Professional Documents
Culture Documents
ENT Reviewer PDF
ENT Reviewer PDF
1. CA
of
tongue:
jugulodigastric
2. CA
of
buccal
mucosa:
submental
and
submandibular
3. CA
of
gingival
and
hard
palate:
mandibular
and
subdigastric
4. CA
of
lips:
submental
and
submandibular
5. CA
of
floor
of
mouth:
mandibular
and
subdigastric
1. epsteins
pearl
or
bohns
nodules:
GINGIVAL
CYST
2. rodent
ulcer:
BCC
3. large
vessel
type
of
hemangioma:
cavernous
hemangiomas
4. immature
forms
of
capillary
hemangioma:
hypertrophic
hemangioma
5. with
spindle-shaped
cells
surrounding
capillaries:
hemangiopericytoma
6. bryces
sign:
laryngocoele
7. cold
abscess:
lymphadenitis
8. horner
syndrome:
laryngocoele
9. location
of
kochs
nodule:
posterior
triangle
1. chorda
tympani:
CN
VII
2. tensor
tympani:
CN
V
3. tympanic
plexus:
CN
IX
4. stapedius:
CN
VII
1. hypotympanium:
floor
2. opening
to
tympanic
membrane:
medial
wall
3. Eustachian
tube
opening:
anterior
wall
4. canal
for
tensor
tympani
muscle:
anterior
wall
5. epitympanium:
roof
6. ossicles:
medial
wall
7. lateral
semicircular
8. aditus:
posterior
wall
1. ampulla:
crista
ampullaris
2. macula:
otoliths
3. organ
of
corti:
hair
cells
for
shearing
1. hot
potato
voice:
PERITONSILLAR
ABSCESS
2. chronic
mouth
breathing,
snoring,
hyponasal
speech:
ADENOIDS
3. mesopharynx:
OROPHARYNX
4. epipharynx:
NASOPHARYNX
5. psueudomembrane:
DIPHTHERIA
6. trench
mouth:
VINCENTs
/
PLAUTS
ANGINA
1. below
cricopharyngeus
posteriorly
where
the
longitudinal
esophageal
fibers
separate:
LAIMER-HACKERMANN
AREA
2. below
lowest
fibers
of
the
cricopharyngeus
and
upper
circular
fiber
of
the
esophagus
on
lateral
aspect
:KILLIAN-
JAMIESON
AREA
3. between
alar
and
prevertebral
sheaths:
SPACE
OF
4
or
DEGREE
SPACE
4. space
between
the
base
of
the
skull
and
the
superior
constrictor
thru
w/c
the
Eustachian
tube
passes:
SINUS
OF
MORGAGNI
1.
2.
3.
1.
2.
3.
4.
5.
FLAPS
VS
GRAFTS
1. can
bridge
defect:
FLAPS
2. requires
pressure
dressing:
FLAPS
3. more
likely
to
contract:
GRAFTS
4. depends
on
recipient
site
for
nutrition:
GRAFTS
5. less
adaptable
to
weight
bearing:
GRAFTS
1. proptosis
and
lateral
rectus
palsy:
PTERYGOID
/
TEMPORAL
SPACE
INFECTION
2. torticollis:
CAROTID
SPINE
ABSCESS
3. horners
syndrome:
CAROTID
SPINE
ABSCESS
4. hot
potato
voice:
RETROPHARYNGEAL
SPACE
ABSCESS
5. respiratory
distress:
PARAPHARYNGEAL
SPACE
INFECTION
6. osteomyelitits:
MASSETER
SPACE
INFECTION
1. fissures
of
santorini:
DEFICIENCY
IN
CARTILAGENOUS
EAC
2. foramen
of
huschke:
DEFICIENCY
IN
BONY
EAC
3. pars
flaccida:
SHRAPNELLS
MEMBRANE
4. notch
of
rivinus:
AREA
DEFICIENT
OF
ANNULUS
FIBROSUS
5. otitis
externa
circumscripta:
STAPHYLOCOCCUS
6. diffuse
otitis
externa:
PSEUDOMONAS
7. epistaxis:
KIESSELBACHS
PLEXUS
8. tripod
fracture:
ZYGOMA
9. blow
out
fracture
of
orbit:
FORCED
DUCTION
TEST
10. temporal
bone
fracture:
BATTLES
SIGN
1.
