ENT Disorders Overview

Podcast

Play an AI-generated podcast conversation about this lesson

Questions and Answers

What is the most common cause of saddle nose deformity in adults?

Congenital abnormalities

Trauma and iatrogenic factors (correct)

Infection

Genetic disorders

Which structure is not a part of the nasal septum?

Vomer

Quadrangular cartilage

Perpendicular plate of palatine (correct)

Maxillary crest

In which condition is the triad of recurrent epistaxis, mucocutaneous telangiectasis, and one affected first-degree relative observed?

Aspirin sensitivity

Wegener's granulomatosis

Chronic sinusitis

Hereditary hemorrhagic telangiectasia (correct)

What is the best prognosis for cases of Bell's palsy attributed to edema of the facial nerve?

Steroid treatment Signup and view all the answers

What is the main arterial source of blood supply to the nose?

Internal maxillary artery Signup and view all the answers

What is vestibular neuritis with unilateral hearing loss commonly referred to as?

Labyrinthitis Signup and view all the answers

What test is used to assess vestibular function?

Galvanic stimulation Signup and view all the answers

What characterizes bisphosphonate-related osteonecrosis of the jaw?

Chronic swelling and mild pain Signup and view all the answers

Which of the following causes bilateral and symmetrical hearing loss?

Ototoxicity Signup and view all the answers

Which structure is not visible through anterior rhinoscopy?

Cribiform plate of the ethmoid bone Signup and view all the answers

What can trigger episodic vertigo in the case of a perilymphatic fistula?

Loud noises and sudden pressure changes Signup and view all the answers

How much maximum decibel loss can otitis media with effusion (OME) cause?

30-40 dB Signup and view all the answers

What is the role of the tensor veli palatini muscle?

To open the Eustachian tube during yawning and swallowing Signup and view all the answers

What is the primary abductor of the larynx?

Posterior cricoarytenoid Signup and view all the answers

Which of the following is NOT a function of the larynx?

Fluid transport Signup and view all the answers

Which stage of cancer management involves chemo and radiation?

Stage 3 Signup and view all the answers

What is a common complication of tracheostomy?

Mediastinal emphysema Signup and view all the answers

Where is the ora serrata located in relation to the eye?

At the boundary of the retina and ciliary body Signup and view all the answers

Which criterion is NOT part of the Center criteria for diagnosing strep pharyngitis?

Presence of cough Signup and view all the answers

What is the primary treatment for pharyngitis caused by strep bacteria?

Amoxicillin Signup and view all the answers

Which of the following is associated with Ludwig angina?

Infection of the upper airway Signup and view all the answers

What is the common site for oral cancer?

Tongue Signup and view all the answers

Which gland is most commonly associated with acute supportive parotitis?

Parotid gland Signup and view all the answers

What symptom is typically found in scarlet fever?

Sandpaper rash Signup and view all the answers

What is the gold standard for diagnosing tonsillar and peritonsillar abscess?

Throat swab and culture Signup and view all the answers

What is a potential risk factor for developing pleomorphic adenoma?

Family history Signup and view all the answers

What is the most common cause of stridor in the elderly?

Laryngeal cancer Signup and view all the answers

Where does the 2nd brachial cleft open?

Anterior to SCM at tonsillar fossa Signup and view all the answers

What is the common cause of deep neck infections in adults?

Odontogenic infections Signup and view all the answers

What is the first step in the management of airway obstruction?

Securing the airway Signup and view all the answers

Which subtype of nasopharyngeal carcinoma is characterized by undifferentiated carcinoma with prominent lymphoid infiltrate?

Lymphoepithelioma Signup and view all the answers

What can occur as a complication during removal of cystic hygroma?

Facial nerve injury Signup and view all the answers

What is the most narrow part of the airway in children?

Subglottis Signup and view all the answers

What condition is characterized by mass enlargement when the patient cries?

Encephalocele Signup and view all the answers

Study Notes

Vestibular Neuritis

Vestibular neuritis with unilateral hearing loss is called labyrinthitis.

Thyroid Cancer

Medullary thyroid cancer recurrence is monitored through serum calcitonin levels.

Laryngeal Papilloma

Laryngeal papilloma can be caused by recurrent respiratory papillomatosis.
HPV 6 and 11 cause recurrent respiratory papillomatosis and genital warts.
Vertical transmission before delivery is the most likely route of acquisition.

Ear Trauma

Barometric tympanometric injuries resolve spontaneously in a few weeks.
Observation and follow-up are recommended.

Osteonecrosis

Bisphosphonate-related osteonecrosis of the jaw is characterized by chronic swelling, mild pain, and exposed necrotic bone.
Tooth extractions or invasive dental procedures often trigger it.
Treatment is largely supportive, focusing on careful oral hygiene and antibacterial rinses.

Perilymphatic Fistula

Head trauma can lead to a perilymphatic fistula.
Episodic vertigo triggered by sudden pressure changes (Valsalva) or loud noises is a characteristic symptom.

