12 Functional Anatomy of the Ear Flashcards

(42 cards)

1
Q

What are the parts of the external ear lined with?

A

Skin

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2
Q

What is the middle ear filled with?

A

Air (fluid in middle ear= pathological)

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3
Q

What is the middle ear lined with?

A

Respiratory epithelium

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4
Q

What structure allows for equilibration of pressure in middle ear (air filled cavity) and drainage of mucus from middle ear?

A

Pharyngotympanic tube ( Eustachian tube) connects middle ear to oropharynx

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5
Q

Fill in the missing labels:

A
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6
Q

Which nerves carry general sensation from the ear ( touch, temperature, pain)? (implications for referred pain)

A

Branches of:

  • V- Trigeminal
    • Auriculotemporal
  • VII- Facial (small contribution)
  • IX- Glossopharyngeal
    • Tympanic
  • X- Vagus
  • Cervical spinal nerves
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7
Q

Explain why nerves carrying general sensory information has implications for referred pain.

A

Pain/sensation felt in ear even if no pathology in ear

Eg in pharyngitis- ear pain even through no pathology of ear

Otalgia with normal ear examination- think alternative site of pathology

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8
Q

Give some examples of non-otological origins of otalgia. (general)

A
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9
Q

What makes up the external ear and what is its function?

A

Pinna, external auditory meatus and lateral surface of tympanic membrane

Function: collects, transmits and focuses sound waves onto tympanic membrane

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10
Q

What is Ramsey Hunt syndrome?

A

Viral- varicella zoster

Patient with facial nerve palsey and evidence of rash on external ear (may need to look in canal)

Shingles of facial nerve

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11
Q

What pathology is shown in this image:

A

Perichondritis

=inflammation of cartilage in pinna

(can be due to infection from ear piercing)

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12
Q

Why is it so important to recognise a pinna haematoma and treat it apporopriately?

A

Pericondrium- supplies blood to cartilage underneath

Haematoma- cuts off blood supply and may cause pressure necrosis

Ear will scar and alter shape of cartilage (califlower ear)

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13
Q

Where does the blood accumulate in a pinna haematoma?

A

Between cartilage and overlying pericondrium

Pericondrium- supplies blood to cartilage underneath

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14
Q

How is a pinna haematoma treated?

A

Drainage

Prevent re-accumulation of blood

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15
Q

Describe the structure of the external acoustic meatus (lining, composition, shape)

A

Composition:

Cartilaginous (outer 1/3)

Bony (inner 2/3)

Shape:

Sigmoid

Lining:

Keratinising, stratified squamous epithelium

Cartilaginous part: hair, sebaceous and ceruminous glands (produce ear wax)

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16
Q

Explain the self-cleaning function of the external acoustic meatus:

A
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17
Q

What is shown in the following image?

A

Normal otoscopic view of tympanic membrane

18
Q

What is otitis externa? Give some causes of it

A

Inflammation of external ear

External auditory meatus-swollen- may afffect hearing

Causes:

Infective- pseudomonas aeriginosa

Eczema

19
Q

What is malignant otitis externa?

A

(NOT cancerous but really bad- potentially life threatening)

Seen in immunocompromised patients

Infection of soft tissue of ear- starts to involve bone

Usually pseudomonas aeruginosa

20
Q

What pathologies of the tympanic membrane are shown in the 2 images on the right?

A

Otitis media with effusion= glue ear- see flashcard 27

21
Q

What is a cholesteatoma and what causes it? Why is it important to recognise?

A

A cholesteatoma is an abnormal, noncancerous skin growth that can develop in the middle section of your ear, behind the eardrum. It may be a birth defect, but it’s most commonly caused by repeated middle ear infections.

22
Q

Name the 3 ossicles.

A

Connected by synovial joints

23
Q

What do the ossicles do?

A

Function:

Amplify and relay vibrations from tympanic membrane to oval window in cochlea

24
Q

Identify the 2 muscles that contract, if there is excessive vibration due to loud noise, in order to tamper ossicle movement.

A

Tensor tympani and stapedius

25
Otosclerosis is a common cause of hearing loss in young adults. How does it occur and what type of hearing loss does it cause?
How? Ossicles fused at articulations due to abnormal bone growth (esp between base of plate of stapes and oval window of cochlea) *Exact cause unknown- environmental and genetic* Type of hearing loss? Unilateral or bilateral **conductive** hearing loss
26
What is another name for otosclerosis?
otospongiosis
27
Otitis media (glue ear) with infusion is not due to infection but may predispose to infections. It is due to an eustachian tube dysfucntion. Explain how this can affect hearing.
Fluid and negative pressure in middle ear Decreased mobility of ossicles and TM
28
How is 'glue ear' treated (usually problem in children)?
1. Most resolve spontaneously- 2-3months 2. If persistent: require **gromets**- equilibriate pressure with atmospheric pressure
29
What are the signs, symptoms and causes of an acute middle ear infection (acute ottitis media)?
30
How does the structure of the Eustachian tube differ between children and adults? Why is this significant?
31
What complications can occurr as a result of acute otitis media?
1. Tympanic membrane perforation 2. Facial nerve involvement 1. Chorda tympani and nerve to stapedius run through middle ear cavity 3. Mastoiditis (infection of mastoid bone)- requires IV antibiotics 4. Intracranial 1. Meningitis 2. Sigmoid sinus thrombosis 3. Brain abscess
32
Outline the route by which acute otitis media can cause mastoiditis.
33
Fill in the missing labels:
34
How do we perceive sound through the cochlear?
35
What symptoms (general terms) might a patient with inner ear pathology present with? (3)
* Hearing loss (sensorineural) * Tinnitus * Balance disturbances and vertigo
36
How does the vestibular apparatus work?
37
What are the 2 broad categories of hearing loss?
1. Conductive hearing loss 2. Sensorineural hearing loss
38
What is presbycusis?
Sensorineural hearing loss associated with old age Bilateral and gradual
39
Outline the pathophysiology of benign paroxysmal postitional vertigo.
Little crystals- become dislodged in semicircular canals Vertigo only (symptom) Short lived episodes- seconds
40
What is Meniere's disease?
Exact cause unknown
41
Differentiate between the infective conditions: acute labrynthitis and acute vestibular neronitis.
42
Give some possible causes for sensorineural and conductive hearing loss: