Ear

Question 1

2 primary functions of the ear

Answer 1

Hearing
-Static and dynamic equilibrium

Question 2

Outer ear components

Answer 2

Pinna and Ear Canal

Question 3

Middle Ear

Answer 3

-Tympanic membrane: Subject to noise trauma
-Ossicles: 3 tiny bones with joints between them/Transmit vibrations from tympanic membrane
-Eustachian tube: Equalize the air pressure in the middle ear with that of the outside ear

Question 4

Two muscles in the middle ear that help dampen sounds when things are really loud

Answer 4

1. Tensor Tympani: Trigeminal; Teeth
2. Stapedius: Seven (CN 7); Singing sounds

Question 5

Which cranial nerve carries sound and body position & motoin from the inner ear to brain

Answer 5

Cranial nerve 8 (vestibulocochlear)

Question 6

Inner Ear

Answer 6

-Cochlea
-Utricle and Saccule
-Semicircular canals

Question 7

Cochlea

Answer 7

-Snail-shaped with tiny hairs inside
-Transforms sound waves into electrical impulses

Question 8

Utricle and Saccule

Answer 8

-Filled with fluid and hairs
-Provide information about body position at rest

Question 9

Semicircular canals

Answer 9

-Provide information about body in motion

Question 10

The big four ear complaints

Answer 10

Hearing loss, equilibrium or balance problems, Dizziness/vertigo, Tinnitus (auditory paresthesia)

Question 11

Cauliflower ear

Answer 11

-Result of physical trauma to the pinna or inflammation or infection
-Can create permenent deformity in the shape of the pinna
-Palpates as a hard lump
-Common in wrestlers and boxers

Question 12

Perichondritis

Answer 12

Another name for inflammation or infection of the external ear
-Treated with astingents and systematic antibiotics
-Drainage when necessary

Question 13

Ear piercing

Answer 13

-Earlobe is safer than cartilage (poorer circulation)
-Refer patients id there is swelling, inflammation, infection or fluid filled lesion

Question 14

Keloid vs Hypertrophic scarring

Answer 14

Keloid: Scar tissue (more excessive and permenent)
Hypertrophic scarring: More temporary

Question 15

Outer ear infection: Swimmers Ear

Answer 15

-Otitis externa
-Infection or inflammation of the ear canal
-Symptoms: itching, swelling, pain, tenderness, discharge and occasionally hearing loss

Question 16

Examination Findings in Otitis Externa

Answer 16

Pain when pressing or manipulating the tragus

Question 17

Medical Care for Otitis Externa

Answer 17

Dependent on cause
-Hematoma or abscess is drained
-Antibiotics: Topically and/or systematically
-Anti-Inflammatory drugs

Question 18

External Auditory Exostosis: Surfer’s Ear

Answer 18

From repeated exposure to cold water, wind and salt water

Question 19

Cancer of the Pinna/Auricle

Answer 19

-Due to exposure of ear to ultraviolet radiation from sun
-Look for suspicious growths that are new or changing

Question 20

Cholesteatoma

Answer 20

-A benign tumor near eardrum
-Appears as white mass behind or on eardrum

Question 21

Symptoms of Cholesteatoma

Answer 21

Hearing loss, dizziness, pressure in ear, ear ache

Question 22

Treatment of Cholesteatoma

Answer 22

-Surgery to remove growth completely and to reconstruct damaged ossicles or eardrum
-Goal is preserve hearing (and language skills) and equilibrium/balance

Question 23

Leading cause of pediatric visits to medical doctor

Answer 23

Middle ear infection/otitis media

Question 24

Why does Otitis media affect kids more

Answer 24

1. Anatomy: Kids eustachian tubes are shorter, more horizontal, and narrower
2. ## Physiology: Kids immune systems are not as developed

Question 25

Otitis media epidemiology

Answer 25

-Most often in kds -More males than females -Family history is important -More in bottle fed -More often in day care kids and kids exposed to second hand smoke -More common in winter

Question 26

Otitis media Diagnosis

Answer 26

Tenderness to pressure on mastoid area

Question 27

Acute vs. Seroud Otitis Media

Answer 27

Serous: Less severe (lower fever, low-grade or no pain, child appears less sick, less redness/no pus) than acute

Question 28

Treatment of Otitis Media

Answer 28

Wait and See Prescription (WASP): Wait 48 hours

Question 29

Treatment/Relief of Otitis Media

Answer 29

-Muncie technique, Gallbreath technique, -Acupuncture -Dietary supplementation (Vitamin C, Zinc, maganese, colloidal silver drops, calcium, goldenseal/echinacea) -Antibiotics -Myringotomy with or without Tympanostomy Tubes

Question 30

Home Care Advice for Otitis Media

Answer 30

Nasal saline drops, NoseFrida

Question 31

Tympanosclerosis

Answer 31

Scarring of the eardrum secondary to acute otitis media or chronic, recurrent middle ear infections -Patient has a history of middle ear infections -Looks like cholesteatoma

Question 32

Treatment of Ruptured/Perforated Tympanic Membrane

Answer 32

Most heal within 4-8 weeks, antibiotics -Self care: keep ear canal dry

Question 33

Otosclerosis

Answer 33

Abnormal bone growth of the middle ear bones -Common cause of hearing impairment -Tends to fun in families -Affects women more than men -Main symptom is hearing loss

Question 34

Which structure of the ear is most affected during otosclerosis

Answer 34

Stapes

Question 35

Diagnosis of Otosclerosis

Answer 35

Weber: Sound will localize to involved ear if UL RInne: Bone conduction is louder and longer than air conduction Otoscopic Exam: To rule out other things; Can’t see otosclerosis with otoscope -CT Scan -Refer to otologist

Question 36

Treatment of otosclerosis

Answer 36

Hearing aid (temporary) -Stapedectomy and prosthesis surgery -Sodium fluoride supplementation

Question 37

Barotrauma

Answer 37

-MC cause is blockage or partial blockage of eustachian tube -Common in airplane take-offs/landings or water pressure -If severe can cause bleeding and/or rupture of tympanic membrane

Question 38

Who identified Eustachian tubes

Answer 38

Bartolomeo Eustachio

Question 39

Maneuver for equalizing air pressure in ears

Answer 39

Antonio Valsalva (Valsalva Maneuver)

Question 40

Preventing & Treating Barotrauma

Answer 40

Chiropractic Adjustments: PARTS likely in upper C spine -Acupuncture and soft tissue work -Muncie/Fossa of Rosenmuller Technique