Nose Anatomy and Investigations

The cribiform plate of the ethmoid bone cannot be visualized during anterior rhinoscopy.
The tensor veli palatini muscle opens the Eustachian tube during yawning and swallowing.

Ear Anatomy and Investigations

Galvanic stimulation is used to assess vestibular function.
In cases of recurrent meningitis, a CT scan of the temporal bone is crucial to identify abnormalities or abnormal connections.

Hearing Loss

Ossicular discontinuity with an intact tympanic membrane results in the maximum unilateral hearing loss with a highly compliant tympanic membrane on tympanometry (Ad).
Otitis media with effusion (OME) can cause a maximum decibel loss of 30-40 dB (actually 55 dB).
Presbycusis, ototoxicity, and noise-induced hearing loss are typically bilateral and symmetrical.
Otoacoustic emission is an objective hearing loss screening test for neonates.
Nasal hematoma and perforation are complications of surgery, but not common occurrences.

Nasal Septum

If someone has septal deviation, inquire about a history of nasal surgery.
Swelling in the nasal septum following a nasal fracture is due to blood collection between the nasal mucosa and perichondrium.
Anti-staphylococcus medications are used to manage pain and swelling after rhinoscopy.
Septoplasty/septal operations are the most common cause of septal perforation.
Trauma and iatrogenic factors are the most common causes of saddle nose deformity in adults.
The nasal septum is composed of the vomer, quadrangular cartilage, and maxillary crest. The perpendicular plate of the palatine bone is not part of the nasal septum.

Epistaxis

Hereditary hemorrhagic telangiectasia (Osler-Weber-Rendu disease) presents with a triad of recurrent epistaxis, mucocutaneous telangiectasia, and one affected first-degree relative.
The internal maxillary artery is the primary blood supply to the nose, giving rise to the sphenopalatine and greater palatine arteries.
The frequency of nasal polyps increases in individuals aged 40 and above.
Bilateral polyps are treated with intraturbinate steroid injections. If ineffective, oral/systemic steroids with or without antibiotics are employed. Polypectomy or FESS (functional endoscopic sinus surgery) may be needed if other treatments fail.
Cystic fibrosis or Kartagener's syndrome can cause bilateral nasal polyps.

Facial Nerve Palsy

Pregnant women have an increased likelihood of developing facial nerve palsy.
Bell's palsy has the best prognosis.
Bell's palsy is caused by facial nerve edema (idiopathic) and is treated with steroids.
Surgical treatment of facial nerve palsy involves tarsorrhaphy (surgical closure of the eyelids).
Lyme disease, caused by Borrelia burgdorferi, can manifest in patients with a history of deer tick bites, cardiac arrhythmia, and facial nerve palsy.

Temporal Nerve

The muscles of mastication include the medial and lateral pterygoid, masseter, and temporalis. The buccinator is not a muscle of mastication and is innervated by the facial nerve.

OSA (Obstructive Sleep Apnea)

Tracheostomy provides a 100% cure rate for morbidly obese individuals with OSA.

Pharyngitis

The clinical pharyngitis score is used to assess strep pharyngitis/pharyngotonsillitis.
The Center criteria for strep pharyngitis/pharyngotonsillitis include cervical lymphadenopathy (1), tonsillar exudate (1), absence of cough (1), high fever > 38°C (1), and age 3-14 (1). Two or more criteria warrant empirical antibiotics.
Amoxicillin is the treatment for pharyngitis.
Rhinovirus is the most common cause of the common cold.
Lemierre's syndrome involves thrombophlebitis of the internal jugular vein.

Scarlet Fever

Scarlet fever presents with fever, a sandpaper rash, and a strawberry tongue.

Oral Lesions

The tongue is the most common site for oral cancer.

Tonsillar and Peritonsillar Abscess

Throat swab and culture are the gold standard for diagnosis.
A peritonsillar abscess is also known as a quinsy.
Peritonsillar abscess is managed with IV fluids, IV antibiotics, and incision and drainage.

Salivary Gland Disorders

The parotid gland has the highest stimulation level, the sublingual gland is stimulated during sleep, and the submandibular gland is stimulated during rest.
Fever, leukocytosis, and severe tenderness and swelling of the left parotid gland following a recent surgical procedure most likely indicate acute suppurative parotitis.
Acute suppurative parotitis often occurs in elderly postoperative patients, particularly those with dementia, who are at risk of inadequate hydration and poor oral hygiene.
Acute parotitis can develop in diabetic patients who have been kept NPO (nothing per os, or nothing by mouth) for several days.
Lymphangioma is a parotid mass with bluish discoloration that expands with crying.
Lymphangioma is not connected to the orbital lymphatic system.
Family history is a significant risk factor for parotid pleomorphic adenoma.
Pleomorphic adenoma is the most common benign salivary tumor, primarily affecting the parotid gland.
Pleomorphic adenoma has a malignant potential, and rapid growth indicates a malignant transformation.
Ludwig's angina is a mixed infection (Streptococcus viridans and anaerobes) commonly originating from an infected mandibular molar, upper airway infection, or acute lingual tonsillitis. Predisposing factors include diabetes mellitus, alcoholism, or immunosuppression.
Ludwig's angina causes a submandibular space infection that presents with fever, mouth pain, stiff neck, difficulty swallowing, and trismus. Airway obstruction may occur, making airway management the first step in treatment.

