1) "TONSILS---/ TONSILITIS / TONSILLECTOMY --- infec. by group A & B streptococcal / strepto.pyogenes-(common org.)
Rx penicillin for 10 days
Pain in the post 1/3 tongue after tonsillectomy is due to injury to / throat pain radiating to the ear following tonsillectomy is due to IX cr. Nerve,
Tonsil develop embryologically from 2nd.pharyngeal pouch,
Hard elongated swelling in the tonsillar fossa after tonsillectomy --elongated styloid process,
Tonsillectomy--indications-(1) F.B. tonsil, (2) unilateral enlargement of tonsil with suspected malignancy, (3) atrophic tonsillitis, (4) Recurrent acute tonsillitis, (5) recurrent quinsy, postop.
Complication hemorrhage--Rx antibiotics + saline wash, sec.hemorrhage(5-8days)-is due to- infection,& it is the common postop. Complication hemorrhage after 6hrs --reactionary H., main blood supply to tonsil is facial artery,
Tonsillectomy is contraindicated in polio epidemic,
Palatine tonsils have Efferents but no afferents,
After
Commonest L.N. to enlarge in acute tonsillitis is Jugulodiagastric L.N.
Tonsils reach their max. Size by 5yrs.,"
2) "OTOSCLEROSIS / OTOSPONGIOSIS ---A.D. more in Females, affects Oval window/stapes, Conductive Hearing Loss, color of T.M.=FLAMINGO PINK, Paracusis willisii, Schwartz sign seen, Gelle's test -ve, Carhart's notch/ dip=2 kHz,
TOC=Stapedectomy with prosthesis/Fluorides--cochlear otosclerosis
3) "VOCAL CORD(S) --- lined by stratified sq. epithelium, REINKI'S layer seen, post traumatic web formation.
Can be prevented by MC NAUGHT'S KEEL,
Unilat.V.C. palsy-- commonest cause-Idiopathic,
Left unilat. V.C. palsy-cause-esophageal ca.,
Precancerous lesion in V.C.-leukoplakia, localized nodule vocal cord of sq.cell ca. vocal cord-Rx-Excision,
Earliest symptom of Ca. vocal cord--Hoarseness,
MOUSE NIBBLED APPEARANCE of V.C.--seen in T.B. of V.C.,
Granuloma of V.C.-is due to Intubations, unilat.complete paralysis of V.C. can be corrected by--Teflon inj., cricoarytenoid arthrodesis, implant procedures,
T1N0M0 Ca of V.C. - Rx--radical radiotherapy
Internal tensor lengthening mucosa of V.C. is Cricothyroid,
Primary etiological factor in contact ulcer of larynx--Vocal Abuse,
V.C. paralysis—respiratory obstruction, aphonia by adductor paralysis can be overcome by Arytenoidectomy,
19yrs.old female with aphonia has bilateral abductor paralysis cause is functional
4) CANCER OF LARYNX---Squamous cell cancer of larynx is commonest presentation, it is the commonest cause of Hoarseness of voice in Elderly man of more than 2mths.duration / Laryngeal Stridor in a 60yrs.man,
Early features of Ca larynx= Hoarseness of voice,
NO neck secondary-->Rx only Radiation,
STAGE-III-->SURGERY+RADIATION,
Rx of Glottic cancer
-- TOC.-for (T1N0M0) - EXTRENAL BEAM RADIOTHERPY,
---Ca larynx with Fully
---Rx of Ca larynx with Stridor -- PLANNED TRACHEOSTOMY,
Glottic cancer has least chance of Nodal Mets.,
Glottic Vocal Cancer has Best Prognosis, and Hoarseness is Early in Glottic Cancer,
INFRAGLOTTIC CA. -->Commonly Spreads to Mediastinal L N'S,
Ant. Commissural growth – Rx -->Conservative Laryngectomy, post cricoid growth
5) CSOM (CHRONIC SUPPURATIVE OTITIS MEDIA) --- attico antral (dangerous type of ear), Schwartz op. done,
CSOM with cholesteatoma with acute onset of vertigo – Rx - immediate exploration, Rx-cholesteatoma- radical mastoidectomy
6) "ACOUSTIC NEUROMA---Auditory defect, sensory aphasia, changes in audiometry, commonly affects-8 Cr. N. & that too Superior Vestibular Nerve, early symptoms - Unilateral hearing loss, it is most common (CPA) Cerebello-Pontine Angle tumors, Numbness of Face, Deafness, Internal Hydrocephalus, Ac. Nr. of 1 cm-IOC/diag.of choice=C.T. SCAN, hypoesthesia of the post. aspect of the ext. auditory canal-this is an early sign,
7) "MENEIRE DISEASE / ENDOLYMPHATIC HYDROPS--- Ass. with Presbycusis, FES.-- Tinnitus, Recurrent Vertigo, Deafness, Low Frequency SNHL/SND.-on pure tone Audiogram, GLYCEROL TEST is done in this, CODYTACK OPERATION is done, Cochlear type M.D.--Cochlear Deafness, Rx – Vasodilators --> increase Endolymph reabsorption, vasodilators of internal ear-is-Nicotinic acid
8) "ANGIOFIBROMA (NASOPHARYGEAL)---Juvenile angiofibroma is locally enlarging tumor producing destruction of bony structures without producing distal secondaries, Young Males(10 yrs boys), Bilateral Nasal Obstruction, bleeding from nose/ Intermittent profuse Epistaxis, firm pinkish mass in nasopharynx, Inv.=X-ray base of skull, carotid angiography, C.T.SCAN(IOC), Benign but potentially malignant
9) "EPISTAXIS---most common site--AnteroInferior Part of the Nasal Septum, this is also called as ' LITTLE'S AREA ‘,
in Elderly pt.--commonest cause-HTN., Rx give NTG to-decrease B.P., Recurrent epistaxis in a 15 yrs. female--most common cause-Hematopoietic disorder,
Epistaxis in 5 yrs. old Boy is due to Bleeding Disorder,
Recurrent Epistaxis=causes--DNS, Atrophic Rhinitis, Maxillary Ca.
