinous matrix with otoconia

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17
Q

What direction are the stereocilia orientated?

A

In all directions so all movements perceived by depolarisation/hyperpolarisation

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18
Q

What are otoconia?

A

Calcium carbonate crystals

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19
Q

Where does the cupula sit?

A

In the ampulla of a semiciorcular canal

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20
Q

What is deflection of the cupula caused by?

A

Movement of perilymph - bending causes stereocilia to deflect

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21
Q

What is the term for when the eyes move without a cognitive, visual or vestibular stimulus?

A

Spontaneous nystagmus

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22
Q

What is a vestibular schwannoma?

A

Tumour of VIII nerve sheath (schwann) cells - imbalance due to slowly progressive loss of function

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23
Q

What type of receptors are receptors for taste and smell?

A

Chemoreceptors which are stimulated by binding to particular chemicals

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24
Q

What is taste perception influenced by?

A

Information from smell receptors

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25
Q

What are the sense organs of taste?

A

Taste buds

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26
Q

What do taste buds consist of that are arranged like slices of orange?

A

Sensory receptor cells and support cells

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27
Q

What is the life span of taste receptor cells?

A

10 days

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28
Q

What are taste receptor cells replaced from?

A

Basal cells within the taste buds

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29
Q

Name four places taste buds are present?

A

Tongue
Palate
Epiglottis
Pharynx

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30
Q

Where do the majority of taste buds sit?

A

In the papillae in the tongue

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31
Q

What are the four types of papillae?

A

Filliform - do not contain taste buds
Fungiform
Vallate
Foliate

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32
Q

Where do taste signals conveyed by cranial nerves via the brainstem and thalamus go?

A

To cortical gustatory areas

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33
Q

What are the five primary tastes?

A
  1. Salty
  2. Sour
  3. Sweet
  4. Bitter
  5. Umani (meat or savory) - triggered by glutamate
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34
Q

What is ageusia?

A

Loss of taste function

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35
Q

What is dysgeusia?

A

Distortion of taste function

36
Q

What three cell types does olfactory mucosa contain?

A

Olfactory receptor cells
Supporting cells
Basal cells - secrete mucus

37
Q

What does each neuron in olfactory receptors have?

A

Thick short dendrite and an expanded end called an olfactory rod

38
Q

What do odorants bind to?

A

Cilia

39
Q

What is the life span of olfactory receptors?

A

2 months - basal cells act as precursors for new olfactory receptor cells

40
Q

What do afferent fibres of olfactory nerve pierce?

A

Cribiform plate of ethmoid bone and enter the olfactory bulbs

41
Q

During quiet breathing how do odorants reach smell receptors?

A

By diffusion

42
Q

What might hyposmia be an early sign of?

A

Parkinson’s disease

43
Q

How do you diagnose infections of the throat and pharynx?

A

Well taken throat swab

44
Q

What are the vast majority of sore throat causes?

A

Viral - do not need antibiotics

45
Q

What is the most common cause of bacterial sore throat?

A

Streptococcus pyogenes (group A streptococcus)

46
Q

How do you treat acute follicular tonsilitis (bacterial sore throat)?

A

Oral penicillin - clarithromycin if allergic

47
Q

Give three complications of streptococcal sore throat?>

A
  1. Peritonsillar abscess (quinsy)
  2. Sinusitis/otitis media
  3. Scarlet fever
48
Q

What are 2 late complications of streptococcal sore throat?

A
  1. Rheumatic fever

2. Glomerulonephritis

49
Q

After streptococcal sore throat what are the signs of rheumatic fever complication?

A

3 weeks post sore throat

Fever, arthritis and pancarditis

50
Q

After streptococcal sore throat what are the signs of glomerulonephritis?

A

1-3 weeks post sore throat

Haematuria, albuminuria and oedema

51
Q

What condition has a severe sore throat with a grey white membrane across the pharynx The organism produces a potent exotoxin which is cardiotoxic and neurotoxic?

A

Diphtheria

52
Q

How do you treat diphtheria?

A

Antitoxin and supportive and penicillin/erythromycin

53
Q

What condition presents with white patches on red, raw mucous membranes in throat/muth?

A

Thrush

Nystatin suspension topically

54
Q

What is the term for an upper respiratory tract infection involving the middle ear by extension up the eustachian tube?

