Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
116 Cards in this Set
- Front
- Back
|
Swallowing
- Three phases - Nerve for phase II - Describe phase II - Phase 3 voluntary or involuntary? |
- Oral preperatory, pharyngeal, esophageal
- CN 9 and 10, involuntary - 1) NP closes (CLOSE) 2) BOT propels bolus (PUSH) 3) Larynx elevates and closes (CLOSE) 4) Pharynx shortens (SHORTEN) 5) UES opens (OPEN) - Trick, BOTH. upper 1/3 voluntary striated, lower 2/3 involuntary smooth |
|
|
What is being evaluated in FEEST? What is not?
|
Laryngeal adductor Reflex, SLN
Esophageal dysfunciton |
|
|
Esophageal layers?
Plexus and function |
- Mucosa, Submucosa, Inner circular muscle, Outer longitudinal
- Auerbachc- Myenteric plexus (Para- swallowing is para!) - Meissners- submucosal plexus - Auerbach's- between muscles |
|
|
Normal LES tone
- Above normal - Below normal |
- 10-40 mm Hg
- >40 = Achalasia - <40 = Scleroderma |
|
|
Three type of peristalsis
|
Primary: initiated by food bolus
Secondary: Initiation by esophageal distention (Residual bolus) Tertiary: non-peristaltic, spontaneous |
|
|
Scleroderma
- Problem in swallowing - CREST |
- smooth muscle atrophy (Lose distal 2/3 motlity
- Calcinosis, Raynauds, Esophagus, Sclerodactyly, Telangectasia |
|
|
Esophageal problem in polymyositis and dermatomyosits?
|
Striated muscle (Proximal 1/3)
|
|
|
Triangles
- Killians - Killian-Jameson - Laimer-Haeckerman |
- Posterior: CP and inferior constrictors
- Lateral: Between CP and longitudinal esophageal muscle - Posterior-Lateral: Between circular and longitudinal fibers of esophagus |
|
|
Typical location of a true esophageal diverticulum
|
mid-esophagus
|
|
|
Corkscrew esophogram
- Pathophys - Treatments |
Diffuse esophageal
- Simultaneous non-peristaltic contactions, normal pressure - CCB, dilation, botox |
|
|
Eagle sydrome
|
Long styid or ossified stylohyoid ligament --> inflammation of surrounding nerves
Pressure reproduces pain |
|
|
Plummer Vinson syndrome
- Site of increased cancer risk |
Web, microcytic hypochromatic anema (Fe deficiency), chelitis, dysphagia
-Post cricoid |
|
|
TE Fistula
- MC type - Silent aspiration - Associated syndrome |
- Esophageal atresia (Blind pouch) with distal Fistula
- H type - VATER- Vertebral, Anal, TE, Radial limb/Renal defects |
|
|
Chagas disease effect on Esophagus
- cause |
- Auerbech's plexus destroyed (Mysenteric Para)
- T Cruzi parasite |
|
|
MC benign tumor of esophagus
|
Leiomyoma
|
|
|
Jones Major?
Jones Minor? what do you need for RF Dx |
MAJOR: carditis, polyarthitis, Aschoff bodies, erythema migranatum, chorea
minor: Arthraliga, fever, CRP, ESR, prolonged PR 2 major or 1 major and 2 minor |
|
|
Cause of Herpangia
|
Coxsackie A virus
|
|
|
Afferent Tongue course
- Ant 1/3, Touch and Temp (T&T)? - Post 1/3, T&T |
- Lingual nerve--> Chorda--> GG --> nervus intermedius --> nucleus solitarious
(V3) - CN IX --> Inf petrosal ganglion --> nucleus solitarius (CN IX) |
|
|
What percentage of taste disorders are smell disorders
|
80%
|
|
|
Risk of malignancy
- Leukoplakia - Erythroplakia |
5-20%
25% |
|
|
Small painful vesicles in oral cavity: treatment
|
Herpetic Gingivostomatitis- HSV-1. Treatment acyclovier- oral or topical
|
|
|
Borrellia Vincentii causes?
- Clinical findings |
Acute necrotizing Ulcerative Gingivitis (Trench mouth , Vincent's gingivitis)
- "Puched out" craters interdental papilla, grey cover |
|
|
Fungal stain Canidida
|
90 degree, pseudo-hyphae
|
|
|
Branching anaerobic gram negative bacteria, sulfur granules?