IMP TOPICS
1) "FACIAL NERVE---secretomotor N.fibres of SphenoPalatine Ganglion supply the Lacrimal gland,
Injury to Facial N.at Geniculate Ganglion--Dryness of eyes,
Site of lesion of F.N. causing Lacrimal gland involvement is Mastoid Foramen,
FACIAL NERVE PALSY---common cause--Bell's Palsy, F.N.P.-due Trauma, Immediate Rx—Decompression
2) "MIDDLE MEATUS OF NOSE---Frontal air cells, Ant. Ethmoids, Maxillary sinus opens in it, BULLA-ETHMOIDALIS, HIATUS SEMILUNARIS are seen
3) "NAOPHARYNGEAL CANCER---EBV is a causative agent, Spreads to Lymph nodes, commonest Presentation--Cervical adenopathy, there is High Incidence of NODAL METASTASIS,
4) "OTITIS MEDIA---ASOM -- commonest cause--Pneumococcus --very serious O.M., Pulsatile Otorrhea seen, 3yrs. Child with Fever, Ear ache, Congested T.M. with slight Bulge, it is the commonest cause of hearing loss?, Rx--Penicillin ( Myringotomy+ penicillin)"
5) "NASAL POLYP---ANTROCHOANAL P. ---& POLYPECTOMY-intranasal & ext.approach--arises from maxillary sinus, single & unilateral
6) "ATROPHIC RHINITIS---Sx young operation done., ozaena is seen, anosmia, alkaline douche sol'n=NaCl, Na-borate, NaHCo3
7) "STRIDOR---effect of BILAT. RLN damage, most common cause in adult--malignancy,
Rx of congenital laryngeal stridor =reassurance to parents,
Most common cause pf stridor in newborn—laryngomalacia
8) "TRACHEOSTOMY- - complication commonly occur in children-is-difficult decannulation, indication--stridor, coma of long duration , diphtheria, laryngeal obst., flail chest, tetanus(cyanotic spells) , It is not used in F.B. / Obst. of post basal lobe /bronchus, commonest complication of pediatric--Pneumothorax,
9) "TYMPANIC MEMBRANE---Blue Drum--seen in Secretory otitis media, nerve supply auriculotemporal nerve, T.M.-mobility--most mobile part-central
10) "LITTLE'S AREA--- arterial supply= Ant.Ethmoidal art., Septal branch of facial art., Nasal branch of Sphenopalatine art., it is the commonest Bleeding site of nose / EPISTAXIS, or KIESSELBACH'S PLEXUS---Bleeding Area of nose is situated in the AnteroInferior surface of septum/medial wall of nasal cavity ,”
11) "HEARING LOSS---SENSORENEURAL H.L.---(SNHL)--causes-old age, Cochlear Otosclerosis,Loud sound, Rx--COCHLEAR IMPLANT, Hydrops of Endolymphatic system-seen-in Alport's synd.,Usher's synd.,Pendred's synd.,"----------((5))
12) "MIDDLE EAR CAVITY---Nerve supply--Glossopharyngeal nerve,Floor--formed by INTERNAL JUGULAR BULB, In middle ear desease-there is - increased Threshold of AC & decreased BC (BC>AC), Resistance in middle ear-is-tested by IMPEDENCE Audiometry, Prominent Emenece over medial wall of midlle ear-is formed by-COCHLEA( BASAL TURNS),"----------((5))
13) "NASAL CAVITY---Function--Warming, Moistening, Filtration, NASAL SEPTUM---is formed by Vomer bone, Perpendicular bone of Ethmoid, Rostrum of Sphenoid, APPLE-JELLY NODULES on nasal septum--is due to Lupus Vulgaris, NASAL CARTILAGE-- 3 Paired & 1 Unpaired cartilages, NASAL MUCOSA---supplied by mainly Ext.Carotid artery,"-----------((5))
14) "RECURRENT LARYNGEAL NERVE---partial RLN palsy produces Vocal cord in PARAMEDIAN position, closely related to Inf.thyroid artery, BILAT.RLN PALSY=ADDUCTED position & stridor, supplies all except cricothyroid( SLN),"----------((5))
15) "RHINOSPORODIOSIS---russel bodies seen, Rx- Dapson, fungal infec.,max.in Tamil nadu, Rx excision with cautery at base,"-----------((5))
16) "DNS / DEVIATED NASAL SEPTUM ---sharp DNS--Epitaxis, SPUR, recurrent sinusitis, Newborn with DNS= 20%, inf.tubinate hypertrophy, COTTEL'S TEST--patency of nares in DNS,"------------((5))
17) "FRONTAL SINUS--F.S. develops from ant. Ethmoidal cells, PNEUMATOCELE--fracture of F.S., not present at birth, FRONTAL MUCOCELE--"-----------((5))
18) "EPIGLOTTITIS---ACUTE--Commonest Organism causing it is -Hemophilus Influenze, DOC.in children--Ampicillin,commonest cause death-is-Respiratory obstruction,"------------((4))
19) "MYRINGOTOMY---done on POSTERO-INFERIOR Quadrant of T.M., commonest indication--Serous Otitis Media, a child with otitis media with Bulging T.M. with dull look, PUS in middle ear under tension,"-----------((4))
20) "PLUMMER VINSON'S SYND.---ass. With oesophageal ca., post cricoid growth, IDA, females, premalignant ( for hypopharyngeal ca., "---------((4))
21) "QUINSY---PERITONSILLAR ABSCESS---org.-streptococcus, quinsy+trimus--> Rx for 48 hrs. antibiotics only & then oral drainage,"----------((4))
22) "SEPTAL PERFORATION---of Cartilagenous nasal septum--septal abscess,leprosy ( ant. Septal perf.), Bony septal perforation--syphilis, Mucosa; inv. With nasal septum perforation in jaws-is-known as GANGOSA, "--------((4))
23) "MAXILLARY SINUSITIS---commonest / chronic sinusitis in children,"---------((4))
24) "PATCH IN THROAT--- / MEMBRANE IN THROAT --- (1) vincents angina, Black colour patch in mouth, (2) candida , (3) diptheria, (4) streptococcus, & IN THROAT OF ADULT----> Hemophilus, streptococcus, Neisseria, organism are seen but not E-Coli, "----------((4))
25) "GLUE EAR---8 yrs. Old child, Bilateral Conductive Deafness, seen in SECRETORY OTITIS MEDIA, or SEROUS OTITIS MEDIA---FLAT Tympanogram , "--------((4))
26) "MYRINGOPLASTY---Plastic Repair of T.M., note- initially audiometry done & then Sx done, or TYMPANOPLASTY---before T.plasty surgeon look for cochlear reserve, temporal fascia is used -it's metabolic rate is low, "-----------((4))
27) "BRAIN OTOGENIC ABSCESS---Mx-drainage of abscess followed by mastoidectomy, commonest site--temporal petrosal lobe, TEMPORAL LOBE ABSCESS---occurs in unsafe otitis media with high fever , convulsions "---------((3))
28) "ADENOIDECTOMY--- Indication--Recurrent Otitis Media, Sleep Apnoea synd., Middle ear infec. With deafness, C I --Submucous Cleft Palate, control of Hemorrhage--by Post.Nasal PACK, " ---------((3))
29) "ARNOLD'S NERVE---is a Branch of VAGUS Nerve, Irritation of this causes Ear Cough, Cough response caused while cleaning ear canal is mediated by stimulation of X Cr.N."----------(3)
30) "CARDIOSPASM / ACHALASIA CARDIA---difficulity for swallowing Liquids but not for solids, ass.with DEGENERATION of nerve plexus in the oesophagus, Barium Swallow-shows-Dilatation with smooth narrow ending, "--------((3))
31) "ENDOLYMPH---most imp. Constituent-K+ , is seen in Scala Media , Drains into Virchow Robin Space,"-------((3))
32) "EUSTACHIAN TUBE---most common cause of E.T. disease--ADENOIDS, LENGTH=36mm( 3.6 cm),"-------((3))
33) "GLOMUS TUMOUR---in middle ear, Location--Hypotympanum, Pulsatile Tinnitus ,Pulsatile tumour in EAM which Bleeds to Touch,"---------((3))
34) "GRADENIGO'S SYND.---abducent VI Nr. Palsy, Retroorbital Pain, pain over face, Aural discharge/ otorrhoea, Pralysis of Ext./lat Rectus, Nr. Inv.= 5,6, GRADENIGO'S TRIAD---Mastoiditis, Petrositis, L R palsy,"--------((3))
35) "MULTIPLE PAPILLOMA OF LARYNX---Rx Excision with Laser, common in Infants & Children, Laryngeal papilloma are usaually Multiple & VIRAL in origin, usual site of papilloma is larynx, Rx of single P.= Removal by Direct Laryngoscopy, "---------((3))
36) "TUBERCULOSIS OF LARYNX/TUBERCULOUS LARYNGITIS--- KISS ULCER of Larynx, common site of T.B. Larynx is POST.COMMISSURE OF L."-------((3))
37) "OTITIS EXTERNA---MALIGNANT--caused by P.Aeroginosa, common in D.M., & OLD age,"----------((3))
38) "RHINOSCLEROSIS / RHINOSCLEROMA--- bacilli infec., Mickulitz & Russel bodies seen,"-------------((3))
39) "RINNE'S TEST---+ve seen in presbycusis, -ve(BC>AC)-->middle ear disease,"--------((3))
40) "CSF RHINORRHOEA--- ant.cranial fossa fractures / Cribriform plate fracture , most imm. Rx-prophylactic antibiotics& x-ray, "-----------((3))
41) "ETHMOIDAL SINUS--First sinus to appear after Birth, ETH.S. Adenocarcinoma--seen in WOOD workers & Nickel workers,"--------((3))
42) "MAXILLARY SINUS---maxillary antrum commonest malignancy=sq.cell ca., secondary deposits from M.S.-->submandibular L.N.'S,this is present at birth,"----------((3))
43) "SINUSITIS---bloood stainded rhinorrhoea, nasal blockage, facial edema, complication=orbital cellulitis, Sx-proof puncture,"---------((3))
44) "STAPEDIAL MUSCLE---supplied by facial cr. Nerve, STAPEDIAL REFLEX---protective against loud sound , mediated by VII & VIII CR. N.,"---------((3))
45) "SUPRAMEATAL SPINE OF HENLE---landmark on lat.surface of temporal bone which acts as a guide to surgery to the antrum,"----------((3))
46) "VOCAL FOLDS---& VOCAL FOLD CA.---Vocal folds are abducted by post.cricoarytenoid, in CA. L.N.'Smets never seen,,has good prog.,"----------((3))
47) "FRACTURES OF ZYGOMA--- undisplaced fracture--no specific Rx,"--------((3))
Topics Asken more than Twice
1) BEZOLD ABSCESS---located in digastric fossa/ sternomastoid muscle,-------------((2))
2) "CALDWELL-LUC OP.---commonest complication=Infra orbital nerve Palsy, used for removal of AntroChoanal Polyp,"------------((2))
3) "CALORIC test---done with Warm & Cold water, has Slow & Fast Component, Tests function of Lat.Semicircular canal,"----------((2))
4) "CHOLESTEATOMA---filled with Keratinised Stratified sq. epithelium, deafness, Erodes bone,"------------((2))
5) "COCHLEAR NUCLEI---appreciation of sound, COCHLEAR IMPLANTS--- used in SNHL/ SND.,"--------((2))
6) "EXTERNAL AUDITORY MEATUS/ EAM---normal length=24 mm ( 2.4 cm),Cartilaginous portion is smaller than Bony portion,"--------------((2))
7) "FISTULA TEST---+VE after OPeration.of Labyrinth fenestration, FALSE +VE F.T.--seen in Hypermobile Ossicular chain, Labyrinthine Fistula, Post fenestration op.,"-------------((2))
8) "FOREIGN BODY OF NOSE---Unilateral Blood Stained & Fetid , Unilat. Nasal Obst., Nasal Discharge,"-----------((2))
9) "FRACTURE OF MAXILLA---fes. CSF Rhinorrhoea, Anasthesia of upper lip, Sugical emphysema cheeks,Not seen is malocclusion"------------((2))
10) "FURUNCLE OF EAR CANAL---Rx ear pack with 10% ICTHAMOL in GLYCERINE wick, most common site-EXT.cartilaginous auditory canal,"----------((2))
11) "LABYRINTH---destruction of Rt. Labyrinth causes nystagmus to Lt.side, Labyrinthine Artery is a branch of Ant. Inf. Cerebellar art.," ---------((2))
12) "LARYNGOSCOPY---KEY HOLE APP. of glottis is seen in PHONASTHENIA, the procedure that should precede microlaryngoscopy is laryngo-endoscopy, "-------------((2))
13) "LARYNGOMALACIA---most common Congenital Anamoly of larynx, most common cause of congenital stridor & inspiratory stridor is normal on crying,"-----------((2))
14) "LARYNX---Important function of Larynx is Protection of Lower Respiratory Tract, Narrowest part of Infantile Larynx=SUBGLOTTIS,"--------------((2))
15) PRECANCEROUS LESIONS OF LARYNX---KERATOSIS LARYNGITIS/ LARYNGIS SICCA?-PRECANCEROUS LESION,”------------((2))
16) "MAC EWEN'S TRIANGLE / SUPRAMEATAL TRIANGLE---felt thru. CYMBA Conche, Landmark for Mastoid Antrum"----------((2))
17) "MASTOIDECTOMY---commonest Extra-Cranial complication--Facial nerve Palsy, RADICAL MASTOIDECTOMY---inv.lowering of facial ridge, scrapping of middle ear ,removal of all ossicle except foot plate of stapes,"------------((2))
18) "MASTOIDITIS---ACUTE--clouding of air cells, deafness, obliteration of retroauricular sulcus, Complications-- Subperipsteal abscess-mastoid infec. Erodes outer cortex of bone,"----------((2))
19) "MAXILLARY SINUS -ANTRAL CARCINOMA---T3NOMO-Rx-->SURGERY+RADIOTH.,Malignant tumour arisis commonly from maxillary sinus,"-----------((2))
20) "NASOPHARYNGEAL FIBROMA---Rx Surgery, NASOPHARYNX---Oval shaped Space,"---------------((2))
21) "ORGAN OF CORTI---situated in SCALA MEDIA, along Inner edge of membrane"-------------((2))
22) "OTOTOXIC DRUGS---kanamycin, streptomycin, vincristine, gentamicin, "------------((2))
23) "PARACUSIS WILLISII---pt. Hear better in NOISE, cinical otosclerosis,"--------------((2))
24) "PAROTID---& TUMOURS OF PAROTID---NERVE commonly sacrificed is facial n. "-----------((2))
25) "PHONASTHENIA---KEY HOLE APP. OF GLOTTIS ON LARYNGOSCOPY,& PUBOPHONIA--- a boy failed to develop the crackling of voice which normally occurs in adolescence,"------------((2))
26) "PYRIFORM FOSSA/ SINUS---lymphatic drainage to upper cervical L.N.'S, malignant lesions of P.S. pain is reffered to Ipsilateral ear via vagus nerve,"------------((2))
27) REINKE'S OEDEMA---oedema of the free margin/edge of the Vocal cord ,”---------((2))
28) "ALLERGIC RHINITIS---test used intracutaneous test, scratch test, rash test, common cause of nasal discharge,"----------((2))
29) "VASOMOTOR RHINITIS---Sx Vidian Neurectomy, autonomic imbalance,"-------((2))
30) "CORYZA / VIRAL RHINITIS---PARCEL viruses, "----------((2))
31) "RHINOLALIA CLAUSA---seen in gross adenoid hypertrophy, voice abn.,"---------((2))
32) "RHINOSCOPY---ANTERIOR--Bulla Ethmoidalis, inf. Tubinates, little's area,are seen , not seen is sup.tubinate, POSTERIOR-- Eustachian tube, inf.meatus, middle meatus, not seen is sup. Concha,"--------((2))
