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ENT conditions
med sci exam 1 material
| Question | Answer |
|---|---|
| external structures of the ear | auricle, external auditory canal |
| functions of external structures | protection, helps gather and channel sound |
| middle ear structures of ear | ossicles (malleolus, incus, stapes), tympanic membrane |
| middle ear functions | sound transmission, separation of middle and external ear |
| inner ear structures | vestibule, semicircular canals, cochlea |
| inner ear structures function | transmission of sound, vestibular function |
| function of nose | odor identification, passage of air, humidification, warmth of air, resonance of laryngeal sounds |
| risk factors for hearing loss in adults | exposure to industrial or recreational noise, genetic disorders, autoimmune disorders, syphilis |
| otalgia | ear pain |
| vertigo | dizziness |
| primary otalgia | pathology from the ear |
| secondary otalgia | pathology outside of the ear |
| common causes of primary otalgia | barotrauma, FB, ETD, ear infections |
| tinnitus | ringing of the ear |
| common causes of tinnitus | hearing loss, meniere's disease, neurological conditions |
| people most at risk for tinnitus | seniors, military personnel, musicians, people who work in loud environments |
| causes of peripheral vertigo | pathology comes from the ear |
| causes of central vertigo | pathology comes from the brain |
| causes of systemic vertigo | cardiovascular, metabolic, medication related |
| internal vertigo patient description | I feel myself turning |
| external vertigo patient description | I feel the room spinning |
| general treatment of vertigo | vestibular suppressant meds, antiemetics |
| transient triggered episodes of vertigo caused by dislodged canaliths in the semicircular canals | benign paroxysmal positional vertigo |
| benign paroxysmal positional vertigo most often seen in patients aged ____ | 50-70 yo |
| characteristics of benign paroxysmal positional vertigo | no significant negative sequelae (benign), episodic lasting seconds to minutes (paroxysmal), triggered by head motions (positional), generally external in description (vertigo) |
| treatment of benign paroxysmal positional vertigo | empley maneuver & or home brandt-daroff exercises |
| spontaneous episodes of vertigo caused by inflammation of the vestibular nerve or labyrinthine organs, usually from a viral infection | vestibular neuritis |
| for vestibular neuritis : patients aged ___ | 30-50 yo |
| clinical diagnosis of vestibular neuritis | severe vertigo with nausea and oscillopsia, abnormal gait |
| treatment of vestibular neuritis | vestibular suppressant |
| inner ear dysfunction caused by excessive endolymph fluid pressure | Ménière's disease |
| Ménière's disease: patient aged ___ | 20-60 yo |
| clinical diagnosis of Ménière's disease | classic triad of severe vertigo, unilateral hearing loss and tinnitus, nausea , vomitiing |
| treatment of Ménière's disease | lifestyle changes , vestibular rehab |
| categories of hearing loss | conductive or sensorineural |
| problems transmitting sound and converting sound waves to mechanical vibrations | conductive |
| middle ear and OUT | conductive |
| problems converting mechanical sound to neuroelectric signals (or interpretation of neuroelectric signals) | sensorineural |
| inner ear and INWARD to brain | sensorineural |
| finger rub test | examiner rubs fingers together 6" from patient's ear. + test = failure to identify rub in at least 3/6 attempts |
| whispered voice test | examiner stands @ arm's length behind patient. patient occludes one ear. examiner whispers letter / number combo 6x, + test = unable to repeat 3/6 letter / number combos |
| direct question test | Y/N question to patent about whether he or she has hearing loss |
| handheld audiometry test | examiner hold device in patients ear, patient indicates awareness of each tone. + test = unable to identify 1,000 or 2,000 Hz in both ears |
| hearing handicap inventory for the elderly test | 10 item, self-administered questionnaire measuring social and emotional handicap due to hearing impairment. score >8 is abnormal |
| tabletop manual audiometry test | various models of small, portable audiometers or audiometric program designed for portable electronic devices |
| rinne test | examiner strikes tuning fork and places on mastoid bone behind ear |
| weber test | examiner strikes tuning fork and places on mid forehead |
| medical SCREAM stands for | sudden hearing loss, cerumen impaction, auditory rehab, education, assistance devices and medication |
| sudden hearing loss description | development of >30 dB hearing loss at 3 consecutive frequencies over 72 hours or less |
| cerumen impaction description | occlusive cerumen causing hearing loss, treatment includes cerumen removal |
| auditory rehab description | training and treatment to improve hearing environment |
| education description | info for patient and family |
