ears - general deafness

Question 1

biggest –> smallest ear bone

Answer 1

malleous, incus, stapes

Question 2

what muscle + nerve innervation opens eustachian tube

Answer 2

Tensor veli palatini (CNV3) + levator veli palatini (CNX) - by constricting muscles of soft palate

Question 3

how is sound transmitted to brain

Answer 3

E.coli - 8th nerve , cochlear nucleus , sup olivary complex , lateral lemniscus, inferior colliculus

Question 4

where is sound processed in brain

Answer 4

left superior temporal gyrus

Question 5

what level of sound is normal on an audiogram

Answer 5

anything above 20dB

Question 6

what colour on audiogram indicates right ear

Answer 6

red

Question 7

what colour on audiogram indicates left ear

Answer 7

blue

Question 8

what symbols on audiogram indicate air vs bone conduction

Answer 8

<> = bone // O or X = air

Question 9

what would a sensorineural audiogram show

Answer 9

loss of both air and bone conduction

Question 10

what would a conduction audiogram show

Answer 10

only loss of conduction hearing

Question 11

Rinnes + webers test in sensoirineaural hearing loss

Answer 11

rinnes (normal) = air conduction > bone conduction // webers = localised to UNAFFECTED ear

Question 12

Rinnes + webers test in conductive hearing loss

Answer 12

rinnes: air conduction > bone conduction = conductive hearing loss // webers = lateralised to AFFECTED ear

Question 13

causes tinnitus

Answer 13

mernieres // otosclerosis // sudden onset sensorineural hearing loss // hearing loss // drugs // ear wax

Question 14

what meds can cause tinnitus

Answer 14

aspirin // NSAIDS // aminoglycosides eg gent // furosemode // quinine

Question 15

what type of tinnitus requires further imaging

Answer 15

pulsatile (may be vascular) // non-pulsatile but unilateral +/- neuro signs

Question 16

imaging in tinnitus

Answer 16

MRI = non-pulsatile // MR angio = pulsatile

Question 17

what is Presbycusis

Answer 17

high frequency, bilateral hearing loss, age related

Question 18

RF for Presbycusis

Answer 18

ateriosclerosis // diabetes // lots of noise exposure // drugs eg salicyltaes, chemo

Question 19

symptoms Presbycusis

Answer 19

can’t understand speech as well // worse with background noise

Question 20

otoscope, tympanometry, audiometry Presbycusis

Answer 20

otoscopy = normal // tympanometry = normal middle ear + hearing loss // audiomoetry = bilateral sensorineural hearing loss

Question 21

what type of hearing loss is noise induced

Answer 21

sensorinearal

Question 22

frequency of noise-induced hearing loss

Answer 22

dip at 4Khz

Question 23

which children are suitable for a cochlear implant

Answer 23

children severe hearing loss +/- difficulty developing auditory skills

Question 24

causes of severe-to-profound hearing loss children

Answer 24

genetic // congenital infection (CMV, rubella, varicella) // idiopathic // infectious eg meningitis

Question 25

which adults are suitable for a cochlear implant

Answer 25

who have severe-to-profound hearing loss +
have triad hearing aids for at least 3 months with no improvement

Question 26

causes severe-to-profound hearing loss adults

Answer 26

viral // ototoxic // otosclerosis // menieres

Question 27

what must be intact for cochlear implants to work

Answer 27

surviving spiral ganglon neurones

Question 28

complications cochlear implant

Answer 28

infection // facial paralysis // CSF leak // meningitis

Question 29

contraindications cochlear implant

Answer 29

lesion of CN VIII or brainstem // chronic otitis media // tympanic membrane perforation // cochlear aplasia