33) "SPENOID SINUS---opens into sphenoethmoidal recess,"--------((2))
34) "ACUTE FRONTAL SINUSITIS---chronic periodic headache, disapears with sunset, "-----------((2))
35) "SUBMUCOUS FIBROSIS---premalignant,"--------------((2))
36) "SMR / SUBMUCOUS RESECTION---done > 16yrs. , DNS, "----------((2))
37) TRACHEA---begins at the level of lower border of cricoid cartilage,---------((2))
38) "TRAUMATIC RUPTURE OF T.M.---Rx conservative / No active Rx, pin-prick injury to eardrum-Rx-antibiotics,"----------((2))
39) "VINCENT'S ANGINA---ulcerative lesion of fusiform bacillus, / anaerobic, spirochaete, "----------((2))
40) "WEBER TEST--- in conductive deafness -W.T. lat. to deaf ear, note=both ear rinne's +ve & W.T. lat.to left I.e. left sided conductive deafness, "----------((2))
41) "IDDM WITH SEPTAL PERFORATION WITH BROWISH BLACK DISCHARGE / COLOUR OF INF.TURBINATE--- diagnosis is MUCOR MYCOSIS, "-----------((2))
ENT:-- Occasionally Asked Topics
1) "ABC / ABSOLUTE BONE CONDUCTION---shortened in SNHL / Perceptive deafness
2) "ACOUSTIC REFLEX DECAY TEST--- +VE in Lesions of Auditory Cortex
3) "ADENOID FACIES--- Fes.-- Open mouth, Pinching of nose, Crowding of teeth, "--------((1))
4) "ANOSMIA----complete-Responda to inhalation of ammonia,"--------------------((1))
5) "ANTRAL WASH---for drainage of maxillary sinus is thru. Inferior meatus,"---------------
6) AUDIOGRAM-U-shaped A.--congenital deafness, FLATTENED A.- serous Otitis media
7) "AUDIOMETRY---IMPEDANCE,"------------------((1))
8) ALLODYNIA---increased perception of Painful stimulus,----------------((1))
9) "BELL'S PALSY---Mx-Steroids & Surgical Decompression,"---------------(1))
10) "BRONCHOSCOPY---indicated in persisitent Wheeze,"------------------((1))
11) BLAST INJURY---most common organ affected -Ear Drum,---------------((1))
12) "CARHART'S NOTCH---seen at 2000 Hz., & in otosclerosis,"-------------((1))
13) "CHOANAL ATRESIA---BiLateral Complete-->life threatening complication,"-----------((1))
14) "CHORDITIS TUBEROSA---is due to Chronic Laryngitis,"--------------((1))
15) "CRICOID CARTILAGE---is Signet Ring shape, "-------------------((1))
16) "CRICOTHYROID MUSCLE---is supplied by SUPERIOR Laryngeal nerve( SLN ), & rest by RLN.,"---------((1))
17) "CONE OF LIGHT---is formed on ANTERIO-INFERIOR Quadrant,"----------------((1))
18) "CSF.---is similar to PERI-LYMPH,"------------(1))
19) "DIPHTERIA---Membranes firmly Attached & Bleeds on Touch, " ----------((1))
20) "DYSPHAGIA---SIDEROPENIC DYSP.--seen in Iron Def. Anemia,"---------------((1))
21) "DYSPHONIA PLICA VENTRICULARIS---is producing sounds with false cord,"------------((1))
22) "CAULIFLOWER EAR---is due to Hematoma of Auricle," -----------------((1))
23) "ENCEPHALOCELE---Herniation of Brain tissue with its Dural covering into the Nasal cavity, "-----((1))
24) "EPITYMPANUM---includes--head of Malleolus , Body of Incus,"----------((1))
25) "FITZGERALD-HALLPIKE TEST---uses Temp. at 30oC& 44oC, also called as caloric test?,"------((1))
26) "LE FORT'S FRACTURE---inv's ZYGOMA, MAXILLA, & NASAL BONES,"----------((1))
27) "Oblique & Horizontal Fracture of nasal septum--- is called as JARJAVAL FRACTURE,"------------((1))
28) "GLOBUS HYSTERICUS---lump in throat not interfering with swallowing,"----------------((1))
29) "GROMMET INSERTION---is done in anteroinferior quadrant,"------------((1))
30) GELLE'S TEST---done in Otosclerosis,-----------------((1))
31) "Great Auricular Nr. ---supplies Skin at Angle of JAW,"---------------((1))
32) "
33) Hearing impairment due to noise starts at 4000 Hz.,----------------((1))
34) "HEMANGIOMA---Bleeding Polyp of nose--arises from septum,"-----------((1))
35) HYPERACUSIS---normal sound are heard as loud & painful.,--------------((1))
36) "HYPERNASALITY---caused by Cleft palate, Submucous celft, Bifed Uvula,"--------------------((1))
37) HYPOPHARYNEAL CANCER---predisposing factors -Plummer Vinson's Synd.,----------------((1))
38) "INVERTED PAPILLOMA---of Rt.side of nasal cavity -TOC.=Total Maxillectomy,"-----------------((1))
39) "INNER AUDITORY MEATUS---facial nerve is lateral to superior vestibular nerve,"
40) "JUVENILE PAPILLOMA---Rx-Surgical excision,"-----------------((1))