2.
3.
4.
5.
6.
bactidol:
HEXITIDINE
docusate:
OTOSOL
nystatin,
gramicidin:
POSTOTOC,
APLOSYN
OTIC
lidocaine,
benzoxonium:
OROFAR-L
antipyrine:
AURALGAN
OTIC
neomycin,
polymyxin:
KENACOMB
OTIC
1.
2.
3.
4.
5.
syphilis:
PENICILLIN
ludwigs
angina:
INCISION
AND
DRAINAGE
salpingitis:
PENICILLIN
herpes:
ACYCLOVIR
candida:
NYSTATIN
1.
2.
3.
4.
11.
12.
13.
14.
15.
16.
17.
18.
RHINITIS
1. IgE
mediated
:
ALLERGIC
RHINITIS
2. tuberculosis:
CHRONIC
RHINITIS
3. prolonged
use
of
decongestant:
RHINITIS
MEDICAMENTOSA
4. pregnancy-related:
NOTA
5. with
dryness:
ATROPHIC
RHINITIS
6. emotional
stress:
VASOMOTOR
RHINITIS
7. infectious/inflammation:
ACUTE
RHINITIS
1. unilateral
hearing
loss:
NOTA
2. bilateral
hearing
loss:
NOTA
3. benign
paroxysmal
positional
vertigo:
CULPOLITHIASIS
4. menieres
dse:
TINNITUS
1. staphylococcus:
CLOXACILLIN
2. streptococcus:
AMOXICILLIN
3. herpes
ACYCLOVIR
4. candida:
NYSTATIN
5. psueomonas:
OFLOXACIN
GRADENIGO
VS
MENIERE
1. diplopia:
GRADENIGO
2. hearing
loss:
MENIERE
3. ear
fullness:
MENIERE
4. dizziness:
MENIERE
5. tinnitus:
MENIERE
6. ear
discharge:
GRADENIGO
1. frontal
sinus
MIDDLE
MEATUS
2. anterior
ethmoid
sinus
MIDDLE
MEATUS
3. posterior
ethmoid
sinus
SUPERIOR
MEATUS
4. sphenoid
sinus
SPHENOETHMOIDAL
RECESS
5. mastoid
ADITUS
AD
ANTRUM
6. maxillary
sinus
MIDDLE
MEATUS
7. cavernous
sins
OPHTHALMIC
VEIN
8. middle
meningeal
sinus
FORAMEN
SPINOSUM
9. highmore
of
antrum
AD
IC
ANTRUM
10. middle
ear
EUSTACHIAN
TUBE
1.
4.
5.
6.
7.
8.
9.
10.
LYMPHATIC
DRAINAGE
1. lips:
LEVEL
I
2. cheeks:
LEVEL
I
3. tongue:
LEVEL
I
4. palatine
tonsil:
LEVEL
II
5. middle:
LEVEL
II
ORAL
MANIFESTATION
OF
SYSTEMIC
DSE
1. syphilis:
GUMMAS
and
ENANTHEMS
2. melkersson-rosenthal
syndrome:
FISSURED
TONGUE
3. anaphylaxis:
ANGIOEDEMA
4. pernicious
anemia:
HUNTERS
GLOSSITIS
NOTES
EXTERNAL
EAR
1. auricle/pinna
2. external
auditory
canal
3. tympanic
membrane
MIDDLE
EAR
1. tympanum/middle
cavity
2. antrum
and
mastoid
air
cells
3. eustachian
tube
INNER
EAR
1. bony
labyrinth
2. membranous
labyrinth
MIDDLE
EAR
BOUNDARIES
floor hypotympoanum
extracranial
o facial
nerve
paralysis
o labyrinthitis
o subperiosteal
abscess
o apical
petrositis
(gradenigo)
LABYRINTHITIS
TYPE
VERTIGO
circumscribed
mild
HEARING
LOSS
conductive
serous
moderate
mixed
suppurative
severe
sensorineural
then
total
COCHLEAR
DISEASES
ONSET
presbycussis
infection
noise-
induced
ototoxicity
trauma
barotrauma
systemic
dse
menieres
LATERALITY
gradual
sudden
gradual
bilateral
uni
or
bi
uni
or
bi
sudden
sudden
sudden
gradual
fluctuant
bilateral
unilateral
unilateral
bilateral
unilateral
(bilateral
30%)
VESTIBULAR
DISORDERS
VERTIGO
(DURATION)
menieres
episodic
(20mins-hour)
vestibular
neuronitis
acute
labyrinthitis
benign
positional
acoustic
neuroma
or
vestibular
schwannoma
vertebrobasilar
insufficiency
PATHOLOGY
erosion
w/o
actual
erosion
of
the
labyrinth
w/
a
fistula
localized
