EAR Flashcards

(28 cards)

1
Q

Clinical presentation for [Treacher-Collins Syndrome] -4

A
  1. Mandibular hypOplasia
  2. Cleft Palate
  3. Auricular malformation (stenosis, atresia)
  4. Downward slanted palpebral fissures

This is Auto DOM

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2
Q

Function of Mid Ear MIS ossicle bones

A

Amplifies acoustic energy to overcome impedance mismatch between [air-filled EAM] and [fluid-filled inner ear]

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3
Q

Name the 2 Mid Ear muscles; Innervation? ; What is their Function?

A

⬇︎ transmission to inner ear to protect cochlea AND reduce low freq background noise

Stapes: = Facial CN7

Tensor Tympani = [Trigeminal CN5B3]

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4
Q

What is the purpose of EPAT-2? What happens when it is dysfunctional?

A

EPAT (Eustacian Pharyngotympanic Acoustic Tube) drains and aerates Mid ear ; Plugged up sensation and Popping that eventually –> Otitis Media

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5
Q
A
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6
Q

Describe the tortuous path of Facial CN7 thru the temporal bone (5 steps)

A

1st: Exits Internal Auditory canal into inner ear
2nd: Travels SuperoLateral to Cochlea and then angles down sharply to make “hairpin” bend and articulate Geniculate ganglion which = first genu
3rd: travels along medial wall of tympanic cavity above OV window and below lateral semicircular canal
4th: Drops inferiorly which = second genu
5th: exits at Stylomastoid Foramen

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7
Q

Why are both CT and MRI needed for Facial CN7 w/u during ear disease

A
  • CT demonstrates integrity of the osseous Facial CN7 canal
  • MRI reveales Facial CN7 itself
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8
Q

What is Perilymph? What is Endolymph? How are they different?

A

Perilymph = fluid in osseous labyrinth (which surrounds membranous labyrinth) = High in Na+ (similar to extracell fluid)

Endolymph = fluid in membranous labyrinth = High in K+ (similar to intracell fluid)

This electrochemical difference –> +80 mV gradient across membranous labyrinth that allows acoustic energy to = neural impulse

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9
Q

Where is Perilymph and Endolymph found in relation to Basilar Membrane Of Organ of Corti

A

Perilymph = Below BM

Endolymph = Above BM

Basilar Membrane is responsible for tonotopic frequency of Cochlea

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10
Q

What is the “traveling wave”

A

Movement of BM in response to sound -

  • High frequencies displace BM near cochlear base
  • low frequencies displace BM apex

Note: [Inner haircells = Affarent] vs [Outer haircells = Efferent]

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11
Q

How is sound transduced (simulate cochlear hair cells)

A

Sound, via shear force, moves tectorial and basilar membrane –> moves sterocilia –> opens/closes ion channels–>receptor potential in inner haircell –> Affarent action potential

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12
Q

What are the Utricle and Saccule

A
  • Utricle = detects Horizontal acceleration
  • Saccule (I’ll Sacc U Vertically) = detects Vertical acceleration

These are Vestibular organs

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13
Q

Superior Canal Dehiscence Syndrome etx; Sx-3 ; Dx

A

Idiopathic Absence of bone over the Anterior Semicircular canal; [High Res CT]

  1. Sound vs Pressure-induced vertigo
  2. Conductive hearing loss
  3. Autophony (perceiving own’s voice/sounds to be loud)
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14
Q

Starting with Auditory n., what is the pathway to the brain for sound and balance? -6

A

Auditory n.–>Cochlear nc. –>[SUP olivary complex]–>Lateral Lemniscus–>Inferior colliculi –> medial geniculate –> [Area 41 Heschl’s gyrus]

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15
Q

What’s the max amount of decibel loss in Conductive Hearing Loss?

A

60 dB (anything >50 = ossicular damage is cause)

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16
Q

What things should specifically be included in Hearing Loss History -8

A
  1. Laterality
  2. Duration
  3. [Severity & Progression]
  4. Asc. factors (otalgia/otorrhea/tinnitus/vertigo/aural fullness)
  5. Meds & Surgery
  6. Head trauma
  7. Fam Hx
  8. Autoimmune Dz
17
Q

Air-Bone Gap on Audiogram indicates what type of hearing loss-2? What is Air-Bone Gap?

A

Conductive or Mixed; Air is blocked, but Bone still conducts sound waves during vibratory part of audiogram–>bypasses external/mid ear obstruction

18
Q

On Tympanogram…What do these results indicate:

⬆︎Compliance of TM

⬇︎Compliance of TM

Poor Compliance of TM-2

A
  • [⬆︎Compliance Type Ad] = MIS ossicle bone disengagement
  • [⬇︎Compliance Type As] = Otosclerosis
  • Poor Compliance (Type B) = Tympanic Perforation vs Mid ear effusion
19
Q

What is the most common finding on imaging for children with Sensorineural hearing loss

A

Enlargement of the Vestibular Aqueduct

20
Q

Describe how to perform Weber test and How you interpret it?

A

1st: Ask Which Ear is deaf? - Pt says RIGHT ear is deaf
2nd: Strike Fork on Mid head

If Fork is heard louder in RIGHT = CHL of RIGHT

vs

If Fork is heard louder in Left = Sensiorineural Hearing loss of RIGHT

Conduction Hearing Loss Concurs in Laterality (if Pt reports deaf on R, tuning fork is louder on the R)

21
Q

Otosclerosis etx

A

Fixation of Stapes in OV window –> uni vs BL Conductive hearing loss

22
Q

Otosclerosis dx and tx-2

A

dx: Carhart notch = 10-15 dB ⬇︎ in bone conduction @ 2000Hz

Tx = Hearing Aids vs Stapedectomy

23
Q

4 Main causes of Conductive Hearing loss

A

check for ITEO!

Impaction of EAC (cerumen vs foreign object)

Tympanic Membrane Perforation

Effusion of Mid Ear

Otosclerosis

24
Q

How can Superior Semicircular Canal Dehiscence cause Hearing loss; Sx?

A

Dehiscence can –> Fistula between SUP Semicircular canal & Dura –> 3rd window into inner ear–>

  1. Tullio sign (Dizziness from sound/pressure)
  2. Hennebert sign (Dizziness from Valsalva or Pneumatic otoscopy)
  3. CHL
25
Sx of CerebelloPontine Angle - 3
1. UL Sensorineural Hearing Loss (SNL) 2. Tinnitus 3. Vertigo
26
Which 3 blood vessels pass thru the CerebelloPontine Angle
1. PICA 2. AICA 3. SCA
27
Clinical Manifestations for [Bells Palsy] (4)
​Bells Palsy = Facial CN7 paralysis Loss of **F** --\> Unilateral Paralysis Loss of **A** --\> Hyperacusis Loss of **C**--\> DEC Eye lacrimation (tearing) Loss of **E** --\> Loss of **ANT 2/3 Tongue** Taste **FACE** 1. **F**acial Muscles 2. **A**fferents(Somatic) from [Ear Pinna (Pain/Temp)] & [External Auditory Canal (stapedius m.)] 3. **C**ry: Parasympathetics to [Lacrimal/Salivary/Sublingual/Submandibular/] 4. **E**at: Taste from ANT 2/3 Tongue
28
list the 5 major motor branches to Facial Muscles from Facial CN7 (*Pes Anserinis*)
"**T**en **Z**ebras **B**it **M**y **C**occyx"