Treatment |
Actinomycosis
- Debride, long term abx (PCN, Tetra, Erythro) |
|
|
Pemphigous Vulgaris
- Cellular site - Anatomic site - Anitbodies - Nikolsky sign? - Dx? - Treatment |
- Intraepithelial
- Oral mucosa - Desmosome - Positive (skin fragile, breaks apart) - Tzanck cells or serum antibodies - Steroids |
|
|
Cicatricial Pemphigoid
- Cellular site - Skin lesions? Other important site? - Nikolsky sign? - Dx? |
- Subepidermal blistering
- NO, mucose membranes, eyes (50%) - Yes, epidermis will sheer - Direct immunoflorescence in basement membrane |
|
|
Bullous Pemphigoid
- Cellular site? - Type of sensitivity - Skin leions? - Nikolsky sign? - Dx |
- Epi/Dermal junction
- Type II - YES, mucosal rare - NO, Epidermis is intact |
|
|
Types of apthous ulcer syndromes
- Which type(s) have risk of scarring - Sutton's disease |
- Minor: MC, <1 cm, last 7-10 days
- Major: more painful, 1-3 cm, mutiple, lasts >1month - 1-3 mm, numerous, lasts >1month Scaring- Major and herpetiform Recurrent major |
|
|
Behcet's disease
|
- Recurrent oral and genital ulcers WITH eye problems (uveitis)....Blind ulcered Japanese guy
|
|
|
Most common odontogenic cyst
- cause - Radiographic findings |
Peripical (Radicular cyst)
- nonviable tooth, epthelial cell rests of Malassz spurred on by inflammation - Radiolucency at root apex |
|
|
2nd Most common odontogenic cyst
- Association - Radiologic findings - Complications - Treatment |
Follicular cyst (Dentigurous cyst)
- Impacted tooth - Radiolucency at crown of unerupted tooth - Risk of malignant transformation - E&C |
|
|
Primordial cyst
- Findings - Treatment - If it recurs? |
- Cyst were a tooth would normally develop
- E&C - Must consider OKC |
|
|
Most aggressive Odontogenic cyst
- Pathology and Findings - Tooth anatomic association - Most common site - FNA dx - Initial Treatment, recurrent treatment |
Odontogenic Keratocyst (OKC)..New name= Keratocystic odontogenic tumor (KOT)
- Similar to Primordial cysts - Root or crown - Mandibular third molar and ramus - White keratin debris - E&C with rotary burr, 1cm margins |
|
|
Name cyst, give treatment?
1) Bluish cyst overlying alveolar ridge 2) Cyst located between maxillary central incisors 3) Palate mass in baby 4) Cyst in teenage mandible after truma |
1)Eruption cyst
- Excise only if symptomatic 2) Nasopalantine duct cyst (Incisive canal cyst) - Same as above 3) Midpalatal cyst of infants - E&C 4) Aneurysmal bone cyst - Rapid Enucleation to avoid hemorrhage |
|
|
Basal cell Nevus Syndrome
- Inheritance - Features |
- AD
- Multiple OKC's, Basal cell CA, hypertelorism, prognathism (Mandible sticks out --> Underbite), calcified falx cerebri, palmar pitting, frontal and parietal bossing, depressed midface) |
|
|
MC odontogenic epithelial tumor
- Location - 3 types - Radiographic findings - Treatment |
Ameloblastoma
- Mandible (80%) - 1) Central - intraosseous 2) Plexiform Unicystic- More aggressive central variant, impacted teeth 3) Peripheral- From soft tissue around bone - Multiloculations with "Soap bubbles" - Peripheral - local excision central - 1 cm margins Peripheral unicystic- 3-5 cm margins |
|
|
Pindborg tumor
- Other name - Derived from? - Association - Radiographic findings - Histo finding |
- Calcifying Epithelial OT
- Stratum intermedium - Impacted molars - Unilocular radiolucency with calcifications - Liesegang rinsgs (Psomomma body like) |
|
|
Ameloblastoma like tumor in younger patient
- Histo - Treatment |
Ameloblatomic fibroma
- Islands of epithelium, connective tissue - E&C only |
|
|
Anterior maxillary mass, slow growing
- 2/3 rule |
Adenomatoid OT
- 2/3 anterior maxilla - 2/3 female - 2/3 associated with impacted cuspid - 2 and 3rd decade |
|
|
Gorlins cyst
- Other name - Where? - Radiographic - Treatment |
- Calcifying Odontogenic cyst
- Anterior mandible - Well circumscribed with calcifications - E&C |
|
|
Asymptomatic mandibular bony mass?