41) "KERATOSIS OBURANS---is a Premalignant condition,"------------------((1))
42) KOBARK TEST---used for Minimal Caloric Stimulation,-------------------((1))
43) "KARTAGENER'S SYND.---Ass.with Sinusitis, Dextrocardia, Bronchiectasis, "----------------((1))
44) "LARYGEAL MIRROR---warmed before use by placing glass surface on Flame,"--------------------((1))
45) "LARYNGOFISSURE---Opening the larynx in midline,"-------------------((1))
46) "LARYNGECTOMY---after laryngectomy Voice is from Oesophagus,"--------------------------((1))
47) "LARYNGOCELE---Gas filled sac in neck region after VALSALVA MANOEURVE,"--------------((1))
48) "ANAESTHESIA OF LARYNX---occurs with Diptheria, Lead Poisoning, Multiple sclerosis,"---------(1))
49) "LYMPH NODE METASTASIS IN NECK --- is seen in SupraGlottic Ca., Ca.of Tonsil, Papillary Ca.of thyroid, NEVER seen in Ca.of Vocal Cords, "--------------------((1))
50) "MASKING---is applied for inability to hear,"-----------------((1))
51) "MASTOID TEMPORAL BONE AIR CELL GROUPS---include Petrosae, Retrofacial, Hypotympanic, Sublabyrinthine."-----------------((1))
52) "MASTOID TIP---appears by 2yrs. of age,"----------------((1))
53) "INFERIOR MEATUS OF NOSE---NasoLacrimal duct/ Frontonasal duct opens," ------------((1))
54) "MONOAURAL DISPLACUSIS---due to Lesions of Cochlea,"------------((1))
55) "MYIASIS OF NOSE---MAGGOTS OF NOSE, Rx-TOC.--CHLOROFORM Water,"---------((1))
56) "MYRINGITIS BULLOSA---caused by Virus,"--------------((1))
57) "NASAL DEPRESSED BRIDGE--- caused by Syphylis, Septal Abscess, Injury,"--------------------((1))
58) CROOKED NOSE---due to Deviated Tip & Septum ,---------------------((1))
59) "SADDLE SHAPED NOSE---due to Destruction of nasal septum," --------((1))
60) "OESOPHAGUS---cervical oesophagus receives its blood supply from Inf.Thyroid Artery, "-----------(1)
61) "BENIGN NEOPLASMS OF OESOPHAGUS---commonest --is Intramural Tumour of oesophagus--LEIOMYOMA,"-------------------((1))
62) "CARCINOMA OF OESOPHAGUS---RAT TAIL APP. on Barium swallowing,"------------------((1))
63) "OLFCTORY AREA---Looks YELLOW in colour,"-------------------((1))
64) "OSSICULAR RATIO = 1.3:1 , " -------------------((1))
65) "TUBERCULAR OTITIS MEDIA---Multiple perforations of T.M., "-------------((1))
66) "ACUTE NON SUPPURATIVE OTITIS MEDIA---Retracted drumhead with a hiar-line or air bubbles on otoscopy," ------------------((1))
67) "OTOMYCOSIS---most common fugas aspergillus fumigatus,"----------((1))
68) CSF OTORRHOEA--- fracture of petrous ridge/ petrous temporal bone,--------------((1))
69) "PENDRED SYND.--Thyroid swelling + nerve deafness,"------------------((1))
70) PARAPHARYNGEAL ABCESS---swelling in post. Part of middle1/3 of sternomastoid & tonsil is pused medially,----------------((1))
71) "PAROSMIA---PERVERSION OF SMELL,"------------((1))
72) "PHARYNGITIS- MEMBRANOUS---causes--streptococcal, ludwig's angina, diptheria, "-----------((1))
73) PHARYNGOMAXILLARY ABSCESS---medial bulge of pharynx ,----------((1))
74) "PLEOMORPHIC ADENOMA---most common tumour of parotid gland,"-------------((1))
75) PNEUMATOCELE--seen in fracture of frontal sinus,--------------((1))
76) PROCESSUS COCHLEARIFORMIS--attaches to handle of mallues,---------------((1))
77) "RESP.ALLERGY--house dust,"------------------((1))
78) "RANADIER'S OPERATION---done in Petrositis,"---------------((1))
79) CHRONIC RETROPHARYNGEAL ABSCESS--due to caries spine,-----------((1))
80) "SICCA RHINITIS--anterior nares inv.,",------------------((1))
81) "RHINOLITH--- deposition of calcium around the F.B. in nose,"-----------((1))
82) RHINOPHYMA---hypertrophy of sebaceous gland,------------------((1))
83) "SINGERS NODULE---Voice abuse,"-------------------(1))
84) "SCALA MEDIA ---shows endolymph,"----------------((1))
85) "SCHIRMER'S TEST---for lacrimal secr. To test facial nerve,"------------((1))
86) "SEMICIRCULAR CANALS--senses Angular movements,"--------------((1))
87) "SCHWARTZ SIGN ---seen in otosclerosis,"----------------((1))
88) "SCHWARTZE OPERATION---done in CSOM,"-----------((1))
89) "SPEECH DISCRIMINATION SCORE---lowest in retrocochlear SND
90) "ALPORT'S SYND.---SNHL+Hereditary nephritis,"--------------((1))
91) "TEMPORAL BONE---petrous part-inner ear,"------------------((1))