invasion
to
severe
w/
toxins
of
the
organism
actual
penetration
and
invasion
by
the
organisms
VESTIBULAR
SYMPTOMS
-
+
-
+/-
+
+
-
+
HEARING
LOSS
fluctuant
(low
freq
in
early
stage)
no
loss
VESTIBULAR
STATUS
decreased
severe SNHL
decreased
recurrent;
related
to
position
and
aggravated
by
head
movt
(seconds)
progressive
no loss
normal
progressive
SNHL
decreased
acute
and
aggravated
by
head
movt
(variable)
compatible
normal
acute;
aggravated
by
head
movt
(>24hrs)
acute
(>24hrs)
decreased
PERMISSIBLE
NOISE
EXPOSURE
DURATION/DAY
SOUND
LEVEL
8
hrs/day
90
dBA
6
92
4
95
3
97
2
100
1.5
102
1
105
0.5
110
<0.25
115
DEGREE
OF
ATTENUATION
OF
SOUND
BY
PROTECTORS
PROTECTION
TYPE
ATTENUATION
AT
LOW
FREQUENCIES
cotton
(pain)
0
waxed
cotton
3.8
ear
plugs
30
ear
muff
40
ear
muss
w/
insert
70
CENTRAL
AND
PERIPHERAL
CAUSES
OF
VERTIGO
PERIPHERAL
CENTRAL
duration
may
be
intermittent,
may
be
persistent,
usually
hrs
to
days
w/
usually
wks
to
mos
w/
normal
periods
no
normal
periods
s/sx
CNS
(-)
usually
(+)
fixation
suppresses
nystagmus
no
effect
spontaneous
fatigue,
jerk
or
rotator
non-fatigable,
does
not
nystagmus
and
occurs
in
one
change
w/
different
particular
direction
plane
of
gaze;
oblique
or
vertical
types
usually
central
in
origin
nystagmus
enhanced
nystagmus
decreases
w/
by
eye
closure
eye
closure
induced
fatigable
duration
<1
non-fatigable>1
min.
nystagmus
min.
follows
COWS
doesnt
follow
COWS
(cold
opposite
warm
same)
causes
menieres,
vestibular
tumors,
multiple
neuronitis,
benign
sclerosis,
epilepsy,
paroxysmal
positional
vascular
problems
vertigo,
acoustic
neuroma
FACIAL
NERVE
TESTS
FOR
LOCALIZATION
taste test
FACIAL
NERVE
TEST
INTERPRETATION
SITE
UM VESTIBU
SCHIRM SALIVATI STAPED TAS
N
LAR
ER
ON
IAL
TE
CNS
+
+
+
+
+
+
CPA
-
+
+
+
+
+
IAC
-
-/+
+
+
+
+
middle
-
-
-
-
+
+
ear
betwe
-
-
-
-
+
en
chorda
&
stapedi -
-
-
-
+
us
SMF
-
-
-
-
-
OPERATIONS
ON
THE
EXTERNAL
EAR
bony
framework
o nasal
bone
o frontal
process
of
maxilla
o nasal
process
of
frontal
bone
cartilaginous
framework
o lower
lateral
(greater
alar)
cartilage
o quadrilateral
cartilage
o upper
lateral
(lateral
nasal)
cartilage
o lesser
alar
cartilage
o sesamoid
cartilage
constrictors
o nasalis
o depressor
septi
o depressor
alaque
nasi
dilators
o procerus
o dilator
nasi
o angular
head
of
quadratus
labii
superioris
INTERNAL
NOSE
BOUNDARIES
o superior
cribriform
plate
of
ethmoid
o inferior
maxillary
bone
o medial
septum
o lateral
maxillary
bone
o posterior
sphenoid
sinus
nasal
septum
o septal
cartilage
o vomer
o perpendicular
plate
of
ethmoid
o maxillary
crest
o premaxilla
turbinates
o inferior
turbinate
largest
o middle
turbinate
part
of
ethmoid
bone
o superior
turbinate
-
part
of
ethmoid
bone
o supreme
turbinate
occasionally
found
meatuses
o inferior
meatus
drains
nasolacrimal
duct
o middle
meatus
drains
frontal,
maxillary,
anterior
ethmoid
sinus
o superior
meatus
o supreme