| assistive devices description | technology to augment hearing, including over the counter assistive devices |
| medications description | evaluating and mitigating medications with ototoxicity |
| auricular hematoma MOI | direct blow to ear, common sports injury |
| auricular hematoma can cause ____ if not treated | cauliflower ear |
| auricular hematoma treatment | surgical damage |
| foreign body of the pinna most commonly caused by | embedded pierced earrings |
| foreign body of EAC | insects, cotton swab pieces at any age. any other object kids less than 6 yo |
| cerumen function | repels water, antimicirobial activity, protective barrier. secreted in the distal 1/3 of EAC |
| cerumen impaction presentation | decreased hearing, feeling of fullness in ear, otalgia, tinnitus |
| otitis externa is aka | swimmers ear |
| otitis externa | inflammation of EAC secondary to infection |
| otitis externa common causes | pseudomonas aeruginosa, staphylococcus aureus, fungal , polymicirobial |
| otitis externa presentation | otalgia, pruritis, decreased hearing |
| treatment of otitis externa | antimicrobial ear drops |
| risk factors for developing otitis externa | anatomic abnormalities, canal obstruction, breach in EAC integrity, dermatological conditions, water in EAC |
| pressure within middle ear must ____ for TM to vibrate normally | match environment |
| Eustachian tube dysfunction | blockage of ET within nasal cavity leading to fluid accumulation in middle ear |
| ear barotrauma | prolonged / difficulty overcoming differences in pressure between the middle ear and external environment |
| clinical presentation of ear barotrauma | clogged feeling, otalgia, vertigo, hearing loss, perforation of TM, blood behind TM |
| causes of barotrauma | flying, scuba diving, hyperbaric oxygen chamber use, skydiving, blast injuries |
| diagnosis of ear barotrauma uses ___ | TEED scale |
| anything that causes nasal mucosa edema can cause | eustachian tube dysfunction |
| middle ear efflusion | serous fluid build up behind TM, may become chronic, leading to DECREASED HEARING |
| diagnosis of middle ear efflusion | clinical with audiometry testing |
| typical organisms of acute otitis media | streptococcus pneumonia, haemophilus influenza, viruses, moraxella catarrhalis |
| risk factors of acute otitis media | anything that causes ETD, immunodeficiency, lack of vaccination |
| the _____ the patient, the more likely to have a bacterial cause of acute otitis media | YOUNGER |
| acute otitis media presentation | fussiness, poor oral intake, poor sleep, decreased hearing, fever, vomiting |
| indications for tympanostomy tubes | middle ear efflusion >3 months hearing loss > 30 dB or speech delay recurring episodes of acute otitis media (>3 episodes in 6mo, >4 episodes in 12 mo) complications of acute otitis media |
| tympanic membrane perforation | hole in the eardrum, establishing communication between middle and external ear |
| causes of tympanic membrane perforation | acute and chronic OM, trauma |
| acute mastoiditis | suppurative infection of the mastoid air cells with symptoms of less than 1 month duration |
| pathophysiology of acute mastoiditis | complication of AOM |
| complications of acute mastoiditis | abscess formation, facial nerve paralysis, hearing loss, meningitis, osteomyelitis |
| clinical presentation of acute mastoiditis | otaliga, postauricular tenderness, erythema, edema, mass formation |
| common nose / sinus complaints | nasal pain/trauma/FB, nasal congestion, nasal discharge |
| episitaxis | nosebleed |
| sinusitis | sinus pain |
| nasal trauma may be associated with | head and neck trauma |
| patients with __________ should be urgently referred | septal hematomas, CSF rhinorrhea, malocclusion, extra ocular movement defects |
| causes of episitaxis | inflammatory, structural, traumatic, tumors, systemic |
| inflammatory epistaxis | chronic siinnusitis, environmental irritants |
| structural epistaxis | septal deviation or perforation |
| traumatic epistaxis | cocaine use, FB, nasal fracture, nose pcking |
| epistaxis description | common, less than 10 yo or 45-65 yo |
| epistaxis divided into 2 categories | anterior and posterior |
| anterior epistaxis makes up ____% of epistaxis | 90% |
| posterior epistaxis makes up _____% of epistaxis | 10% |
| anterior epistaxis originates from | kiesselbach's plexus (picking zone) |
| anterior epistaxis description | UNILATERAL, no sensation of blood at back of throat |
| treatment of anterior epistaxis | stepwise: compressive, directive, then topical and nasal packing |
| posterior epistaxis originates from | branches of internal maxillary, sphenopalatine and descending palatine arteries |
| posterior epistaxis more common in | elderly |
| posterior epistaxis description | BILATERAL, profuse bleeding with significant amount of blood draining down posterior pharynx (patient usually admitted to hospital) |
| complications of epistaxis | infection, sinus perforation, tissue necrosis, airway compromise (greater risk with posterior bleeds) |
