Ent

Front 1

most epithelial malignancies in the head and neck are what?

Back 1

squamous cell carcinomas AKA epidermoid carcinoma

Front 2

squamous cell carcinomas in this region usually metastasize to where?

Back 2

lung

Front 3

what are the premalignant lesions that may preceed a squamous cell carcinoma?

Back 3

heaped up white mucosa - leukoplasia. red inflamed mucosa - erythroplasia.

Front 4

describe characteristics of basal cell carcinoma.

Back 4

most common cutaneous malignancy and most benign, only locally destructive, no metastasis, and affects facial structures typically exposed to sun (ears, cheek, scalp).

Front 5

differentiated carcinomas of the thyroid include?

Back 5

most commonly papillary followed by follicular thyroid cancers and then medullary thyroid cancers which affect the interfollicular C cells and may produce calcitonin (these are usually inherited)

Front 6

compare the prevalence of malignant vs. benign salivary gland tumors.

Back 6

benign ones are more common, but malignant ones are more likely to occur in smaller salivary glands.

Front 7

cervical node metastasis of squamous cell carcinoma is present in what percent of patient's at time of diagnosis? what does this do to the prognosis?

Back 7

40%, diminishes prognosis by half

Front 8

compare the metastasis of midline tumors versus glottic tumors.

Back 8

midlines tend to go bilaterally while glottics only spread in advanced stages due to anatomical barriers of spread.

Front 9

what is the most common site of metastasis in head and neck cancers?

Back 9

level II or the upper jugular area medial to the SCM above the level of the hyoid/bifurcation of the carotid.

Front 10

obviously there are many presentations of head and neck cancers, but what are the common presentations and what do they mean?

Back 10

dysphonia (hoarseness - indicates larynx, CN X or the RLN), dysphagia (swallowing difficulty), odynophagia (pain on swallowing), otalgia (CN IX, CN X), trismus (difficulty opening mouth - mastication muscles or CN V), hemoptysis (coughing blood), hearing loss (CN VIII or fluid in ear), otorrhea (drainage from ear), epistaxis (nosebleed), facial weakness (CN VII especially in parotic or ear malignancies), facial hypesthesia, diplopia

Front 11

if otalgia exists and there is no ear pathology what does this mean?

Back 11

TMJ, tonsil, larynx, and teeth may all refer pain to the ear bc of common innervation (V, VII, IX, and X)

Front 12

blocking of the eustacian tube at the nasopharynx will indicate and cause what?

Back 12

indicates nasopharynx cancer and will cause hearing loss by fluid buildup in the middle ear

Front 13

what type of biopsies should be done with cancers in the head and neck?

Back 13

fine needle aspiration, slicing it open might spread the cancer

Front 14

what would a neck dissection remove?

Back 14

the lymph nodes with or without removing other structures

Front 15

what does the internal nasal valve seperate and what does it do in terms of air resistance?

Back 15

it divides the nasal cavity into the nasal cavity proper and the nasal vestibule; it is the narrowest part of the nose and thus offers the greatest resistance to air flow.

Front 16

what structure provides conveniant access to pituitary tumors?

Back 16

sphenoid sinus

Front 17

what is the source of most epixstasis (nosebleeds)?

Back 17

kiesselbach's plexus which is from the internal and external carotid

Front 18

taste buds can only distinguish what?

Back 18

sweet, sour, salty, and bitter

Front 19

anosmia and hyposmia may be due to what?

Back 19

most commonly due to post viral infections but also due to head trauma, alzheimer's and environmental toxins

Front 20

who is at risk for nasal polyps and how are they treated?

Back 20

nasal allergies, chronic sinusitis, asthmatics... surgery

Front 21

what mediates allergic rhinitis?

Back 21

mast cell's release of IgE

Front 22

diseases where may lead to vocal cord paralysis?

Back 22

mediastinum, apex of the lung, thyroid and esophagus

Front 23

in terms of the larynx, how can a CVA affect it and where would the lesion need to be?

Back 23

lesion in the brainstem may lead to aspiration secondary to sensory and motor function

Front 24

bilateral paralysis of the vocal cords can lead to what? What conditions may cause this?

Back 24

airway obstruction. Can be due to bilateral injury of recurrent nerve, hydrocephalus, or chiari malformation

Front 25

describe the four stages of swallowing.

Back 25

the oral preparatory phase is bolus formation. the oral phase is the elevation and sweeping of the tongue. the pharyngeal phase uses motor activity of IX and X and is very fast, larynx moves up, neg pressure, glottis closes and the cricopharyngeus opens so the bolus can pass. The esophageal phase is done via CN X and is completely autonomic

Front 26

how can dysphagia be treated?

