PGMEEnotes--IMP.ENT 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 Matoid Foramen, FACIAL NERVE PALSY---common cause--Bell's Palsy, F.N.P.-due Trauma, Immediate Rx--Decompression,"----------((6))

2) "MIDDLE MEATUS OF NOSE---Frontal air cells,Ant. Ethmoide, Maxillary sinus opens in it, BULLA-ETHMOIDALIS, HIATUS SEMILUNARIS are seen, "-------------((6))

3) "NAOPHARYNGEAL CANCER---EBV is a causative agent, Spreads to Lymph nodes, commonest Presentation--Cervical adenopathy, there is High Incidence of NODAL METASTASIS, "-----------((6))

4) "OTITIS MEDIA---ASOM (ACUTE SUPPURATIVE OTITIS MEDIA) 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)"------------((6))

5) "NASAL POLYP---ANTROCHOANAL P.---& POLYPECTOMY-intranasal & ext.approach--arises from maxillary sinus, single & unilateral,"---------((6))

6) "ATROPHIC RHINITIS---Sx young operation done., ozaena is seen, anosmia, alkaline douche sol'n=NaCl, Na-borate, NaHCo3"----------((6))

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,"---------------((6))

8) "TRACHEOSTOMY---complication commonly occur in children-is-difficult decannulation, indication--stridor, coma of long duration , diptheria, laryngeal obst.,flail chest, tetanus(cyanotic spells) , It is not used in F.B. / Obst.of post basal lobe /bronchus, commonest compli.of paediatric--Pneumothorax, "--------((6))

9) "TYMPANIC MEMBRANE---Blue Drum--seen in Secretory otitis media, nerve supply auriculotemporal nerve, T.M.-mobility--most mobile part-central, "----------((6))

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 ,” ----------------((6))

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))