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Unit 14 Week 2 (Tommy) > 14.2 Ear Disease > Flashcards

14.2 Ear Disease Flashcards

(36 cards)

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1
Q

Label the diagram

A
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2
Q

Label the diagram

A
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3
Q

What is this a picture of and explain what the normal signs & abnormal signs are?

A

Tympanic membrane

  • Normal:
    • Handle of malleous above cone of light
    • Good cone of light reflection
  • Abnormal signs:
    • Dull & non-reflective cone of light
    • Fluid present
    • Hole in tympanic membrane
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4
Q

Label the diagram

A
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5
Q

What things to ask with the ear?

A
  1. Otalgia - ear pain
  2. Otorrhoea -ear discharge
  3. Hearing Loss
  4. Tinnitus - sensation of sound in the abscence of external stimulus
  5. Vertigo - sensation of rotation when not moving (can become nauceus)
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6
Q

What to look at ear?

A
  • External ear (pinna)
  • Ear canal (hairs & skin & little wax)
  • Tympanic membrane
  • Facial nerve
    • As runs through temporal bone
    • Can get infections here e.g. viral & fractures
    • Can be a LMN disorder
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7
Q

What can the following picture be due to?

A

Herpes zoster virus (can cause facial paralysis) and can be due to reactivation by the Ramsey Hunt Syndrome

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8
Q

What is the following picture an example of?

What can it be caused by?

A

Tympanic membrane perforation

Causes:

  • Trauma e.g. diving
  • Infection e.g. otitis media (INCREASE pressure on ear drum)
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9
Q

What is the following condition?

A

Tympanosclerosis (scarring of the ear drum) - shouldn’t affect function of ear drum

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10
Q

What is the following condition?

A

Ear effusion

Fluid behind ear drum (common in children)

Buldging and pushed forwards appearance

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11
Q

What are the:

Symptoms

Signs

Treatment

of otitis media with effusion?

A

Symptoms

  • Ear pressure/congestion
  • Sometimes otalgia
  • ‘Popping’ noises
  • Hearing loss [conductive]
  • Disequilibrium
  • Affects speech development in children

Signs

  • TM dull/opaque, fluid level/bubbles

Treatment

  • Audiogram, otoscopy, counsel parents
  • Watch and wait, f/u in 3 months
  • Consider myringotomy/grommets (can equalise air pressures without the function of the Eustachian tube), hearing aid
  • In adults with unilateral middle ear effusion - consider nasopharyngeal malignancy
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12
Q

What can cause problems equalising pressures in the ear & retraction of the tympanic membrane?

A

Swelling/inflammation of the Eustachian tube

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13
Q

What is the following condition?

A

Acute otitis media

Buldging, dull tympanic membrane, red TM

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14
Q

Who is more susceptible to otitis media infections, symptoms & treatments & red flags?

A
  • Common, esp in under 7’s
  • Symptoms
    • Otalgia, no discharge, red & bulging TM
    • Acute suppurative otitis media: crescendo pain, then resolution (sometimes with ‘pop’), then discharge and TM perforation
    • Associated hearing loss, tinnitus, fever common
    • Children: unwell, crying, pulling affected ear
  • Treatment:
    • often conservative. amoxicillin in severe cases.
  • Red Flags:
  • systemic sepsis (give IV antibiotics), CN palsy, meningism, etc.
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15
Q

What is the complication of what infection? (explain)

A

Mastoiditis complication from otitis media infection

  • Usually heal themselves
  • Sometimes infection spread to mastoid air cells (fill with pus)
  • Can cause intracerebral abscess
  • Symptoms
    • ​Tender, boggy, swollen mastoid process (maybe otalgia & discharge)
  • Treatment
    • ​IV antibiotics (may need mastoidectomy - drill into mastoid)
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16
Q

What is the following condition?

Study These Flashcards
A

Furoncle

Related to infected hair follicle

Treatment:

  • Pop it and give antibiotics
17
Q

What is the following condition?

Study These Flashcards
A

Cholesteatoma - collection of keratinising squamous epithelium

e.g. thinning of tegmen due to this can lead to meningitis/intracranial abscess

Treatment:

  • Surgically - e.g. mastoidectomy
  • Ear drops (antibiotics/steroids)

And has a hole perforation of the tympanic membrane

18
Q

Acute otitis externa what is it, symptoms, risk factors, signs, management?

