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HNN > Anatomy Of The Ear > Flashcards

Anatomy Of The Ear Flashcards

1
Q

Signs and symptoms of ear disease

A
  • hearing loss
  • tinnitus
  • vertigo
  • otorrhoea
  • otalgia
  • facial droop : rare complication of disease involving middle ear
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2
Q

What is tinnitus?

A

Sounds perceived but do not come from external source such as ringing, humming, whistling

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3
Q

What two things is the ear an organ of?

A

Hearing
Balance

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4
Q

What is otalgia?

A

Ear pain

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5
Q

What is otorrhoea?

A

Discharge from the ear

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6
Q

Describe the external ear region

A
  • pinna + external auditory meatus (ear canal)
  • skin-lined (keratinised squamous epithelium)
  • extends as far as lateral surface of tympanic membrane
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7
Q

What is the external auditory meatus?

A

Ear canal

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8
Q

What is the boundary between the external and middle ear regions?

A

Tympanic membrane

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9
Q

Describe the middle ear region

A
  • air filled cavity
  • ossicles (malleus, inus + stapes)
  • lined with respiratory epithelium (ciliated pseudostratified columnar epithelium)
  • connected to nasopharynx via pharyngotympanic tube
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10
Q

What is the external ear region lined with?

A

Skin lined
Keratinised squamous epithelium

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11
Q

What is the Middle ear region lined with?

A

Respiratory epithelium
Ciliated pseudostratified columnar epithelium

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12
Q

What is the inner ear lined with?

A

Stereocilia

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13
Q

Describe the inner ear region

A
  • fluid filled ducts
  • cochlea
  • semicircular canals, utricle, saccule
  • lined with sterocilia
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14
Q

What bone is the ear associated with?

A

Petrous part of temporal bone

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15
Q

Innervation to the external ear for general sensation

A

Cervical spinal nerves C2/3
Trigeminal V > auriculotemporal nerve
Vagus X
Facial VII

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16
Q

Innervation of the middle ear cavity + medial surface of tympanic membrane

A

Glossopharyngeal IX (tympanic nerve)

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17
Q

What should you suspect if a patient presents with otalgia with no other signs suggestive of ear disease + normal ear exam?

A

Alternate site of pathology due to referred pain
e.g. laryngeal + pharyngeal cancers, TMJ disease, oropharyngeal disease

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18
Q

What nerve carries hearing from the ear?

A

Vestibulocochlear VIII

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19
Q

Function of the external ear

A

Collects, transmits + focuses sound waves on to tympanic membrane

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20
Q

Describe the external acoustic meatus

A
  • 2.5cm long
  • sigmoid shape
  • outer 1/3 cartilage + inner 2/3 bone
  • skin lined (keratinised squamous epithelium)
  • hair + glands only in cartilage part
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21
Q

What glands produce ear wax?
Where are they located?

A

Ceruminous glands
Cartilaginous part of the eternal acoustic meatus

22
Q

Describe the self cleaning function of the external acoustic meatus

A

Dead skin migrates laterally out from the tympanic membrane

23
Q

Describe a otoscopic exam

A
  • visualises external acoustic meatus + external surface of tympanic membrane
  • pinna is pulled up + back in adults | down + back horizontally in children
24
Q

Parts of the tympanic membrane

A
  • pars tensa
  • pars flaccida
  • manubrium of malleus
  • cone of light (way the light reflects off the TM off the otoscope)
25
Q

What nerve is associated with the tympanic membrane?

A

Chorda tympani nerve
(From the facial nerve VII)

26
Q

Why can the tympanic membrane perforate?

A

Loud noise
Infection building up behind it

27
Q

If you see little white patches on the tympanic membrane, what are they called and what is it?
What does it indicate?

A
  • Tympano sclerosis
  • Hardening of the membrane
  • Indicates trauma or irritation in past
28
Q

What abnormal things may you see on the tympanic membrane?