- 3 types - When to extract and curretage |
Cementoma
1) Periapical: Black females, multiple 2) Cementoblastoma: first mandibular tooth 3) like ossifying fibroma - Cementoblastomas |
|
|
Non-odontogenic Tumors
1) Young african american- cotton wool appearance on xray 2) Multiple lesions associated with: precocious puberty, skin pigment changes 3) Cannon ball like opacity 4) xray findings- chinese writing |
1) Osseous dysplasia
2) Fibrous dysplasia (McCune-Albright) 3) Ossifying fibroma 4) Fibrous dysplasia |
|
|
Pagets
- Inheritance - Age group - ENT problems - Lab findings |
- AD
- Older, FD younger group - CHL/SNHL - Elevated Alk phos |
|
|
What type of joint is TMJ
|
Diarthroidial Joint- True synovial joint
|
|
|
Work type I and II
- Most common |
I) Dupliate EAC, ectodermal only
II) Presents near angle of mandible, VII at risk |
|
|
Warthin Starry stain?
Disease Pathogen |
Catch scratch fever
- Bartonella Henselae |
|
|
MC Atypical Mycobacterium H&N presentation?
- Lymph node features - Treatment |
- Corneal ucleration
- Purple, adherent to overlying skin - Complete excision |
|
|
Fascial layers of the neck? Conents?
|
1) Superficial cervical fascia: Platysm and muscles of facial experession
2) Superfical layer deep cervical fascia (DCF): - Forms stylomandibular ligament - SCM, Trap, Parotid, SMG 3) Middle layer DCF: strap muscles, larynx, pharynx, trachea, esophagus (Everything, bascially!) 4) Deep layer DCF- prevertebral fascia 5) Carotid sheeth- All layers of DCF "Lincoln Highway"- Caroitd, IJV, Vagus |
|
|
Pathogen in Nec Fasc
|
Group A B-hemolytic streptococci
|
|
|
Contents of Pterygopalantine fossa
|
Nerves:
V2, vidian nerve, sphenopalantine nerve, lesser and greater palanine nerve Ganglion: Sphenopalatine ganglion Vessels: Maxillary artery |
|
|
Langherhan Cell histiocytosis
- Hand-Schuller-Christian disease - Eosinphilic granuloma - Letterre- Siwe disease |
- chronic disseminated form (Granluoma of unknown etioogy)
- Localized form: middle ear granulation - Acute disseminated form--> Fatal, <3 years old |
|
|
Heerfordt's Disease
|
Uveparotid fever
- facial palsey - recurrent parotitis - uveitis |
|
|
Hutchinson Triad
|
Conenital syphilis
- Central inncisor - interstial keratitis - deafness |
|
|
Fungal disease
1) Braod based bud 2) Cenral America and midwest 3) Southwest 4) Mississippi and Ohio river valley 5) Bird droppings association 6) pseudoepitheliomatous hyperplasia (2) 7) Sac with bugs histo 8) bat exposure |
1) Blasto
2) Blasto 3) Coccidio 4) Histo 5) Crypto 6) Histo and blasto 7) Coccido 8) Histo |
|
|
What improves reliability of choanal atresia repair?
What is the mechanism? |
Mitomycin C
DNA crosslinker |
|
|
Definition of a hypopnea
|
50% drop in airflow for 10 seconds
|
|
|
Nerves involved in Frey's syndrome
|
Parasympathetic of Jacobsons (IX) and auriculotemporal nerve (local nerve)
|
|
|
Definitive prevention of pneumocephalous in Ant cranial resection
|
Trach
|
|
|
Management vWD disease prior to tonsillectomy
|
1) DDAVP 30 minutes before
2) cryoprecipitate vs. factor VIII |
|
|
Course of superior trochlear artery?
