Multiple-choice Questions in Otolaryngology: With Explanatory Answers

227 Pages·1989·7.07 MB·English

by  Ramindar S. Dhillon FRCS (Eng)

Multiple-choice Questions in Otolaryngology
with explanatory answers
Multiple-choice Questions in
Otolaryngology
with explanatory answers
Ramindar S. Dhillon, FRCS (Eng)
James W. Fairley, FRCS (Eng)
Ferens Institute of Otolaryngology
University College and Middlesex School of Medicine, London
M
MACMILLAN
PRESS
Scientific & Medical
© R.S. Dhillon & J.W. Fairley 1989
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First published 1989
Published by
THE MACMILLAN PRESS LTD
Houndmills, Basingstoke, Hampshire RG21 2XS
and London
Companies and representatives
throughout the world
Typeset by
Ponting-Green Publishing Services, London
ISBN 978-0-333-49109-6 ISBN 978-1-349-10805-3 (eBook)
DOI 10.1007/978-1-349-10805-3
CONTENTS
Foreword xii
Preface xiii
Section 1: The Ear
1 Foetal development 2
2 Development of the foetal ear 2
3 Development of the temporal bone 2
4 Development of the mastoid process 4
5 Anatomy of the external ear 4
6 In the adult 4
7 In the middle ear cleft 6
8 The anterior wall of the tympanic cavity 6
9 In the middle ear cleft 6
10 Mucosal folds, compartments and ligaments of the
middle ear cleft 8
11 The middle ear cleft 8
12 Neurovascular supply of the middle ear cleft 8
13 In the labyrinth 10
14 In the inner ear 10
15 In the cochlear nerve 10
16 In the vestibular labyrinth 10
17 The vestibular nerve 12
18 Blood supply of the labyrinth 12
19 Anatomy of the internal auditory canal 12
20 Sensory nerve supply of the ear 14
21 The following lesions may cause referred otalgia 14
22 The following neoplasms may present with otalgia 14
23 In the physical examination of the ear 16
24 Radiological investigation of the petrous temporal bone 16
25 The following procedures are usually performed via a
permeatal incision 18
26 In temporal bone surgery 18
27 Principles of temporal bone surgery 18
28 The seventh cranial nerve 20
29 Physical properties of sound 20
30 Sound transmission in the middle ear 20
31 Middle ear acoustic impedance 20
32 Abnormalities of middle ear function 22
33 Middle ear muscles 22
34 Hearing by bone conduction 22
v
vi MCQs in OTOLARYNGOLOGY
35 In the cochlea 24
36 Theories of hearing 24
37 Localization of sound stimulus 24
38 In testing the hearing 24
39 In non-organic hearing loss 26
40 Audiological investigations 26
41 Impedance audiometry 28
42 Electric response audiometry 28
43 Assessment of hearing thresholds in young children 30
44 Electronic hearing aids 30
45 Vestibular labyrinthine physiology 32
46 Vestibular function tests 32
4 7 Bithermal caloric test 32
48 Electronystagmography 34
49 Congenital abnormalities of the external ear 34
50 Haematoma Auris 34
51 In otitis externa 36
52 In malignant otitis externa 36
53 Viral infections of the external ear 36
54 Neoplastic disease of the external ear 38
55 In the external auditory meatus 38
56 Congenital anomalies of the middle ear cleft 38
57 Surgery of congenital ear anomalies 40
58 Surgical correction of congenital atresia of the
external auditory meatus 40
59 Traumatic perforation of the tympanic membrane 40
60 In basal skull fractures involving the petrous temporal bone 40
61 Otitic barotrauma 42
62 Acute suppurative otitis media 42
63 Acute petrositis 44
64 Complications of acute inflammation of the middle ear
cleft include 44
65 Factors in the development and behaviour of chronic
otitis media include 44
66 Tubotympanic chronic suppurative otitis media (CSOM) 46
67 Pathogenesis of acquired cholesteatoma 46
68 In attica-antral CSOM 46
69 Management of chronic suppurative otitis media
with cholesteatoma 48
70 Management of cholesteatoma in children is difficult because 48
71 In an open mastoid cavity 48
72 Acute mastoiditis 48
73 Intracranial extension of suppurative otitis media 50
7 4 Complications of suppurative otitis media 50