meatus
o sphenoethmoid
recess
NASAL
BONE
FRACTURES
class
1
(chevallet
along
quadrilateral
cartilage
&
distal
thin
fracture)
portion
of
nasal
bone
due
to
low-velocity
trauma
class
2
nasal
bones,
frontal
process
of
maxilla,
structures
/
iin
class
1
due
to
medium-velocity
trauma
w/
jarjavay
cartilaginous
fracture
class
3
extends
thru
ethmoid
labyrinth
w/
inward
telescoping
nasal
skeleton
pig-nose
SEPTAL
DEVIATION
lateral
(jarjavay)
lateral
nasal
fracture
w/
displacement
of
type
septum
from
vomerian
groove
&
maxillary
crest
depressed
frontal
nasal
fracture
w/
twisting,
buckling,
(chevallet)
type
reduplication
&
fibrosis
of
quadrilateral
septum
laterofrontal
type
combination
of
lateral
&
depressed
types
NASAL
BONE
FRACTURE
assault
MC
cause
MANDIBLE
FRACTURE
nd
5-15%
MAXILLARY
FRACTURE
CLASSIFICATION
dishpan
or
panface
le
fort
I:
GUERIN
-
horizontal
separation
(horizontal
separation)
-
palate
separated
from
the
rest
of
maxilla
-
interdental
&
intermaxillary
fixation,
4-
6wks
lefort
II:
PYRAMIDAL
-
MC
of
maxillary
fracture
(midfacial
fracture)
-
palate
w/
maxilla
is
separated
from
zygoma
and
the
ethmoid
-
as
above
fixation
from
zygomatic
suture
or
orbital
rim
lefort
III:
-
nasofrontal
suture
CRANIOFACIAL
-
across
floor
of
orbit
DYSJUNCTION
-
maxilla
and
zygoma
are
separated
from
the
cranium
-
interdental
&
intermaxillary
fixation,
suspension
from
zygomatic
suture
&
wiring
from
infraorbital
rim
BENIGN
PEMPHIGUS
site
lesions
BULLOUS
PEMPHIGUS
oral
mucosa
small
&
w/
bleeding
on
rupture
histopath
no
acantholysis
immunoflourescence
fluorescence
at
basement
membrane
prognosis
benign
OBSTRUCTIVE
SLEEP
APNEA
ADULT
etiology
multiple
sleep
manifestations
daytime
manifestation
sleep
study
findings
management
potential
morbidity
of
untreated
snoring,
restless
sleep,
frequent
awakening
excessive
daytime
sleepiness
decreased
oxygenation,
sleep
fragmentation
often
medical
(positive
airway
pressure
therapy)
vehicular
accidents,
cognitive
impairment,
medical
conditions
ACUTE
EPIGLOTTITIS
VS
CROUP
ACUTE
EPIGLOTTITIS
area
PEMPHIGUS
VULGARIS
nasal,
oral
larger,
may
leave
denuded
area
on
rupture
massive
acantholysis
at
area
of
acantholysis
high
mortality
if
untreated
PEDIATRIC
usually
enlarged
tonsils
&
adenoids
snoring,
restless
sleep,
odd
sleeping
positions
hyperactivity,
inattention,
sleepiness
oxygenation
usually
maintained,
CO2
retention
&
hyperventilation,
sleep
architecture
maintained
often
surgical
(tonsillectomy
&
adenoidectomy)
medical,
neuroanatomic
&
cognitive
CROUP
(ACUTE
LARYNGOTRACHEOBRONCHITIS)
laryngeal
area
just
below
vocal
cords
surface
of
epiglottis
etiology
H.influenza,
viral
-
parainfluenza
type
I-IV
type
B
peak
age
3-6yrs
6mos-3yrs
s
&
s/x
sit
up
w/
tends
to
lie
down
mouth
open
&
chin
forward
hoarse
not
hoarse
very
croupy
cough
cough
not
no
dysphagia
croupy
may
have
dysphagia
course
rapid,
can
be
less
rapid
fatal