A

Grommet
Perforation
Tympano sclerosis

29
Q

What is a bulging + erythematous tympanic membrane indicative of?

A

Something is building up in the middle ear cavity which is pushing the TM up

30
Q

What is a excessively retracted (pulled in medially) tympanic membrane +/- fluid behind it indicative of?

A

Middle ear pathology (possibly related to pharyngotympanic tube + pressure)
e.g. otitis media with effusion

31
Q

What are changes to the tympanic membrane that are indicators of middle ear pathology?

A
  • bulging + erythatmous
  • excessively retracted +/- fluid behind
32
Q

Function of the middle ear ossicles

A

Relay + amplify vibrations from tympanic membrane to oval window

33
Q

What are the ossicle vibrations tampered by?

A

Tensor tympani
Stapedius

34
Q

What is hyperacusis?

A

Unusual intolerance to ordinary sounds
(Normal sounds sound really loud)

35
Q

What is the acoustic reflex?

A

When the tensor tympani + stapedius muscles contract if there’s excessive vibrations from loud noise

36
Q

What does an ineffective acoustic reflex cause?
What could cause an ineffective reflex?

A

Hyperacusis
Facial nerve lesion related to nerve to stapedius

37
Q

What does opening of the pharngotympanic tube do?

A
  • Allows for equalisation of pressure both sides of the tympanic membrane
  • ventilation
  • drainage of mucous
38
Q

What can dysfunction of the pharyngotympanic tube cause?
Examples

A

Pressure imbalances involving the middle ear
e.g. otitis media with effusion, cholesteatoma

39
Q

How can infection spread from the nasopharynx to the middle ear?

A

Along the pharyngotympanic tube

40
Q

Compare the pharngotympanic tube between children and adults
What does this mean?

A

In children:
- Shorter and more horizontal in infants + children
- easier passage for infection to spread between the nasopharynx + middle ear
- PT opens near pharyngeal tonsils (can get blocked if enlarged)

41
Q

Important anatomical relations of middle ear

A
  • pharyngotympanic tube
  • mastoid cells
  • facial nerve runs through
  • sigmoid sinus behind
42
Q

Why are complications in the middle ear potentially life threatening?

A

If they spread intracranially:
- they can involve the sigmoid sinus + cause dural venous sinus thrombosis
- they can affect the meninges > meningitis
- could form an abscess in the brain itself

43
Q

Describe the fluid movement in the inner ear and what it’s perceived as

A

Fluid movement in:
- cochlea > perceived as sound
- semicircular canals, utricle, saccule > perceived as position sense/balance

44
Q

What does a disease of the inner ear cause?

A

Hearing loss
Tinnitus
Balance disturbance + vertigo

45
Q

What is fluid movement in the cochlea perceived as?

A

Sound

46
Q

What is fluid movement in the semicircular canals, utricle, saccule perceived as?

A

Position sense/balance

47
Q

Describe how the body senses position + balance

A
  • in the inner ear canal
  • head movements cause movement of fluid within the vestibular system
  • fluid shifts gelatinous matrix in which the stereocilia are
  • stereocilia bend > AP generate > CN VIII
  • signals perceived as sense of position and balance
48
Q

Describe how we hear
Indicate what parts can cause hearing loss (underlined)

A
  • pinna + external auditory meatus focus + funnel sound waves to tympanic membrane
  • TM vibrates
  • vibrations of ossicles > movement in cochlear fluid
  • sensed by sterocilia in cochlear duct
  • movement of sterocilia in organ of Corti > AP in CN VII
  • primary auditory cortex make sense of the input in the temporal lobe
49
Q

Conditions involving what can cause hearing loss?

A
  • external auditory meatus
  • tympanic membrane
  • vibrations of ossicles
  • movement of the sterocilia in organ of corti
  • vestibulocochlear nerve VIII
50
Q

What are the ossicles of the ear?
From TM to oval window of cochlea

A

Malleus
Incus
Stapes

HNN (24 decks)

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