Back 26

thicker foods, maneuvering during swallowing, double swallow

Front 27

what are the three zones in terms of penetrating neck trauma? what does an injury in each level indicate?

Back 27

1. sternal notch to cricoid. 2. cricoid to angle of mandible
3. angle of mandible to skull

areas 1 and 3 are more likely to have damaged major vascular structures and will need angiography. Level 2 injuries may be managed by endoscopy and angiography or surgical exploration

Front 28

how are mandibular fractures described?

Back 28

anatomic location, condition of the surrounding teeth, favorability (masticator muscles pulling it open or closed?), and type (simple or comminuted).

Front 29

what are the types of midface fractures and their classifications?

Back 29

lefort 1 seperates teeth and palate from the rest of the face. lefort II seperates the middle of the face and palate from the orbits and skull. lefort III seperates the face and orbits from the skull. A blowout fracture is caused by blunt direct trauma to the eye causing the orbital floor bone to go into the maxillary sinus

Front 30

what is a rhytidectomy?

Back 30

face lift

Front 31

what is a blepharoplasty?

Back 31

improves the appearance of the eyelids

Front 32

what is the most common branchial cleft anomaly and how is it treated?

Back 32

branchial cleft cyst which is treated surgically. Note is usually from the second arch and becomes enlarged esp in URI.

Front 33

what is a branchial cleft anomally that presents in the posterior triangle of the neck, is an abnormality in the development of the lymphatic channels, and can obstruct the mouth and airway?

Back 33

cystic hygroma AKA cavernous lymphangioma

Front 34

this branchial cleft anomaliy is due to the migration of the thyroid and is treated by surgery as well as removal of part of the hyoid and the migrational tract.

Back 34

thyroglossal duct cyst

Front 35

when are tympanostomy tubes used?

Back 35

with recurrent acute otitis media that antibiotics will not eliminate

Front 36

what is a cholesteatoma and how is it treated?

Back 36

the tympanic bursts near the edge and thus ingrowth of the TM may occur forming these bad boys. They may become infected and must be removed via a mastoidectomy

Front 37

what is a tympanocentesis?

Back 37

aspiration of the middle ear contents

Front 38

what is a tympanoplasty?

Back 38

repair of the eardrum with or without the repair of the ossicles (ossiculoplasty)

Front 39

describe the two divisions of hearing loss.

Back 39

conductive involves lesions of the external ear canal, TM, and middle ear. Sensorineural involves the cochlea, VIII, or the CNS

Front 40

what is the pathology of otosclerosis?

Back 40

the stapes has extra bone and becomes fixed, thus it cannot vibrate and soundwaves are not transported to the cochlea. Note it can be treated with a prosthetic stapes

Front 41

What are the genetic reasons for sensorineural hearing loss?

Back 41

sporadic via cochlear malformations, chromosomal via tri 18, or dominant inherited via pendrids syndrome or wardenbergs

Front 42

what are the prenatally aquired ways to develop sensorineural hearing loss?

Back 42

infections, toxins, hypoxia, prematurity, or kernicterus (elevated bilirubin)

Front 43

what are postnatal ways to develop sensorineural hearing loss?

Back 43

meningitis, mumps, measles, and otitis media

Front 44

what are the two ways to test an infant's hearing abilities?

Back 44

auditory brainstem response (reflex) or by detecting otoacoustic emissions from the movement of hair cells thus indicating a functioning cochlea

Front 45

if the cochlea is damaged by say meningitis, how can hearing be restored?

Back 45

by cochlear implant

Front 46

What is a vestibular schwanoma?

Back 46

benign tumor located on the vestibular nerve which grows slowly causing hearing loss with out vertigo

Front 47

bell's palsy is usually caused by what?

Back 47

herpes simplex virus

Front 48

this paralysis is caused by herpes zoster, is associated with pain, and a rash near the ear canal

Back 48

ramsay hunt syndrome

Front 49

a rinne negative test result means what?

Back 49

bone conduction is greater than air conduction thus conductive hearing loss

Front 50

describe benign paroxysmal positional vertigo.

Back 50

the posterior semicircular canal develops canoliths in its fluid and thus vertigo occurs when the head is rotated and extended toward the affected ear.

Front 51

the cause of this disease is unknown, but the pathology is periodic distension of the endolymphatic space in the cochlea and semicircular canals

Back 51

menieres disease

Front 52

this is caused by a viral infection in the inner ear.

Back 52

vestibular neuronitis