92) "TONE DECAY TEST---done to fineout retrocochlear lesions,"------------((1))
93) "TOBEY AYER TEST---Lateral sinus thrombosis,"----------------((1))
94) "TRACHEOSTOMY TUBE---double tube, made of Titanium silver alloy, cuffed tube is used for IPPV, "--------((1))
95) "TROTTER'S TRIAD---seen in nasopharyngeal ca.,"-----------((1))
96) "UMBO---most reliable landmark on otoscopy,"-------------((1))
97) "VERTIGO---peripheral/ labyrinthine V. fes--unidirectional nystagmus, marked vertigo, ass.central abn.absent,"--------------((1))
98) "VESTIBULE---IS present in nose, larynx, pharynx,"--------------((1))
99) "VESTIBULAR SCHWANOMMA---IOC--GADOLINIUM ENHANCED MRI,"------------------((1))
100) VIDIAN NERVE---/ NERVE OF
101) "VOCAL NODULES---present at junction of anterior 1/3 & post. 2/3, "--------------------------((1))
102) "WOODRUFF'S AREA---post. End of inferior turbinate, "-----------------((1))
103) "WALDERYER'S RING ---inner w.group of L.N.=tonsils, lingual tonsils, adenoids,"-----------------((1))
104) "WARTHIN'S TUMOUR---Rx superior paratidectomy,"------------------((1))
105) ZENKER'S DIVERTICULUM --- it's asymp.-------------------((1))
106) "AT BIRTH---following structures are of adult size--tympanic cavity, malleus, tympanic ring , except -mastoid antrum,"-------------------((1))
107) "The ADDUCTION OF V.C. cannot occur while talking , but can occur with good cough --is a condition ass. With functional aphonia,"--------(1))
108) "SUPRAGLOTTIS--- include -aryepiglottic folds, false cords, laryngeal surface of the epiglottis,"---------------((1))
109) "TRANSBRONCIAL BIOPSY---is thru. Fiber-optic bronchoscopy,"----------------((1))
110) "
111) "AUDIBLE SOUND FOR NORMAL HUMANHEARING = 40-45 db,"---------------((1))
112) "PROLONGED EXPOSURE TO NOISE LEVELS > 85 db can impair hearing permanently,"---------------((1))
113) "RUPTURE OF T.M. /EAR DRUM occur at noise level > 160 db,"--------------((1))
114) "40 db COMPARED TO 20 DB is 100 TIMES,"-------------((1))
115) "RHINITIS SYNDROME---in mast cell mediator release category are categorised by sneezing , marked postnasal discharge, lacrimation,"----------------((1))
116) "WATER'S VIEW ( OCCIPITOMENTAL )--- provides good visualization of maxillary sinus, orbitofrontal sinus, frontal sinus,"--------------((1))
117) "CHILD WITH COMPRESSIBLE SWELLING ROOT OF NOSE---MENINGOMYELOCELE,"------------((1))
118) "STRUCTURES PASSING between the upper border of the superior constrictor muscle & base of the skull are levator palati muscle & the cartilagineous eustachain tube,"--------------------((1))
119) QUALITY OF VOICE--- not changed in total adductor palsy
120) "FAMILIAL PREDISPOSITION of malignancies--- are seen in -breast, leukaemia, thyroid,"----------------(1))
121) "GLOSSOPHARYNGEAL NERVE---supplies sensation to the middle ear mucous memb.,& tongue (post1/3)"-------------((1))
122) MICROPHONIC POTENTIALS ORIGINATING IN COCHLEA are resistant to Ischemia
123) "IVORY OSTEOMA--- sen in fronto-ethmoidal region,"-------------((1))
124) "PLICA SEMILUNARIS---is situated in Tonsillar area,"----------((1))
125) "SUBMANDIBULAR GLAND SURGERY---may result in damage of 7,11,12 Cr.N
126) "MICROLARYNGOSCOPY---size of lens used is 400mm
127) "VOCAL FREMITUS ---decreased in Emphysema , thick pleura, Pleural effusion,"
128) "common site of F.B. in lower respiratory tract is --Rt.Main Bronchus,"------------------((1))
129) "IMPAIRMENT OF hearing due to noise starts at ---4000 hz.,/ 4khz.,"-----------------((1))
130) "EAM=24 mm, / 2.4 cm.,"-------------------((1))
131) "E.T / PT.TUBE=36 mm., / 3.6 cm.," -----------((1))
132) "U-SHAPED AUDIOGRAM---CONGENITAL DEAFNESS,"----------((1))
133) FLAT AUDIOGRAM---SEROUS OTITIS MEDIA,---------------((1))
134) "CARHART'S NOTCH ---2000 hz., / 2Khz.,"--------------((1))
135) "WAX IN EAR ---commonest cause of deafness,"-----------((1))
Adie's pupil
A weak light reaction with segmental palsy of iris sphincter, a strong slow near response. an idiopathic postganglionic denervation of the parasympathetically innervated intraocular muscles, usually complicated by signs of aberrant regeneration of these nerves: See Also: tonic pupil. Syn: Adie's pupil, Holmes-Adie pupil, Holmes-Adie syndrome, pupillotonic pseudotabes.
