ENT

Question 1

Dysphonia

Answer 1

alterted vocal quality, pitch, volume or vocal effect that impairs communication or quality of life

Question 2

Which strucutres/muscles are responsible for vocal cord movement?

Answer 2

1. Arytenoid cartilage (paired)
2. Abduction: posterior cricoarytnoid muscle
3. Adduction: lateral cricoarytenoid, thyroarytenoid

Question 3

Innervation of the larynx

Answer 3

1. Reccurrent laryngeal nerve: intrinsic muscles, sensation below cords
2. Superior laryngeal nerve: cricothyroid muscle

Question 4

What are the two common risk factors for laryngeal tumours?

Answer 4

1. Benign laryngeal papilloma: HPV

2. Malignant (Squamous Cell Carcinoma): smoking

Question 5

What characterizes functional voice disorders?

Answer 5

1. Voice fluctuating between normal and abnormal over a short course of time

Question 6

What characterizes chronic non-infectious laryngitis?

Answer 6

1. Voice fluctuates but is never normal

Question 7

What are common laryngeal infections?

Answer 7

1. Acute- viral

2. Chronic- bacterial or fungal (asthma)

Question 8

What is the most common neurogenic voice disorder and what are the side effects?

Answer 8

1. Vocal cord paralysis

2. voice changes + aspiration + upper airway obstruction

Question 9

Paradoxical vocal cord motion

Answer 9

1. Dysphonia common in women, often misdiagnosed as asthma
2. Intermittent inspiratory stridor
3. Tx= behavioural therapy

Question 10

Tinnitus

Answer 10

Auditory perception when there is no external source of sound
Ex:
Objective: anatomical abnormality like bruit
Subjective: Loss of input to neurons in central auditory pathways leads to abnormal firing
Ix: audiogram

Question 11

Otitis externa

Answer 11

1. Bacterial infection of the outer ear
   Bugs: S. aureus, herpes zoster, varicela
   Sx: Ear pain particularly with movement of the auricle, Ottorhea, ear fullness
   Tx: Clean ear, consider topical or systemic abx, antiviral if varicella

Question 12

Malignant otitis externa

Answer 12

Osteomyelitis of temporal bone

bug: pseudomonas

Question 13

Acute otitis media

Answer 13

Dx: acute symptomatic onset, middle ear effusion, middle ear inflammation
Bugs: S. pneumo, H. Flu, Moraxella, rhinovirus, adenovirus
Sx: otalgia, fever, conductive hearing loss
Tx: watchful waiting unless high fever, worsening of symptoms, no resolution in 48-72h, less than 2yo.