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21 Cards in this Set
- Front
- Back
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causes of conduction hearing loss |
otitis media with effusion peroration otosclerosis nasopharyngeal tumour cholesteatoma |
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causes of sensorineural hearing loss |
age-related noise-related Viral - labyrinthitis Meniere's acoustic neuroma |
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causes of hoarseness |
Acute laryngitis Smoking (chronic laryngitis) Squamous cell carcinoma Vocal cord nodules Vocal cord palsy e.g. due to lung cancer impingement of RLN |
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initial management of epistaxis |
direct (vessel located) - cautery indirect (vessel not located) - packs |
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causes of upper airway obstruction |
1. within the lumen (e.g. foreign body, tumour, bilateral vocal cord palsy) 2. within the wall (e.g. oedema from anaphylaxis, laryngospasm, tumour, croup, acute epiglottitis, amyloidosis 3. extrinsic (e.g. goitre, oesophagus, lymphadenopathy, post-op stridor, after neck surgery) |
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how is stridor caused by malignancy? |
Malignant lesions of the larynx and hypopharynx can present with stridor due to direct tumour obstruction of the airway or indirectly by causing vocal cord palsy and oedema. |
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indications for cricothyroidotomy |
Upperairway obstruction when endotracheal intubation not possible, e.g.irretrievable foreign body; facial oedema (burns, angioedema); maxillofacialtrauma; infection (epiglottitis) |
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complications of otitis media |
incomplete resolution perforation of ear drum spread of infection - to inner ear, to mastoid (mastoiditis), to extradural space (abscess / intracranial sepsis) facial nerve palsy |
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causes of otalgia |
otitis externa acute otitis media pain referred from head & neck cancer - CN9/10 neurological disease psychogenic |
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causes of otorrhoea |
perforation of ear drum (after acute otitis media) chronic otitis media cholesteatoma |
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peripheral (aural) causes of dizziness |
Acute labyrinthine dysfunction - viral, vascular, traumatic Benign paroxysmal position vertigo Meniere's Cholesteatoma, acoustic neuroma Vestibulo-toxic drugs |
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clinical features of vestibular neuronitis |
Abrupt onset of severe vertigo, nausea, vomiting +/- prostration Lateralised nystagmus and gait ataxia No deafness or tinnitus |
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clinical features of Meniere's disease |
Unilateral tinnitus (with a sense of aural fullness) Unilateral sensorineural hearing loss Recurrent attacks of vertigo lasting >20 mins |
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clinical features of BPPV |
Brief attacks (<30secs) of vertigo provoked by rapid changes in head position relative to gravity |
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features of cerebellar dysfunction |
DANISH Dysdiadochokinesis Ataxia (gait and posture) Nystagmus Intention tremor Slurred, stacatto speech Hypotonia/Heel-shin test |
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Positive Romberg's test |
Testis positive if patient falls or is unable to maintain balance withoutcorrective movements of the feet. positive test indicates loss of proprioception |
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causes of cerebellar lesions |
demyelination stroke/TIA neoplasm - acoustic neuroma drugs and alcohol inherited conditions - e.g. spinocerebellar ataxia |
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CN involvement in parotid tumour |
Facial nerve |
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presentation of head & neck cancer |
Hoarseness Stridor Dysphasia Otalgia Lymphadenopathy Weight loss Cranial nerve palsy |
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Management of the airway in patients with a tracheostomy |
100% O2 applied to both the face and the tracheostomy stoma call for help - anaesthetics/ITU, ENT/MaxFax inflate tracheostomy cuff if present suction the airway connect rebreathing bag consider oral intubation / intubation of stoma |
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head and neck cancers that cause hard cervical lymphadenopathy |
oropharynx nasopharynx larynx thyroid oesophagus |