75 Secretory otitis media (SOM) 50
76 Diagnosis and management of secretory otitis media 52
77 Late sequelae of otitis media 52
78 Tuberculous otitis media is 52
79 Malignant tumours of the middle ear cleft 54
80 Paragangliomas of the temporal bone 54
81 Osseous disorders of the temporal bone 54
Contents vii
82 Pathology of otosclerosis 56
83 Patients with otosclerosis 56
84 Diagnosis of otosclerosis 58
85 Treatment of otosclerosis 58
86 During stapedectomy 58
87 Complications of stapedectomy 60
88 Perilymph fistulae following stapedectomy 60
89 Van der Hoeve de Kleyn syndrome 62
90 In late syphilis in the temporal bone 62
91 Congenital deafness 62
92 Temporal bone fractures 64
93 In closed head injuries without fracture 64
94 Inner ear barotrauma 64
95 Excessive sound stimulation of the ear 66
96 lnfrasound 66
97 Hearing conservation programmes in industry 66
98 Otitic blast injury 68
99 Labyrinthine window rupture 68
168 Otitic labyrinthitis 68
10 1 In circumscribed labyrinthitis 70
10 2 In syphilitic labyrinthitis 70
103 Pathophysiology of Meniere's Disease 70
104 Clinical manifestations of Meniere's disease 72
105 Cogan's disease is characterized by 72
106 Investigation of Meniere's disease 72
107 Medical management of Meniere's disease 7 4
108 Surgical management of Meniere's disease 74
10 9 Pathology of presbyacusis 7 4
11 0 Management of presbyacusis 76
111 The ototoxic effects of 76
112 Objective tinnitus 76
113 Subjective tinnitus 78
Section 2: The Nose and Sinuses
114 Blood supply of the nose 82
115 Nasal anatomy 82
116 Examination of the nose and sinuses 82
117 Sinus X-rays 84
118 Operations on the nose and sinuses 84
119 Antral washouts 84
120 Sinus operations 86
121 Nasal respiration 86
122 The mucociliary 'conveyor belt' of the upper respiratory tract 86
123 Anosmia 86
124 Disorders of smell 88
125 Cleft lip and cleft palate 88
126 Congenital nasal malformations 88
127 Congenital choanal atresia 88
128 Management of maxillofacial injuries 88
129 Middle third facial fractures 90
viii MCQs in OTOLARYNGOLOGY
130 Blowout fracture of the orbit 90
131 Fractures involving the frontal or ethmoidal sinuses 90
132 Cerebrospinal fluid rhinorrhoea 90
133 Oro-antral fistula 92
134 Bullet wounds in the head and neck region 92
135 Sinus barotrauma 92
136 Nasal septal deformities 92
137 Septal haematoma 94
138 Septal abscess 94
139 Septal perforation 94
140 Foreign bodies in the nose 94
141 Rhinolith 96
142 Inflammation of the external nose 96
143 Acute infective rhinitis 96
144 Chronic non-specific rhinitis 96
145 Chronic hypertrophic rhinitis 98
146 Atrophic rhinitis 98
147 Wegener's granulomatosis 98
148 Syphilis and the nose 10 0
149 Nasal lupus vulgaris 10 0
150 Chronic specific rhinitis 10 0
151 Acute infective sinusitis 10 0
152 Acute infective sinusitis 10 2
153 Chronic non-specific sinusitis 10 2
154 Mixed infective and vasomotor chronic sinusitis 10 2
15 5 Acute maxillary sinusitis 10 4
156 Acute frontal sinusitis 10 4
157 Acute sphenoidal sinusitis 10 4
158 Treatment of chronic maxillary sinusitis 104
159 Treatment of chronic frontal sinusitis 106
160 Aetiology of sinusitis in children 10 6
161 Sinusitis in children 106
162 Spread of infection in suppurative sinusitis 10 8
163 Osteomyelitis of the frontal bone 10 8
164 Osteomyelitis of the frontal bone 10 8
165 Orbital complications of suppurative sinusitis 10 8
166 Orbital complications of suppurative sinusitis 11 0
167 Intracranial complications of suppurative sinusitis 11 0
168 Secondary effects of suppurative sinusitis 11 0
169 Transitional cell papilloma (Ringertz tumour) 112
170 Benign tumours of the paranasal sinuses 112
171 Malignant tumours of the nose and paranasal sinuses 112
172 Malignant tumours of the paranasal sinuses 114
173 Treatment of malignant tumours of the paranasal sinuses 114
17 4 Pituitary tumours 114
175 Maxillary cysts 116
176 Cysts of dental origin 116