| epistaxis prevention | humidity, discontinue any offending meds, saline nasal spray, avoid nose picking or forceful blowing, sneeze with mouth open |
| 3 causes of rhinosinusitis | infectious, allergic, noninfectious / nonallergic |
| infectious rhinosinusitis | bacterial, viral |
| allergic rhinosinusitis | occupational, perennial, seasonal rhinitis |
| noninfectious / nonallergic rhinosinusitis | drug induced, emotional, gustatory, irritant, reflux-induced rhinitis |
| rhinitis | inflammation of the nasal mucosa leading to nasal discharge and or nasal congesting |
| sinusitis | inflammation of the lining of the paranasal sinus cavities |
| acute viral rhinosinusitis | common cold |
| acute bacterial rhinosinusitis | sinus infection |
| acute infectious rhinosinusitis | nasal congestion, rhinorrhea, facial pain, fever |
| use antibiotics for _____ only | ABRS |
| laryngitis | lost voice |
| pharyngitis | sore throat |
| tonsillitis | inflamed tonsils |
| tonsillar hypertrophy | enlargement of the tonsils |
| coarse, scratchy sound that frequently correlates with irregularity of the medial, or vibratory edge of the true focal fold | hoarseness |
| term describing the perception of excessive air escape during phonation, in which the voice sounds or feels weak | breathiness |
| degradation in vocal quality and loss of control of vocal quality with extended periods of voice use | vocal fatigue |
| causes of hoarseness | laryngitis, benign vocal cord lesions, laryngeal cancer, neurological disease, vocal cord paralysis |
| acute laryngitis | inflammation of the larynx |
| causes of acute laryngitis | vocal strain, infections (URI*, viral, bacterial), tobacco/alcohol use, gastroesophageal reflex |
| presentation of acute laryngitis | hoarseness, aphonia |
| supportive treatment examples for acute laryngitis | vocal rest, humidifier, hydration, remove / treat underlying causes |
| most common viral causes of pharyngitis / tonsillitis | rhinovirus, coronavirus, EBV |
| most common bacterial causes of pharyngitis / tonsillitis | group A beta-hemolytic streptococcus |
| presenting symptoms of pharyngitis / tonsillitis | sore throat, fever, erythematous, enlarged tonsils with or without exudate, lymphadenopathy |
| treating strep throat helps prevent | spread of rheumatic and local complications |
| Epstein-barr virus | Infection is most often asymptomatic, When symptomatic - Clinical syndrome of Infectious Mononucleosis (IM) |
| EBV - infectious mononucleosis most common in | adolescents and young adults |
| presentation of EBV- infectious mononucleosis | typical is acute exudative pharyngitis / tonsillitis, lymphadenopathy. less common is splenomegaly |
| common complications of infectious mononucleosis | ampicillin-associated rash, upper airway obstruction, chronic EBV infection, increased risk for hodgkin lymphoma, hepatitis, splenic rupture |
| diagnosis of EBV infectious mononucleosis | rapid mon-spot test, atypical lymphocytosis on CBC |
| strep throat is most common in patients aged | 5-15 year olds , very uncommon in kids less than 3 |
| presentation of strep throat | + fever, sore throat with exudative pharyngitis/ tonsillitis, lymphadenopathy |
| diagnosis of strep throat | rapid strep test, throat culture |
| scarlet fever | atypical presentation of strep throat , delayed - type skin reactivity to pyrogenic exotoxin. diffuse, erythematous, 1-2 mm papular eruption that blanches with pressure. strawberry tongue |
| complications for group A beta- hemolytic strep pharyngitis | recurrent strep throat infections, peritonsillar abscess, pneumonia, rheumatic fever, post-streptococcal glomerulonephritis |
| deep neck infections commonly arise from | septic focus of the mandibular teeth, tonsils, parotid gland, deep cervical lymph nodes, middle ear, sinuses. uncommon since use of antibiotics |
| types of deep neck infections | peritonsillar abscess, Ludwig's angina |
| peritonsillar abscess | localized infection, purulent fluid accumulates between fibrous capsule of the tonsils and superior pharyngeal constrictor muscle |
| presentation of peritonsillar abscess | worsening sore throat, fever, odynophagia, drooling, muffed 'hot potato' voice, foul-smelling breath, deviation of uvula |
| diagnosis of peritonsillar abscess | CT scan |
| treatment of peritonsillar abscess | surgery and antibiotics |
| complications of peritonsillar abscess | airway obstruction, aspiration, pneumonia, life-threatening hemorrhage, post-strep sequelae |
| Ludwig's angina | bilateral cellulitis of the submandibular and sublingual spaces with associated tongue elevation |
| Ludwig's angina is commonly associated with | dental infections or recently extracted tooth |
| presentation of Ludwig's angina | severe mouth pain, fever, forward-leaning posture, "bull neck" |
| treatment of Ludwig's angina | airway protection and IV antibiotics |
Created by:
thomask9
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