- Location form midline |
Under and medial to trochlea
Over corrugator and under frontalis and orbic 1.6 cm |
|
|
Treatment of chornic mucocutaneous candidasis
|
Fluconazole
|
|
|
Medical treatment of glossopharyngeal neuralgia
|
Tegretol (Carbamazepine)
|
|
|
Classes of medications used to treat GERD
|
H2 blockers
PPI Prokinetic (Dopamine antaganist) Cytoprotective (Sucralafate) Antacid |
|
|
Organism covered in leech therapy?
Abx? |
Aeromona Hydrophila
Cipro |
|
|
Most common cause of unilateral exopthalmous in child
|
Orbital abscess/SPA = Infection
|
|
|
When can you enecucleat a Ameloblastom?
Rest of the time? |
- Unicystic
- 1 cm margins |
|
|
Changes to the following in aging nasal skeleton
1) Tip 2) Nasolabial angle 3) Projection 4) Maxillary bone 5) Columella 6) Upper vermillion length 7) Nasal tip thickness 8) Nasal dorsum thickness 9) Intradomal ligament |
1) ptosis
2) decreased 3) decreased 4) Resorbed 5) shortened 6) decreased 7) increased 8) decreased 9) Laxity |
|
|
Muscles innervated by V
|
Muscles of mastication
TVP TT Mylohyoid Ant. Belly digastric |
|
|
Muscles of masctication
Open mouth? Close mouth? |
- L Pterygoid (minor: digastric, mylohyoid, geniohyoid)
- Temporalis, Masseter, M. Pterygoid |
|
|
Muscles innervated by VII
|
Facial expression
Stylohyoid Post. Belly digastric Stapedius |
|
|
Test for Wegner's. Use? Limit?
|
C-Anca
- diagnosis - monitor progression - Not good for recurrence |
|
|
Most specific test for DIC
Treatment of DIC |
D-Dimer
FFP replaces clotting factors and inhibitors Cryoprecipitate provides fibrinogen and should be given if fibrinogen <100 mg/dL Platelets are given if platelet levels < 15-20K, or if < 50K with active bleeding Give vitamin K and folic acid |
|
|
Findings in Hep B with-
1) Acute infection 2) Resolved infection 3) Chronic infection 4) Vaccinated person |
1) Antigen - HBsAg, HBeAG
Antibodies- HBcAb 2) Antibodies- HBcAb, HBsAB 3) Antigens- HBsAG Antibodies- HBcAb 4) Anitbodies- HBsAb |
|
|
When to give HBIG in exposure? (2)
|
1) Source Antigen Positive/Exposed non-responder or unvaccinated
2) Unknown Source high risk/Unvaccinated or known non-responder |
|
|
Calcium change in MH
|
Intracellular increae in calcium (No effect on serum calcium)
|
|
|
Bood volume for infant
|
70-80 cc/kg
|
|
|
Histo fidingsin Alzheimers
|
Neurofibrillary tangles (-fibril is never good!) adn neuritic plaques
|
|
|
Classification of caustic esophageal injury
|
First degre- Erythema/edema
2nd degree- Full thickness mucosal injury and ulceration 3rd degree- Full thickness into or through muscular layer |
|
|
Esophageal caustic injury?
- When to use G tube - When to look again in 24 hours - When to use a string? |
- 3rd degree or significant necrosis
- if unsure of necrosis look again b/c it coudl get worse - After NGT placed for 3 weeks to use for future dilation |
|
|
What does student T-test assume
|
Normative data and independent measures
|
|
|
Advantages to crossover design (2)
|
Patients serve as own control
Reduce confounders |
|
|
Where does PPI work in cell?
Where does H2 blocker work? |
Secretor side H/K ATPase transport
Basal side- Histamine receptor |
|
|
Stain for Cat Scratch
|
Warthin starry silver stain
Remember: Cat looking up at starry sky |
|
|
Treatment of cicatrixal pemphigoid?