177 Radiographic diagnosis of maxillary cysts 116
178 Odontogenic tumours 116
179 Causes of epistaxis 116
180 Sites of bleeding in epistaxis 118
Contents ix
181 Initial treatment of severe epistaxis 118
182 Surgical intervention in epistaxis 118
183 Epistaxis in hereditary haemorrhagic telangiectasia 120
184 Vasomotor rhinitis 120
185 Clinical features of vasomotor rhinitis include 120
186 Medical treatment of vasomotor rhinitis 120
187 Surgical treatment of vasomotor rhinitis 122
188 Aetiology of allergic rhinitis 122
189 Immunology of allergic rhinitis 122
190 Pathology of allergic rhinitis 124
19 1 Clinical features of allergic rhinitis 124
192 Treatment of allergic rhinitis 124
193 Surgical treatment of allergic rhinitis 124
19 4 Pathology of nasal polyps 126
19 5 Antrochoanal polyps 126
196 Treatment of simple nasal polyps 126
19 7 Epiphora 126
Section 3: The Larynx and Tracheobronchial Tree
19 8 Development of the larynx 130
19 9 The infantile larynx in comparison with the adult 130
200 Cartilaginous framework of the larynx 130
201 Laryngeal musculature 130
202 In the cavity of the larynx 132
203 Neurovascular supply and lymphatic drainage of the larynx 132
204 Physical examination of the larynx 132
205 Sphincteric functions of the larynx 134
206 During deglutition 134
207 In voice production 136
208 Symptoms and signs of laryngeal disease in the
newborn include 136
209 Congenital laryngeal stridor (laryngomalacia) 136
21 0 Congenital laryngeal web 138
211 In closed laryngeal injuries 138
212 Laryngeal trauma 140
213 Abnormal voice production 140
214 Acute non-specific laryngitis in children 140
215 Acute epiglottitis 142
216 Acute laryngotracheobronchitis 142
217 Keratosis of the larynx 142
218 Juvenile respiratory papillomatosis 144
219 Benign lesions of the larynx 144
220 In the 19 87 UICC classification of malignant tumours
of the larynx 146
221 Spread of malignant disease of the larynx 146
222 Total laryngectomy 148
223 Laryngocoeles 148
224 Oedema of the larynx 148
225 In episodes of stridor 150
226 Neural paralysis of the larynx 150
x MCQs in OTOLARYNGOLOGY
227 Management of laryngeal paralysis 150
228 Voice disorders 150
229 Development of the trachea and bronchi 152
230 In the trachea 152
231 In the neck 152
232 In the tracheobronchial tree 152
233 In the upper air passages 154
234 In performing a tracheostomy 154
235 In the postoperative care of tracheostomy 154
236 In a child with a tracheostomy 156
237 Congenital abnormalities of the tracheobronchial tree 156
238 The following are indications necessitating tracheostomy 156
239 Tracheobronchial foreign bodies 158
240 In the management of an inhaled foreign body 158
241 Inflammatory processes in the tracheobronchial tree 158
242 In carcinoma of the bronchus 160
243 Management of benign tracheal stenosis 160
Section 4: The Mouth, Pharynx and Oesophagus
244 Development of the mouth 164
245 Development of the tongue 164
246 Development of the pharynx 164
247 The second pharyngeal pouch 166
248 Anatomy of the mouth 166
249 Dental anatomy 166
250 Anatomy of the nasopharynx 166
251 Anatomy of the oropharynx 168
252 The pharyngeal constrictor muscles 168
253 Anatomy of the palatine tonsil 170
254 The parapharyngeal space 170
255 The retropharyngeal space 172
256 The glossopharyngeal nerve 172
257 Lymphatic drainage of the pharynx 172
258 Immunology of the pharyngeal lymphoid tissue 174
259 Anatomy of the parotid gland 174
260 Anatomy of the submandibular gland 176
261 The infratemporal fossa 176
262 The temporomandibular joint 176
263 The soft palate 178
264 Derivatives of the pharyngeal pouches 178
265 White lesions of the oral cavity 178
266 Mouth ulcers 180
267 Tumours of the oral cavity 180
268 Salivary gland tumours 180
269 Benign salivary gland disease 182
270 During deglutition 182
271 Pathophysiology of swallowing 184
272 Stertor 184
273 Sleep apnoea in children 184