Argyll Robertson pupil( absent reaction to pupillary light reflex & present reaction to accomodation ) a form of reflex iridoplegia characterized by miosis, irregular shape, and a loss of the direct and consensual pupillary reflex to light, with normal pupillary constriction to a near vision effort (light-near dissociation); often present in tabetic neurosyphilis. Syn: Robertson pupil.
Marcus Gunn pupil relative afferent pupillary defect. Syn: Gunn pupil.
Marcus Gunn jaw-winking is a form of synkinetic ptosis. An aberrant connection exists between the motor branches of the trigeminal nerve (CN V3) innervating the external pterygoid muscle and the fibers of the superior division of the oculomotor nerve (CN III) that innervate the levator superioris muscle of the upper eyelid. Electromyographic studies demonstrate this synkinetic innervation by showing simultaneous contraction of the external pterygoid and levator muscle. In these cases, the eyelid elevates on closing the mouth and clenching the teeth. jaw-winking ptosis. Jaw winking worse in downgaze o Decreased vision secondary to amblyopia o Strabismus + Vertical deviation, usually a hypotropia on involved side
Horner's pupil constricted pupil due to impairment of sympathetic nerve innervation of the dilator muscle of the pupil. See Also: Horner's syndrome.
causes of horners synd. include: -post. inf. cerebellar artery or basilar artery occlusion -MS -Hypothalamic lesions -cavernous sinus thrombosis -cervical cord, mediastinal or pancoast's tumour -Aortic aneurysm -Klumpke's paralysis -cervical lymph adenopathy
Horner synd. Shows= MAPEC.
M=Miosis,
A=Anhidrosis
P=Ptosis
E=Enphthalmoses
C=Loss of Ciliospinal reflex.
Amaroutic pupil:-pupil in an eye that is blind because of ocular or optic nerve disease; this pupil will not contract to light except when the normal fellow eye is stimulated with light.
Cat's eye pupil-
distorted, elongated pupil; usually due to anterior segment anomaly.
Tonic pupil
a general term for a pupil with delayed, slow, long-lasting contractions to light and to a near vision effort, often with light-near dissociation; due to denervation and aberrant reinnervation of the iris sphincter; seen in various autonomic neuropathies and in Adie syndrome.
Tadpole-shaped pupil
n intermittent, brief distortion and dilation of a pupil that draws one part of the iris into a peak so that the pupil resembles a tadpole; a temporary, benign condition associated with migraine that may leave the patient with a Horner's syndrome.
LASIK
LASIK
Laser Assisted in-Situ keratomileusis (LASIK)
USED FOR: -
1. Myopic correction of = -1 to –20.00 diopters (-2 to –12 D; Parsons’), with up to 5 diopters of astigmatism
2. Hypermetropic corrections for +4.00
3. Central cornea thickness should be at least 500 microm.
CI: -
1. Unstable refractive error.(Refraction must be stable for 12-18 months)
2. Age less than 18 years.
3. iritis or scleritis, conjunctivitis, severe dry eye
4. Keratoconus. Cornea should not be excessive flat or steep.
5. Presence of a pacemaker
Preop’ly: -
Contact lens wear should be discontinued
--3 days before for soft contact lens wear prior to Lasik
--2 weeks before for rigid gas permeable lens wear prior to Lasik
PROCEDURE
1. A suction ring placed on the eyeball elevates IOP to about 60 mmHg (temporary blackout of vision occurs).
2. The microkeratome advances and creates an epithelial flap, which is hinged usually nasally.
3. EXCIMER LASER is used.
4. Leave behind residual corneal thickness of at least 250 microns.
5. Irrigate bed with saline and close the flap. No sutures. It sticks by itself.
6. Use antibiotics and steroid drops for about 1 week.
ENHANCEMENTS
• Enhancement LASIK (i.e. repeat procedure) can be performed but usually after 3 months of table refraction. Ref- internet notes and edited by drkbravva
PseudoMembranous conjunctivitis causative organisms
bacterial
corynebacterium diphtheriae of low virulence
staphylococi aureus
streptococcus pneumoniae (pneumococcus)
H.influenza
H.aegyptus
viral
herpes simplex
adenoviral epidemic keratoconjunctivitis
chemicals
acids
ammonia
lime
silver nitrate
copper sulphate
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