Study These Flashcards
A

Inflammation of outer ear (from auricle → outer surface of TM)

Symptoms

  • Otalgia (± discharge)
    • Often after change in environment- humidity/pH or swimming
  • Conductive hearing loss, tinnitus, dysequilibrium

Risk Factors

Age, Diabetes, recurrent OE, immunocompromise

Signs

Stenosed ear canal with debris, periauricular/pinna cellulitis, pinna/tragus tender to palpate

Management

Topical Antibiotics (+/- pope wick/regular microsuction), keep ear dry

19
Q

What is the following condition? & treatment

Study These Flashcards
A

Pinna Cellulotis (including the lobules)

Treatment:

  • Ear drops & antibiotics
20
Q

What is osteomalitis? (& treatment)

Study These Flashcards
A

Infection of the ear which causes infection of the bone

Treatment:

  • Aggressive IV antibiotics
21
Q

What is this? How does it work?

Study These Flashcards
A

Pope wick

Keeps a swollen ear canal patent

Disperses ear drops deep into ear canal

22
Q

What happens when you give someone antibiotics for an otitis ear infections? (BAD?)

Study These Flashcards
A

Get rid of GOOD & BAD bacteria thus, INCREASE risk of fungal infection (difficult anti-fungal treatment)

23
Q

What is the following condition? & causes

Study These Flashcards
A

Perichondritis (inflammation of the pinna cartilage) - LOBULE spared

Cause:

  • Bacterial infections
  • High pinna piercing
  • Diabetes
  • Pseudomonas infection
24
Q

Symptoms, risk factors, treatment of perichondritis

Study These Flashcards
A

Symptoms

  • Red
  • Swollen
  • Tender ear

Risk factors

  • Piercing
  • Lacerations
  • Otitis externa

Treatment

  • Antibiotics
25
What is the following condition? Cause? Treatment?
**Pinna haematoma** **Cause:** * Trauma to ear & collection of blood under *_perichondrium_* * If no blood supply for cartilage it dies = *_cartilage necrosis_* **Treatment** * Drain them (needle) When **_un_**treated = cauliflower ear
26
What condition is this?
**Cauliflower ear** (associated with pinna haematoma)
27
How to treat **foreign bodies** in ear?
Common: bugs & batteries **Bugs** * Drown with *olive oil* **Batteries** * Remove ASAP as causes ***_errosion_*** e.g. of tegmen, TM, ossicles
28
Explain the following CT images
**LEFT** * Patient fracture through *mastoid* portion of temporal bone & skull fracture * Worries about ***conductive hearing loss*** (as loss of blood) **RIGHT** * *Sensorineural* hearing loss (as fracture at optic capsule) - could be DEAD ear * Check *facial nerve* & do *Rinne's & Weber's test*
29
What is the following condition?
**Haemotympanum** (blood in the tympanic cavity of the middle ear)
30
What is the following condition?
**Battle's sign** Associated with base *skull fracture* (blood + bruising under skin of mastoid process)
31
What is the following condition?
**LMN facial nerve palsy** (right sided) e.g. *due to temporal bone fracture* which transected facial nerve
32
What is this imaging & what is the condition?
**Left vestibular Schwannoma** *_Uncommon_* benign tumour growing from the *vestibular portion* of the *vestibulocochlear nerve*. Can cause unilateral sensorineural hearing loss, unilateral tinnitus, vertigo, facial palsy. Unilateral/asymmetrical hearing loss or tinnitus is investigated with an **_MRI_** scan of the *_internal acoustic meatus_* where *_CN VIII_* passes from the brain out towards the inner ear.
33
What is this condition?
***_Asymmetric sensorineural hearing loss_*** (left ear worse than right ear. You can tell this is sensorineural as the bone conduction and air conduction are equally reduced (no air-bone gap)
34
What is **benign Paroxysmal Positional Vertiogo**?
***_Benign Paroxysmal Positional Vertigo_*** - *otoconia* (small crystals) are *_dislodged_* from the *otolith organs* and can fall into the *semicircular* canals, causing ***_ROTATORY VERTIGO_*** - sensation of inertia/room feels as though it spins horribly. It is short lasting and episodic, triggered by head movements e.g. turning over in bed / looking up to reach for a high cupboard. Diagnosed using the Dix Hallpike Manoeuvre, treated with Epley’s Manoeuvre (positions that move otoconia back to original positions)
35
What is **vestibular neuronitis**?
***Vestibular Neuronitis*** - *inflammation* of the *vestibular nerve* (often viral) - produces continuous *_vertigo_* (not episodic). Vertigo can mimic ***STROKE*** so get MRI to check and treat immediately
36
What is **labyrinthitis**?
***Labyrinthitis*** - *inflammation* of all of the inner ear *structures*, causes continuous vertigo AND hearing loss.

Unit 14 Week 2 (Tommy) (5 decks)

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