A

Acute otitis

55
Q

What does otitis media present with?

A

Earache - predominantly infants and children

56
Q

What are the three most common bacteria to infect the middle ear?

A

Haemophilus influenzae
Streptococcus pneumonia
Streptococcus pyogenes

57
Q

What is the treatment of infections of the middle ear?

A

80% resolve in 4 days with no antibiotics

Amoxocillin if bilateral under 2 years of age and AOM with otorrhoea

58
Q

How is acute sinusitis treated?

A

If uncomplicated avoid antibiotics as 80% resolves in 14 days

Otherwise 1st line penicillin V, 2nd line deoxycycline but not in chilren

59
Q

What condition involves redness and swelling of skin of outer ear canal, may be itchy, can become sore and painful, may be discharge or increased ear wax?

A

Otitis externa

60
Q

Give three bacterial causes of otitis externa?

A
  1. Staphylococcus aureus
  2. Proteuis spp
  3. Pseudomoas aeruginosa
61
Q

Give two fungal causes of otitis externa?

A
  1. Aspergillus niger

2. Candida albicans

62
Q

How is otitis externa treated?

A

Topical aural toilet. or if cultured - topical clotrimazole for fungal or topical gentamicin for pseudomonas infection

63
Q

What condition presents with fever, pharyngitis and lymphadenopathy?

A

Glandular fever - infectious mononucleosis

64
Q

What do half of patients with glandular fever present with>

A

Splenomegaly

65
Q

What two blood conditions are seen in glandular fever?

A

Anemia and thrombocytopenia

66
Q

Why should sport be avoided in glandular fever?

A

Risk of splenic rupture

67
Q

What virus causes glandular fever?

A

Epstein-Barr virus

68
Q

What are the two phase sof primary infection with EBV?

A

Primary infection in early childhood rarely results in infectious mononucleosis
Primary infection in those greater than 10 often causes infectious mononucleosis

69
Q

What is the kissing disease?

A

Glandular fever

70
Q

How is glandular feve confirmed in the lab?

A

Epstei-Barr virus IgM
Heterophile antibody - PaulBunnel test, Monospot test
Blood count and film
LFTS

71
Q

aFTER PRIMARY INFECTION WHat happens to HSV-1?

A

latent - in trigeminal ganglia

72
Q

What is herpetic whitlow?

A

Abscess at end of finger

73
Q

What causes herpangina?

A

Coxsackie viruses

74
Q

What are non viral, selflimiting recurring painful ulcers of the mouth that are round or ovoid and have inflammatory halos?

A

Apthous ulcers

75
Q

What condition causes recurrent oral ulcers, genital ulcers, uveitis, can involve visceral organs such as GI tract, pulmonary, MSK, CVS and neurological systems and it is commonest in middle east and asia?

A

Behcets disease

76
Q

What term is given to chronic otitis media and perforated tympanic membrane?

A

Cholesteatoma

77
Q

What is the normal lining of the middle ear?

A

Cuboidal or columnar glandular epithelium

78
Q

What should you consider if there are bilateral vestibular schwannomas?

A

NF type 2

79
Q

Name three other features of NF type 2 other than vestibular schwannomas?

A

Multiple meningiomas
Gliomas
Cafe au lait spots

80
Q

What should you consider if a young patient presents with nasal polyps?

A

Cystic fibrosis

81
Q

What carcinoma has a strong association with Epstein Barr virus?

A

Nasopharyngeal carcinoma

82
Q

What tumour is related to HPV exposure types 6 and 11 and has peaks of incidence at less than 5 years and between 20 and 40?

A

Squamous papilloma

83
Q

What is a paraganglioma?

A

Tumours arising in clusters of neuroendocrine cells dispersed throughout the body

84
Q

Give two biggest risk factors for squamous cell carcinoma?

A

Smoking and alcohol

85
Q

What tumour is benign, common in parotid gland, more common in over 50 ladies and are poorly circumsised?

A

Pleomorphic adenoma

86
Q

Name a benign tumour which is common in parotid gland, associated with smoking in older males and is a mixture of bilayer of oncocytic epithelium with dense lymphoid infiltrate?

A

Warthins tumour

87
Q

What is the most common ENT malignancy?

A

Mucoepidermoid carcinoma

JL ENT (5 decks)

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