Side effect form treatment? Treatment of side effect? |
Dapsone
Methemoglobineniam- HA, tachy, hypoxia, cyanosis, seizures, comas O2 and methylene blue |
|
|
Where does LSN branch off the vagus
|
Above carotid bifurcation. Remember that external branch goes with Sup. Thyroid, the firs branch off of ECA
|
|
|
Antibody found in Rubella fetus
|
IgM
|
|
|
Inheritance of HHT
|
AD with HIGH penetrance and VARIABLE expression
|
|
|
Treatment of diptheria
|
Single dose of antitoxin plus Abx (Flagyl, Erythro, PEN G)
|
|
|
MC complication with transantral orbital decompression
|
hyposthesia > Diplopia
|
|
|
When are steroids safe in pregnancy
|
3rd Trimester
|
|
|
Reasons to leave bites open
|
1) Puncture- Like cats
2) Involing legs/arms 3) 6-12 hours old |
|
|
Relative contraindications to Secondary TEP
|
1) Radiation >6500
2) Stoma <1.0 cm 3) Dysphagia 4) COPD |
|
|
Eagle's Syndrome
When? Size? Exacerbation? |
Sharp pain form elongated styloid process
- post-tonsillectomy - Styloid process > 2.5 cm - swallowing, turning head, carotid compression |
|
|
Stroke of
1) MCA 2) ACA 3) PICA 4) AICA |
1) Middle Cerebral Artery: Contralateral hemiplegia and sensory loss affecting the face, hand, arm and leg.
2) Anterior Cerebral Artery: Contralaateral paralysis and sensory loss affecting the leg. Impaired voluntary control of micturition. 3) Posterior Inferior Cerebellar Artery: (Wallenberg’s, or lateral medullary syndrome) ipsilateral cerebellar ataxia, Horner’s, facial sensory deficit, contralateral impaired pain and temperature, nystagmus, vertigo. 4) Anterior Inferior Cerebellar Artery: Ipsilateral facial weakness, gaze palsy, deafness and tinnitus |
|
|
What happens if phenyleprhine is given --> HTN then B-Blocker is given.
Why? |
Brady/hypotension
B-Blockade in face of increased afterload |
|
|
MC complication of Adenoidectomy?
|
Bleeding 0.5-1%
|
|
|
vWD Disease
1) Problem 2) Test 3) Treatment? Effect? |
1) decreased vWF and Factor VIII --> increased bleeding times
2) Ristocen 3) DDAVP --> Increase vWF and VIII peaking 30-90 minutes |
|
|
Optic Canl traverses which bone
|
Lesser wing of sphenoid
|
|
|
O2 tension curve
- What shifts to right - Left |
Right (BAD)- Increased CO2, Temp, and Acidity
Left- Decreased CO2, Temp and acidity |
|
|
How does cocaine cause vasoconstriction
|
Increase norepi
|
|
|
Which local anesthetics are cleared by plasma cholinesterases
|
Esters- One "I"
Amides- Two "I"'s, Liver clearacne |
|
|
What do do if tooth falls out
|
Replace in socket or saline/milk
|
|
|
What to do. Child becomes bradycardic during intubation
|
Atropine
|
|
|
Worse prognosis with laryngeal cleft repair?
|
TEF
|
|
|
Effect of lupus anticoagulant antibodies
|
MINSOMER
Actually causes clot, no preop intervention |
|
|
What does fibrin need to work?
|
Thrombin
Think evicele |
|
|
General Language milestones
- 3 months - 6-8 months - 15 months - 18 months - 2 years |
- Vowels
- Consonant sound "Mama, Dada" - Words up to 10 - Nouns and 2 step commands - 50 words, jargon |
|
|
Size of newborn airway
|
4mm
|
|
|
Propofol compared to gas (Induction and nausea)
|
Faster and Less
|
|
|
Mechanism of Hirudin
|
Natural inhibitor of thrombin --> anitcoagulant
|
|
|
Enhancing mass in thyroid of young male. Two possibilties
|
Infected TGDC or 3/4th branhcial cleft with intrathyroidal abscess
|
|
|
Action of NO
|
NMDA antagonist
|
|
|
What vitamin overdose --> Neuromusclar problems
|
B6
|
|
|
What worsens symptoms of glossopharyngeal neuralgia
|
Taking, swallowing, chewing, coughing and yawning
|
|
|
Treatment of NP stenosis after UPPP
|
laser and obturator
|
|
|
Treatment of NP stenosis after UPPP
|
laser and obturator
|