w/in
hrs
w/o
treatment
recurrence
rare
more
common
laryngoscopy
cherry-
subglottic
swelling
seen
thru
red,markedly
glottis
swollen
epiglottis
treatment
penicillin,
ampicillin,
sulbactam
TRIANGLES
OF
THE
NECK
POSTERIOR
TRIANGLE:
o supraclavicular
o occipital
ANTERIOR
TRIANGLE
o muscular
o digastrics/submandibular/submaxillary
o submental/suprahyoid
o carotid
FLAP
VS
GRAFT
pp
FLAP
limited
to
transplantation
of
skin
can
carry
other
tissues
depends
on
recipient
site
for
has
own
blood
supply
nutrition
may
discolour;
likely
to
contract
better
color;
less
likely
to
contract
less
adaptable
to
weight
bearing
more
adaptable
to
weight
bearing
less
able
to
survive
on
a
bed
w/
can
be
used
on
a
bed
w/
questionable
nutrition
questionable
nutrition
requires
pressure
dressing
not
require
pressure
dressing
cannot
bridge
defect
can
bridge
defect
HEMOLYTIC
STREP
/
S.AUREUS
-
MC
pathogenic
organism
of
the
head
and
neck
POTTS
DSE
-
retropharyngeal
space
infection
in
adults
OROPHARYNX
waldeyers
ring:
o lingual
tonsils
base
of
tongue
o faucial
tonsils
paired
and
w/in
palatine
fauces
o adenoids
o lateral
pharyngeal
bands
o tonsils
of
gerlach
w/in
tip
of
fossa
of
rosenmuller
NASOPHARYNX
boundaries:
o superior
base
of
skul
o anterior
nasal
cavity
o inferior
oropharynx
and
soft
palate
o lateral
opening
of
Eustachian
tubes
o posterior
cervical
vertebrae
pharyngeal
bursa
o saclike
depression
in
posterior
wall
o remnant
of
notochord
o site
of
thornwaldts
cyst
DIFFERENTIATION
S
&
S/X
ANGIOFIBROM
A
JUVENILE
TYPE
age
1-18yrs
sex
male
bleeding
profuse
NASOPHARYNGEA
L
MALIGNANCY
30-60yrs
more
male
scanty
to
mild
nasal
passage
obstructio
n
neck
nodes
minimal
to
severe
minimal
to
the
beginning
(-)
cranial
nerve
Nil
ear
occasional
treatment
surgery
can
be
an
early
sign
radiation
/che&
mo
NASAL
MALIGNANC
Y
40-70yrs
female
minimal
to
moderate
moderate
to
severe
late
CN
V
for
advanced
cases
(-)
surgery
&
RT
and/or
chemo
ACUTE
TONSILLITIS
CAUSES
tx:
penicillin
CHRONIC
TONSILITTIS
tx: tonsillectomy
ABSOLUTE
o obstruction
causing
dysphagia,
airway
obstruction
o pharyngeal
or
peritonsillar
abscess
o suspected
mignancy
RELATIVE
o recurrent
GABHS
infection
o tonsil
hyperplasia
w/
functional
obstruction,
such
as
dysphagia
or
sleep
apnea
o rheumatic
fever
w/
heart
damage
w/
recurrent
tonsillitis
&
poor
antibiotic
control
INDICATIONS
FOR
ADENOIDECTOMY
suspicion
of
malignancy
CONTRINDICATIONS
TO
TONSILLECTOMY
&
ADENOIDECTOMY
cleft palate
blood dyscrasias
medical
contraindications
LARYNGEAL CARTILAGES
thyroid - biggest
epiglottis
EXTRINSIC
MUSCLES
OF
LARYNX
6-12
nodes
SUBMANDIBULAR
INFECTION
benign
male;
adolescent
EBV
-
viral
etiology
of
nasopharyngeal
carcinomas
MOST
COMMON
TUMORS
a) BCC
o MC
epidermal
tumor
of
the
head
and
neck
o rodent
ulcer
b) SCC
o MC
malignancy
in
the
oral
cavity
o lip:
lower
lip
=
95%;
upper
lip
=
5%
o tonue
o MC
malignancy
in
the
phrynx