Brachial Cleft Cysts

The first brachial cleft opens near the mandible in the submandibular region.
The second brachial cleft opens anterior to the sternocleidomastoid muscle (SCM) in the tonsillar fossa.
The third brachial cleft opens at the piriform sinus.

Neck Mass

Fibrotic endoscopic evaluation of swallowing is used in patients with dysphagia.
A mass near the piriform sinus can compress the vagus nerve, which provides sensory branches to the larynx, pharynx, and external auditory meatus.
A brainstem lesion is the most common cause of glossopharyngeal nerve disturbance.
Left supraclavicular lymphadenopathy is a marker of metastatic abdominal cancer.
Facial nerve injury is a complication of cystic hygroma removal.
Following submandibular gland removal, there could be a loss of somatostatin in the anterior 2/3 of the tongue due to damage to the lingual nerve, a branch of the mandibular branch of the trigeminal nerve.
In cases of dermoid cysts, a CT scan is necessary to rule out intracranial extension.
Odontogenic infections are the most common cause of deep neck infections in adults. These infections stem from dental abscesses, periodontal infections, and pericoronitis.

Nasopharyngeal Carcinoma

Lymphoepithelioma is a subtype of nasopharyngeal carcinoma characterized by undifferentiated carcinoma with a prominent lymphoid infiltrate.
Infectious mononucleosis causes 20% cellular atypia (atypical lymphocytes).
There are no vaccines for CMV, EBV, RSV, and HSV.

Epiglottitis

Examination of patients with epiglottitis should be conducted in the operating room.

Croup

Croup is managed with nebulized epinephrine and dexamethasone, oxygen, moist air, and IV hydration.
The subglottis is the narrowest part of the airway in children.

Stridor

Laryngeal cancer is the most common cause of stridor in the elderly.

Diphtheria

Diphtheria leads to breathing difficulties, heart failure, and can cause vocal cord paralysis. Treatment includes antitoxin and antibiotics.
Encephalocele manifests as a mass that enlarges when crying.

Laryngotracheal Stenosis

Endotracheal intubation is a common cause of laryngotracheal stenosis.

Laryngeal Carcinoma

Laryngeal carcinoma most commonly affects the true vocal cords, is caused by smoking, and is treated with radiation.
If a glottis mass is observed, a biopsy should be performed.
In cases of unilateral vocal cord paralysis, consider recurrent laryngeal nerve paralysis.
The posterior cricoarytenoid muscle is the only abductor of the larynx.
Plummer-Vinson syndrome presents as a triad of dysphagia, glossitis, and iron deficiency anemia, and has been associated with postcricoid hypopharyngeal cancers, especially in women from Scandinavia.
The functions of the larynx include phonation, cough reflex, protection of the lower respiratory tract, and respiration.
Stage 1-2 laryngeal carcinoma is managed with radiation, transoral laser resection, or transoral laser endoscopic resection.
Stage 3 is managed with chemotherapy and radiation.
Stage 4 is managed with total laryngectomy followed by radiation.

Tracheostomy

Mediastinal emphysema is a complication of tracheostomy.
Intubation should be avoided in post-radiation patients.
Complications of airway and airway management in children include failure to secure the airway, esophageal intubation, hypoxic or hypercapnic respiratory failure leading to arrest, injury to the oropharynx or larynx, bleeding, soft tissue swelling, and vocal cord injury.
A fistula is a side effect of a tracheostomy where blood gushes from the tracheostomy site and should be addressed until proven otherwise.

Eye Anatomy

The majority of light refraction occurs at the anterior surface of the cornea.
The aqueous humor flow rate is 2 microliters per minute.
The vitreous body is located behind the lens.
The ciliary body extends from the root of the iris to the ora serrata.
The ora serrata is the weakest connection point between the sclera and uvea.
Photoreceptors form the outer layer of the retina.
The optic media of the eye refer to the structures through which light passes and is refracted before reaching the retina.

Studying That Suits You

Use AI to generate personalized quizzes and flashcards to suit your learning preferences.

Description

Explore key concepts related to various ENT disorders, including vestibular neuritis, thyroid cancer, and laryngeal papilloma. Delve into the causes, monitoring, and treatment approaches for conditions such as perilymphatic fistula and bisphosphonate-related osteonecrosis. This quiz will test your understanding of these important health issues.