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  • Head and Neck (ENT)
• LOCOMOTOR
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BRAIN AND BEHAVIOUR: Head and Neck (ENT)

Index

• General outcomes for Head and Neck
• Disorders of the Nose and Paranasal Sinuses
• Disorders of the Ear and Hearing
• Disorders of the Facial Nerves
• Lumps and Swellings of the Neck
• Head and Neck Cancer
• Disorders of the Larynx

• General outcomes for Head and Neck
  • Medical knowledge: ANATOMY (TD 8.1)
    • Nasal Cavity and Sinuses
      1. Identify the organs of the upper respiratory system.
      2. Know the basic anatomy of the nose and paranasal sinuses. (ENT4)
      3. Describe the structure, function and interconnections of the nose, paranasal sinuses and pharynx
    • The Neck - Anterior and Posterior Triangles
      1. Indicate the course of the common and internal carotid arteries in relation to the surface of the neck
      2. Describe the attachments and actions of the sternomastoid muscle and give its nerve supply
      3. Describe the peripheral course of the sympathetic nervous system in the neck
    • Larynx and Trachea
      1. Describe the structure of the larynx, and discuss its roles in normal breathing and in the production of sound.
      2. Explain the nervous innervation to the pharynx and larynx.
      3. Describe the form and major internal features of the larynx
      4. Describe how the vocal folds produce sound and variation in pitch
      5. Outline the sensory and motor innervation of the larynx and explain the effects of damage to the recurrent laryngeal nerve
      6. Know the basic anatomy of the oral cavity, pharynx and larynx.
    • Pharynx and Oesophagus
      1. Explain the nervous innervation to the pharynx and larynx.
      2. Describe the major features of the nasopharynx, oropharynx and laryngopharynx and define their boundaries
      3. Outline the nervous innervation of the pharynx and briefly review how they control swallowing
  • Medical knowledge: PHYSIOLOGY (TD 8.2)
    • Hearing
      1. Describe the main functions of the auditory system
      2. Give an account of the anatomy of the cochlea, and explain how it enables us to determine the frequency and loudness of incoming sound; explain how the direction of incoming sound may be determined
      3. Define the unit of sound intensity and draw a typical human hearing curve
      4. Describe the auditory pathways
      5. Define conduction and nerve deafness, and state tests for these
  • Clinical skills: PLANNING AND INTERPRETING INVESTIGATIONS (TD 14 c-d)
    • General
      1. Know how dysphagia may be investigated.
  • Clinical skills: MAKING A DIAGNOSIS and CLINICAL JUDGEMENT (TD 14 e-f)
    • Diagnosis and Reasoning
      1. Be able to list a differential diagnosis for a patient presenting with dysphagia.
• Disorders of the Nose and Paranasal Sinuses
  • General Outcomes for Disorders of the Nose and Paranasal Sinuses
    1. Know the basic anatomy of the nose and paranasal sinuses. (ENT4)
    2. Be able to list the common causes of nasal obstruction.
    3. Be able to list the differential diagnoses for a patient presenting with nasal obstruction. (ENT4)
    4. Know the presentation and management of acute and chronic rhinosinusitis.
    5. Understand the aetiology and treatment of rhinitis.
    6. Know how to manage a fractured nose and in particular know the time frame for manipulation. (ENT4)
  • Epistaxis
    1. Know the causes and management of epistaxis. (ENT4)
• Disorders of the Ear and Hearing
  • General Outcomes for Disorders of the Ear and Hearing
    1. Describe the prevalence and pattern of hearing impairment in the population
    2. Be able to list the differential diagnosis in a patient presenting with otalgia.
    3. Have a basic understanding of the physiology of balance. (ENT4)
    4. Describe methods of working with hard of hearing people including lip-reading and hearing aids
    5. Be able to list the causes of vertigo. (ENT4)
    6. Describe what is meant by deaf culture and the implications of this for communicating with people who are deaf
    7. Be familiar with the term chronic suppurative otitis media.
    8. Know that ear conditions usually present with one or more of the following symptoms: hearing loss, otorrhoea, otalgia, tinnitus and vertigo. (ENT4)
    9. Identify ways in which communication with people who are deaf or hard of hearing can be enhanced
    10. Describe the principles of British Sign Language and be able to use a few basic signs
    11. Know the aetiology, presentation and management of cholesteatoma.
    12. Know the causes and management of otitis externa.
    13. Understand that nasopharyngeal carcinoma can present with a middle ear effusion. (ENT4)
    14. Know the complications of middle ear infection.
    15. Know the presentation and management of ear drum perforation.
    16. Understand that otalgia can be caused by ear conditions or can be caused by referred pain. (ENT4)
    17. Know the presentation and management of glue ear and acute otitis media in children.
    18. Have a basic knowledge of the diagnosis and management of the otological causes of vertigo. (ENT4)
  • Hearing Loss
    1. Know the basic anatomy and physiology of hearing. (ENT4)
    2. Be able to list the common causes of hearing loss in adults and children. (ENT4)
    3. Understand the difference between conductive and sensorineural hearing loss. (ENT4)
    4. Know how to conduct Rinnes and Webers tests and be able to interpret the results. (ENT4)
• Disorders of the Facial Nerves
  • General Outcomes for Disorders of the Facial Nerves
    1. Be able to assess and list a differential diagnosis in a patient presenting with facial palsy.
    2. Be familiar with the concept of upper and lower motor neurone facial nerve palsy and understand that an upper motor neurone palsy may allow frontal sparing.
    3. Be familiar with the term Bells palsy and understand that it is a diagnosis of exclusion.
    4. Know the anatomy of the facial nerve.
    5. Know the immediate and long term management of facial palsy.
• Lumps and Swellings of the Neck
  • General Outcomes for Lumps and Swelling of the Neck
    1. Be able to list a differential diagnosis in a patient with a neck swelling.
    2. Be able to describe the triangles of the neck. (ENT4)
    3. Know how to describe a lump in the neck i.e site, size, shape, surface, consistency, surrounds, pulsatility, trans-illumination and movement on swallowing and tongue protrusion. (ENT4)
    4. Know the differential diagnosis and management of a salivary gland swelling. (ENT4)
    5. Know the differential diagnosis and management of a thyroid swelling. (ENT4)
    6. Know the diagnostic features and treatment of thyroglossal and branchial cysts. (ENT4)
    7. Know that investigation may include ultrasound, CT and MRI (and sometimes radioisotope scanning for thyroid disease). (ENT4)
    8. Know the differential diagnosis for cervical lymphadenopathy and understand why examination of the upper aerodigestive tract is important. (ENT4)
    9. Understand the difference between fine needle aspiration biopsy, incisional and excisional biopsy and the indications for these. (ENT4)
• Head and Neck Cancer
  • General Outcomes for Head and Neck Cancer
    1. Be familiar with the concept of TNM classification.
    2. Know the aetiology and pathology of head and neck cancer. (ENT4)
    3. Understand that the presentation will depend on the site and size of the tumour. (ENT4)
    4. Understand that a tumour may present with metastatic cervical lymphadenopathy. (ENT4)
    5. Understand the place of surgery, radiotherapy and chemotherapy in the treatment of Head and Neck cancer. (ENT4)
• Disorders of the Larynx
  • General Outcomes for Disorders of the Larynx
    1. List the differential diagnosis of hoarseness and stridor

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