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37 Cards in this Set
- Front
- Back
- 3rd side (hint)
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Signs/symptoms of a squamous cell cancer
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Hoarseness for 2 weeks or more (Must Be viewed by an ENT to visualize cords)
One sided ear pain (tumor until proven otherwise; one sided hearing loss is also a tumor, but usually a glioma (hearing loss lecture) New neck mass in someone over 40 (younger is infection) Sore throat for more than a few weeks - must be looked at by an ENT Middle Ear Fluid - have to examine nasopharynx for nasopharyngeal carcinoma |
(5 big ones)
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Risk Factors for developing squamous cell cancer
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Smoking
Exposure to HPV or Epstein-Barr Virus (nasopharyngeal) Drinking |
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Definition of Acute sinusitis and Recurring Acute sinusitis
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No longer than 6-8 weeks and no more than 4 times a year.
Recurring acute - as long as the infection resolves w/o significant mucosal damage |
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Definition of Chronic Sinusitis
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longer than 6-8 weeks or 4 episodes a year and is associated w/ persistent CT changes
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Symptoms of Sinusitis
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Pressure on the face
Nasal Obstruction Headache or toothache Purulent Discharge Those are the major signs Fever, halitosis, fatigue, cough are less useful |
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Mechanism for horizontal canal firing when you turn your head
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Move to left --> fluid in the canal will move the other way (right) --> bends hairs towards the right --> causes depolarization in the left ear and hyperpolarization in right ear. you depolarize ear that you turn to.
Also remember that when hair cells go toward the kinocillium, they depolarize and fire. When they move away from it, they fire more |
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Mechanism for otolith organ function
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Membrane with calcium crystals and hairs attached to the membrane. when you accelerate linearly (forward or up/down) the crystals will slide in one direction or other and this causes the hmembranes to depolarize
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Neuronal pathway for VOR
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utricle/sacula --> ipsilateral vestibular nucleus (via CN8?) --> both sides abducens nuclei (cross over here) ---> abducens muscle and oculomotor nuclei --> occulomotor innervates medial rectus
(you have to both activate the lateral rectus and inactivate the medial rectus to get the eye to move) |
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what is BPV. How do you test for it
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benign positional vertigo. caused by crystal deposits in one of the canals, most often the posterior one. to test for it you have a person lie down supine, tilt head back 45 degrees and rotate it 45 degrees. This maximally stimulates the posterior canal. If this causes nystagmus symptoms, it is absolutely indicative of BPV.
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which way does nystagmus occur
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always to the side that you are moving toward. Note this is also the side that is firing more. So the side you are turning to = side that fires more = side of fast beat of nystagmus. If you knock out one side, then the other side fires unaposed, so you get more nystagmus to that direction (I think)
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What are the basic steps in evaluating anyone for facial fractures?
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Stabilize and monitor ABCs first always
Then look for loss of function or deforminy with Xrays, CT, or Panorex (2D xray of the entire mandible). Angiograms should be ordered for blood supply |
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What are some nerves to watch out for in mandible reconstruction?
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Transoral approach look for mental nerve. Extraoral approach - mandibular nerve. Midface degloving - infraorbital nerve
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What is the main goal in any mandible repair surgery?
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Proper occlusion (getting teeth to close well)
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What are two things to watch out for in the eye with orbital fractures?
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Entrapment and Enopthalmos. Entrapment is when a piece of bone is causing a muscle to be trapped - not moveable. Enopthalmos is when you break the floor of the orbit and one eye is noticeably sunk compared to the other.
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What does pouisselle's law say about airway obstruction?