o MC
malignancy
in
the
larynx
o MC
malignancy
in
the
esophagus
o MC
carcinoma
of
the
pranasal
sinuses
o followed
by
adenocarcinoma
c) papillary
carcinoma
o MC
thyroid
carcinoma
o psamomma
bodies
o orphan
annie
eye
o adenocarcinoma
o MC
benign
tumor
of
larynx
HPV
16
(18)
d) follicular
carcinoma
o pericapsular
vascular
invasion
HPV 6, 11
clinical
picture:
o glottic
-
hoarseness
-
MC
early
symptom
o floor
of
ventricle
including
TVC
o supraglottic
dysphagia
o tip
of
epiglottis
including
false
VC
o subglottic
dyspnea
late
o 1cm
below
TVC
to
cricoid
o transglottic
advance
and
large
tumors
CORNICULATE
CARTILAGE
cartilage
of
santorini
CUNEIFORM
CARTILAGE
cartilage
of
wrisberg
BILATERAL
ABDUCTOR
PARALYSIS
MC
form
of
bilateral
motor
paralysis
LARYNGOMALACIA
MC
congenital
anomaly
of
larynx
INSPIRATORY
STRIDOR
major
symptom
of
laryngomalacia
PTYALISM
SIALORRHEA
excessive
saliva
production
XEROSTOMIA
dry
mouth
SJOGREN
-
absence
of
saliva
production
TB
cols
abscess
SCARLET
FEVER
/
KAWASAKI
strawberry
tongue
DIPHTHERIA
bulls
neck
2:1
incidence
of
oral
CA
FREY
SYNDROME
gustatory
sweating
after
parotidectomy
S.AUREUS:
MC
cause
of
acute
sialodenitis
EXTERNAL
AUDITORY
CANAL
pars
flaccid
o shrapnells
membrane
triangular
s.aureus
canaliths
cupulolithiasis
cause:
canaliths
free-floating
abnormally
dense
particles
RAMSAY
HUNT
SYNDROME
Arnolds/aldermans nerve
jacobsons nerve
pseudomonas
CAULIFLOWER
EAR
hematoma auris
severe perichondritis
abscess
APICAL
PETROSITIS
/
GRADENIGO
SYNDROME
discharging ear
retroorbital pain
diplopia
MELKERSSONS
SYNDROME
peripheral palsy
jewish
postulated
hypersensitivity
JERVELL
and
LANGE-NIELSEN
SYNDROME
autosomal recessive
TB in the nose
membranous
10-20%
RHINITIS
1) infections
most
prevalent;
common
cold
2) allergic
IgE
mediated,
high
socioeconomic
class
3) non-allergic
a. vasomotor
idiopathic
rhinitis
cholinergic
glandular
activity
heightened
sensitivity
b. gustatory
eating;
vagally-mediated
c. non-allergic
rhinitis
with
eosinophilia
syndrome)
unknown
etiology
paroxysmal
exacerbations
of
sx
4)
occupational
a. protein
and
chemical
allergies
IgE
mediated
b. chemical
respiratory
sensitizers
uncertain
immune
mechanism
c. work
aggravated
rhinitis
5) hormonal
pregnancy
/
menstrual
cycles
6) drug-induced
rhinitis
medicamentosa
7) atrophic
rhinitis
thinning
and
drying
of
nasal
mucosa
EPISTAXIS
mucositis MC in children
HPN mc in adults
cystic
fibrosis
PAROSMIA
perverted smell
streptomycin
HYPOSMIA
impaired smell
smoking
ANOSMIA
loss
of
smell
ACUTE
PHARYNGITIS
viral
sore throat
rigid
O.R.
o direct
laryngoscopy
o bronchoscopy
o esophagoscopy
flexible
office
EOPHAGEAL
DISORDERS
MC
in
females
NASOPHARYNX
base
of
skull/posterior
choanae
to
soft
palate
ORAL
CAVITY
B. vincente
tx:
penicillin
THORNWALDTS
DSE
nasopharyngeal
bursitis
QUINSY
peritonsilar abscess
tx:
clindamycin
PAROTID
ABSCESS
MC organism is staph
trisomy 21