LECTURE 1 - Otorhinolaryngology introduction

Otorhinolaryngology

1. Introduction to otorhinolaryngology, its content, tasks and place among other disciplines. History and ways of development of domestic otorhinolaryngology. Physiological functions of the nose and their importance for humans .

2. Subject of Otorhinolaryngology Otorhinolaryngology is a clinical discipline, the subject of study of which is morphological and physiological features and diseases of the upper respiratory tract and the relationship of the ear with all organs and systems of the body. The name of the specialty comes from the Greek words: otos - ear, rhinos - nose, laryngos - larynx and logos - teaching. The abbreviation for the first letters of these sections is ORL or ENT specialty

3. - RINOLOGY -AUDIOLOGY - PHONIATRICS - PEDIATRIC REGISTRY AND LARYNGOLOGY -VESTIBULOLOGY - ENT-ONCOLOGY

4. Features of the ENT organs:- The ENT organs form the initial section of the respiratory and digestive tracts.- The otolaryngologist deals with a range ofof analyzers: auditory, vestibular, gustatory,olfactory .- The mucous membrane of the upper respiratory tractis a powerful reflexogenic zone. It's also where allergic reactionsallergic reactions.- The topographic and anatomical featureslocation of the ENT organs determinethe possibility of mutual influence of developing in thempathologic processes developing in them (orbit, cavitycranial cavity, formations of the neck, etc.).

5. HISTORY Ancient Egypt 1550-1560 BC.- Ancient China - Ancient India Ancient Judea Hippocrates 5th-6th century B.C. -Cornelius Celsus -Galen of Pergamon (Ancient Rome) - Avicenus (960-1037)

6. Research methods Reflector mirror Hoffmann (1841). - A. Trelch (1861) suggested to use a round concave mirror with a hole in the center to focus the light from the source and direct it toward the object of study. Treltsch's mirror was attached to the head. In 1859, Cermak applied the mirror principle to examine the nasopharynx and the posterior of the nose and thus in1860, he was the first to diagnose adenoids.

7. Otorhinolaryngology surgical headlight

8. Indirect laryngoscopy

9. D irect laryngoscopy

10. Procedure Ask the patient to relax and to stick out his or her tongue. Cover the tongue in gauze and pull it with the thumb and middle finger of your nondominant hand. Your index finger should be free to lift up the upper lip if necessary. With the patient breathing in and out, direct the mirror into the mouth and toward the back of the throat, making sure the glass side is downward. When at the back of the throat, press the mirror upward, against the uvula and soft palate. Avoid the gag reflex by not touching the posterior pharyngeal wall or tongue base. Slightly alter the mirror and try various angles to visualize the desired structures. Ensure the patient’s head, chin, and body are still in the correct position. Make sure the patient is breathing in and out. Take note of the vocal cords while they are at rest. Then ask the patient to make a loud sound and watch the vocal cord activity. If the mirror begins to fog up, reheat it and repeat from step 1.

11. Laryngoscope samples

12. Advances in rhinology in recent Decades: The introduction of endoscopic techniques to improve the diagnosis and treatment of diseases of the nose and paranasal sinuses.Surgical interventions in the nasal cavity and on the nasal cavity and paranasal sinuses have become gentler, and "functional" surgery is being introduced.- The use of endoscopy, CT and MRI has made it possible to more accurately to diagnose diseases of the cuneiform sinuses and posterior cells of the lattice bone (B.V. Shevrygin , Stamberger , В. Messerklinger , G.Z. and S.Z. Piskunovs , V.S. Kozlov , etc.).- The method of endoscopic endonasal dacryocystic surgery has been introduced into clinical practice. Unresolved problems remain: - There has been a worldwide failure to stem the rising incidence of allergic diseases of the nose and ENP; - sinusitis is also becoming increasingly common.