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Resistance to airflow is inversely proportional to 4th power of radius. So a 75% obstruction results in 16 times increase in resistance
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Characteristics of strider caused by supraglotic obstruction
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Inspiratory - KEY. (also called extrathoracic obstruction)
Deep sound because you need a large object to obstruct that high and large objects resonate at low frequencies will cause difficulty in feeding |
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Characteristics of strider caused by subglottic or Glottic obstruction
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inspiratory or expiratory strider or both
Will often have hoarse voice. Also has barking cough |
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Characteristics of strider caused by tracheal obstruction
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Expiratory strider only
usually brassy feel to it caused by intralung problem (or trachea on down) |
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What is the "Robin Sequence?"
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Child is born with a congenitally small mandible. This has variable manifestations - it can show up as difficulty breathing, difficulty eating, difficulty with both, or as no problems at all with eating or breathing
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Most common cause of congenital strider?
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A laryngiomyalacia - where some soft cartilage above/at top of vocal cords collapses down. 99% spontaneously resolve within 18-24 months after birth.
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Causes of nasopharynx airway Obstruction discussed in class?
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Encephalocele/glioma/dermoid. encephelocele is still attached to brain while a glioma isn't.
Choanal atresia (bone/cartilage in the airway) various craniofacial abnormalities |
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Causes of oral cavity/pharynx obstruction. Also, criteria for removing tonsils.
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robin sequence (glossoptosis)
Lingual Thyroid Thyroglossal duct cyst adenotonsillar hypertrophy (remove if 7 cases in 2 years or 5 cases for each of 3 years in a row or if they cause sleep apnea) |
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most common cause of juvenile sleep apnea?
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adenotonsillar hypertrophy
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Laryngeal and tracheal obstructions discussed in class
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laryngiomyalacia
subglotic stenosis - often due to vocal cord scarring vocal cord paralysis (2nd most common cause of congenital strider). Tracheomalacia (collapsing of tracea that normally resolves on own) and tracheatitis |
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Thyroglossal duct cyst appearance
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midline neck mass in child that elevates upon tongue sticking out
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Most likely cause of an enlarged lymph node in a child
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Infection (or normal. 40% of kids have palpable nodes)
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2 juvenile cancers that can cause neck masses that we should know
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Lymphoma (esp. if hard node, immobile, and no fever)
rhabdomyosarcoma - only happens in kids, 2-5 or 15-19 |
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Cauliflower ears in wrestlers (name and etiology)
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Auricular hematomas (just a hematoma)
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Blood supply of the nose
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Mainly branches off the external carotid artery (maxillary and facial artery) and internal carotid (opthalmic artery). It is a unique anastomoses of these arteries.
Most meet at Kiesselbach's plexus and this supplies the front 3rd of the nose |
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Kiesselbach's plexus
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supplies front part of the nose, 90% of nose bleeds occur here so you can just put pressure there
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Zones of the Neck (the 3 zones we had to know in ENT emergencies, not the 5 regions discussed in the cancer lecture)
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Zone 1 clavicle to cricoid. any injury here = angiogram
zone 2 = cricoid to mandible - exploratory surgery here Zone 3 = mandible to maxilla/base of skull. angiogram here |
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Ludwig's Angina
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A big swolen mass in the base of the mouth caused by an infection. It results in pushing the tongue up and back which can potentially choke a person.
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Rinne test
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compare sound from a tuning fork when you place it by the ear compared to placing it on the mastoid. If bone sound > air sound, there is conductive loss in the ear
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Weber test
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Put tuning fork on forehead. If the sound is louder in the affected ear, you have conductive hearing loss
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Causes of outter ear hearing loss (including tympanic membrane)
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Ear wax buildup
obstruction (ie a bug) perforated/torn membrane |
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Causes of middle ear hearing loss
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Glomus tympanicum tumor that can be seen. neuromas, schwanomas. Remember, one sided hearing loss = tumor unless proven otherwise
Sclerotic/lost bones |
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signs of true Vertigo
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Starts Quickly
Very Severe Goes seconds to hours Have a TRUE SENSE that everything is moving around you Has nystagmus, often with deafness and tinnitus (other ear things) Inner ear people NEVER lose consiousness. That is probalby cardiogenic. |
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