.What is ENT - Describe the hypopharynx's piriform sinuses' orientation.
The piriform sinuses are shaped like an inverted pyramid, with the tip reaching just below the cricoid cartilage and the base at the level of the pharyngoepiglottic fold.
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What is ENT - What are the boundaries and subsites of the hypopharynx )?
• Anterior: Larynx • Superior: Hyoid bone and pharyngoepiglottic folds • Posterior: Retropharyngeal space • Inferior: Esophageal introitus at the cricopharyngeus muscle • Subsites: Piriform sinuses, postcricoid area, and posterior pharyngeal wall What is ENT - What are the boundaries and subsites of the oropharynx?
• Anterior: Oral cavity • Superior: Soft palate • Posterior: Posterior pharyngeal wall • Inferior: Hyoid • Subsites: Base of tongue (posterior third), palatine tonsil/lateral pharyngeal wall, soft palate, and posterior pharyngeal wall . What is ENT - What are the boundaries of the nasopharynx?
• Superior: Sphenoid sinus • Posterior: First and second vertebrae • Inferior: Soft palate • Lateral: Eustachian tube, torus tubarius, and the fossa of Rosenmüller What is ENT - What do the oral cavity's subsites and limits look like?
• Lateral: Tonsillar pillars • Superior: Hard-soft palate junction • Anterior: Vermillion border of the lip Subsites include the lip, oral tongue's front two-thirds, buccal mucosa, the floor of the mouth, the hard palate, the upper and lower gingiva (alveolar ridges), and the retromolar trigone. What is ENT - What abnormality of the branchial cleft is most typical?
The majority of anomalies (95% of all anomalies) are second branchial cleft anomalies. Anomalies with the first branchial cleft are the second most frequent. Anomalies of the third and fourth branchial clefts are uncommon. What is ENT - Describe the possible branchial cleft sinus tracts.
Typically, sinus tracts pass deeply to the aortic arch derivatives that are connected to them. In order to stop a recurrence, it is crucial to try surgical excision of the branchial cleft cyst as well as the sinus tract. There are two types of first branchial cleft anomalies, which are duplications of the external auditory canal's membranous portion. Type I is a duplication abnormality of the external auditory canal, which is placed antero-inferior to the lobule and is of ectodermal origin. Type II is of ectodermal and mesodermal origin, repeats the external auditory canal in addition to the cartilage, and manifests below the mandibular angle. First branchial cleft tracts can travel medially, laterally, or between branches to the facial nerve's main trunk. Anomalies with a second branchial cleft are visible below the mandibular angle, near the anterior sternocleidomastoid muscle border (SCM). The tract, which opens in the tonsillar fossa, goes deep to the external carotid artery, stylohyoid, and digastric muscle and superficial to the internal carotid artery. Anomalies with third branchial clefts appear anterior to the SCM and lower in the neck than those with second branchial clefts. The tract opens in the pharynx at the thyrohyoid membrane or piriform sinus, passing deep to the glossopharyngeal nerve and internal carotid artery and superficial to the vagus nerve. Fourth branchial cleft anomalies typically appear as thyroid masses or paratracheal masses in the lateral neck, and they are left-handed. The superior laryngeal nerve and the recurrent laryngeal nerve, which opens into the hypopharynx, are both deep to the tract of this sinus. What is ENT - Which test should be carried out on every patient whose laryngitis symptoms have persisted for more than two weeks?
To rule out the possibility of other causes of symptoms, such as malignancy, any patient with chronic laryngitis lasting longer than two weeks, those with alarming symptoms, or those with a high risk history of cancer should be examined by an otolaryngologist. What is ENT - How are chronic laryngitis' more prevalent causes and treatments managed? Environmental variables, such as smoking, inhalational exposure, or laryngopharyngeal reflux, are more frequently to blame for chronic laryngitis. In individuals with impaired immune systems or those using long-term inhaled steroids, a laryngoscopy can be utilized to identify fungal laryngitis. Nystatin is used to treat this, which is typically brought on by a species of Candida. Because it can be challenging to get a sample in the office, cultures are typically not taken.
What is ENT - What further unusual causes of acute laryngitis exist?
A history and physical examination can aid in determining the etiology of acute laryngitis and, if necessary, guide further testing. A history of chemical or smoke exposure justifies checking for inhalational damage. Young children left unattended may require additional testing for a caustic ingestion or an aerodigestive foreign material. Airway compromise, a high temperature, or other unusual symptoms may point to a more serious infection. The following is a list of some typical severe infections: Croup, also known as laryngotracheobronchitis, is characterized by the emergence of stridor and a barking cough that gets worse with excitement or overnight after a typical URI prodrome. Patients with croup commonly range in age from 6 months to 3 years. With supportive care and steroids, more than 95% of patients can be handled as outpatients. Rarely do patients who need oxygen assistance, a high-flow nasal cannula, heliox, or other more intrusive ventilatory techniques need to be hospitalized. Infections are most frequently brought on by parainfluenza. An A/P neck xray reveals the well-known "steeple sign." b. Supraglottitis/epiglottitis: This is an emergency involving the airway. Patients often present with a high temperature that comes on suddenly, along with toxic look, dysphonia, drooling, dysphagia, and dysphagia. This is typically caused by H. influenzae type B and affects children. Immunization programs have reduced this occurrence. There has been an upsurge in polymicrobial infections that affect teenagers or adults (most frequently caused by Staphylococcus or Streptococcus). The "thumb" sign, which denotes a large epiglottis, is frequently visible on lateral neck x-rays. A surgically created airway or intubation in the operating room may be required in addition to the administration of antibiotics. c. Bacterial tracheitis: This ailment typically affects kids who have croup symptoms and are rapidly deteriorating. Methicillinsensitive The most common cause of bacterial infections is Staphylococcus aureus. Bacterial tracheitis may be indicated by pain when palpating the thyroid cartilage, voice loss, a high fever, and an abrupt deterioration in respiratory status. On rigid endoscopy, the presence of thick, pus-filled secretions or pseudomembranes in the subglottis and trachea is diagnostic. Intubation and aggressive control of the airway are frequently necessary. Up until the start of culture-guided therapy, IV antibiotics with vancomycin or oxacillin and a third-generation cephalosporin are given empirically. |
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