13. Advances in Otiatrics Application in the diagnosis of lesions of the auditory analyzer modern diagnostic methods (perception of ultrasound,hearing research in the extended frequency range,registration of auditory evoked potentials,impedanceometry , otoacoustic emission) made it possible to to detect hearing impairment at the earliest stage (in a child even before birth) (B.M. Sagalovich , G.A. Tavartkiladze , et al.etc .).- Methods of surgical treatment of diseases of the middle and inner ear: hearing-preserving and hearing-improving surgeries for inflammatory diseases of the middle ear, decompression of the encephalic ear middle ear, decompression of the endolymphatic sac in Meniere's disease, optimization of the treatment of Meniere's disease, optimization of otosclerosis treatment(V.T. Palchun , N.V. Mishenkin , Y.M. Ovchinnikov , etc.).- The introduction of cochlear implantation allows hearing even for people who have been deaf since birth (M.T. Palchun , N.V. Mishenkin , Yu.deaf from birth (M.R. Bogomilsky , N.S. Dmitriev,A.A . Lantsov , etc.).

14. Unresolved problems in otiiatrics : Prevention of sudden and acute sensorineural hearing loss; - effective treatment of patients with ear murmurs.

15. Advances in vestibulology - Development of methods of vestibular training in cosmonaut training(I.Y. Yakovleva , E.I. Matsnev , etc.). - Introduction into practice of the method of posturography to optimize the diagnosis of disorders balance function and rehabilitation patients with vestibular disorders(L.A. Luchikhin , O.M. Doronina et al.). Unresolved problems in vestibulology : - Development of the methodology of the system approach to the assessment of the function of the vestibular analyzer.

16. REFLEX CONNECTIONS OF THE NASAL CAVITY AND PARANASAL SINUSES Reflex influences from the mucosa of the nasal cavity and paranasal sinuses play an important role in the regulation of various functions of the body and the maintenance of normal activity of the body. Rhinobronchial reflex Connection with the cardiovascular system Influence on CNS Rhinocranial reflex Influence on the GI tract Effect on sexual function

17. Olfactory Receptors- Located in the roof of the nasal passage Olfactory Bulbs- Located in brain Olfactory Epithelium- Located 7 cm into the nose Olfactory Tract- Located in the brain Olfactory Cortex- Located in the Brain The function of the Olfactory system is to recognize the scents inhaled by the nose .When one smells an odor the chemicals that cause an odor are absorbed into a mucus membrane known as the Olfactory Epithelium and dissolve. From there Olfactory receptors detect the odor transmitted from the epithelium. Then the Olfactory Filaments that are connected to the Olfactory Receptors and lead to bulb in brain. The Olfactory Bulbs then receive information from chemical- sensing cells from the roof of the nose . After the Olfactory Bulbs receive the information, the Olfactory Tract sends this information to the brain . When the brain receives the information, the Olfactory Cortex recognizes the sent .

18. DISEASES Smell is commonly affected by the disease Anosmia. Anosmia can be caused by a head injury due to the fact that it damages the olfactory nerves that are connected to the olfactory bulb. Another important factor that contributes to Anosmia is damage in the frontal lobes due to a tumor or surgery Exposure to certain toxic chemicals can also cause it Also, cocaine abuse can lead to Anosmia. Some medications, like antibiotics, antidepressants, heart medications, etc., can also cause it

19. In 2004, Americans Richard Axel and Linda Buck,were awarded the Nobel Prize in Physiology and medicine. They made their major discovery relatively recently, in 1991, when they studied the olfactory system of the sense of smell in animals and humans. You could say that this study set the stage for the study of the physiology of the human senses.- The key to unraveling the workings of the olfactory system was the discovery of a huge family of about 1,000 genes that control the function of the olfactory receptors. In 2001, Linda Buck and her colleagues created a detailed map of the olfactory system. They were able to recognize the "codes" that the brain receives in response to a particular odor, as well as to determine how the behavior of the animal. The scientists were struck by the fact that odor recognition involves more than three percent of the total of the body's genes.