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Flashcards in Ear Deck (115):
1

What is the normal Hz of hearing

<20 Hz

2

if you hear 20 -40Hz you have

mild hearing loss

3

If you hear 60+ Hz you have

profound hearing loss

4

what is the eustachian tube held open by

tensor veli palatine and levator palatine muscles

5

Dysfunction of the eustachian tube leads to what

middle ear negative pressure - glue ear

6

What happens when perilymph vibrate

hair cells vibrate

7

The cochlea is made up of how many turns

2 and a half

8

What does the apex hear

low frequency

9

What does the outer rings hear

high frequency

10

Perilymph is like what type of fluid

extracellular

11

Endolymph is like what

intracellular fluid (high in K, low in Na)

12

What contains the organ of Corgi

the basilar membrane

13

What does the organ of corgi contain

hair cells

14

What do hair cells do

transduct - convert mechanical bending force into an electrical impulse

15

what are hair cells made up of

stereocillia - arranged in height order

16

What stereocilia here high frequency

short

17

what steroceilia here low frequency

long

18

The APs made by the hair cells follow which course

-> cochlear nucleus -> lateral lemniscus -> auditory cortex (in superior temporal gyrus)

19

Where are the 3x ampullators found for balance

at the semi-circular canals

20

Where are the 2x otilators found for balance

at the urticle and the saccule

21

What do the otilators contain

maculae of these organs contain steroecilia and otoconia (crystals)

22

What are the crystals in the ear made of

calcium carbonate

23

where is there a capula (gel finger that projects into the cavity of fluid)

ampullator of the semi-circular canal

24

What does the superior semi-circular canal do

recognises nodding of the head

25

What does the posterior semi-circular canal do

recognises tilting of head

26

What does the lateral semi-circular canal do

recognises when head shakes side to side

27

What is present in the capula

hair cells with otoconia (crystals) attached

28

What is the vestibulo-ocular reflex

when focusing on something and turning your head - e.g. to the R, the R side will be innervated and the L will be inhibited

29

What is nystagmus

when the vestibulo-ocular reflex fails

30

what is the clinical sign of vertigo

nystagmus (eyes flicker to one side as one side is failing so the eye is trying to go to the opposite side

31

Oscillopsia is

no vestibulo-ocular reflex

32

When does oscillopsia usually occur

due to gentamicin injection - eyes can't focus on any point

33

Vestibulospinal tract does what

tells the brain that the body is moving

34

On audiogram what does conductive hearing loss look like

significant gap between air and bone conduction (bone will be within normal limits)

35

Sensorineural hearing loss will be seen on audiogram as

no gap between air and bone

36

What percentage of people with migraines have episodes of vertigo and ataxia

25%

37

What is the most common auditory symptom of a migraine

phonophobia

38

What is the first test for hearing

pure tone audiometry

39

What does mixed hearing loss look like on audiogram

significant gap between air and bone conduction but bone isnt in normal threshold (damage to both outer/middle and inner ear)

40

Tympanometry is for

testing middle ear function
not for hearing

41

What is otitis externa

diffuse inflammation of the skin of the ear canal

42

What are the causes of otitis externa

infection - bacterial: staph aureus/pseudomonas
fungal: aspergillus niger

43

What is the investigation for otitis externa

swab for culture

44

what is the treatment for otitis externa

topical aural toilet
topical Abx
clotrimazole - fungal
gentamicin 0.3% - bacterial

45

What is a feature of pseudomonas causing otitis externa

green pus

46

When is pseudomonas seen

swimmers ear

47

What are the side effects of the topical ear drops

dizziness
local sensitivity
ototoxicity (gentamicin)

48

what is a complication of otitis externa

malignant otitis externa - extension of infection into temporal/mastoid bone
- usually caused by pseudomonas
- investigated by PV/CRP, imaging and biopsy

49

What causes increased risk of malignant otitis externa

DM
head and neck radiotherapy

50

what is acute otitis media

acute inflammation of the middle ear

51

What does otitis externa present with

severe pain
tender pinna
discharge /increased wax
if blocked - conductive hearing loss
if severe - swollen EAM and TM not visible

52

what does acute otitis media present with

severe pain
conductive hearing loss
bulging TM
"itchy for a while then TM bursts over night leaving pus on the pillow"

53

What is the cause of acute otitis media

usually viral (follows a cold/URTI)
bacterial - H. influenza, strep. pneumoniae

54

What is the treatment for acute otitis media

80% resolve within 4 days
if bilateral/ loss of hearing/ doesnt resolve - amoxicillin 1st line
doxycycline 2nd line

55

What is the complication of acute otitis media

extension into the mastoid bone

56

What is otitis media with effusion

inflammation of the middle ear without the signs of acute inflammation

57

what will otitis media with effusion present with

conductive hearing loss
retracted TM
painless
"misbehaving child with impaired speech"

58

Who is more likely to get otitis media with effusion

children
people from temperate climates
Down syndrome

59

What is otitis media with effusion also known as

glue ear

60

What is the cause of otitis media with effusion

negative pressure caused by dysfunction of the eustachian tube

61

What is the treatment for otitis media with effusion

watchful waiting
if bilateral/ hearing loss - Grommet insertion (equalises the pressure)

62

when will a Grommet fall out

after 6-12months

63

What is cholesteatoma

keratising squamous epithelium in the middle ear with abundant keratin

64

What type of epithelium should be in the middle ear

columnar/cuboidal

65

What is the cause of cholesteatoma

chronic otitis media

66

What will a pt with cholesteatoma present with

chronic smelly discharge
"dandruff"

67

What might be seen on examination of someone with a cholesteatoma

white/cheesy TM

68

What is the treatment for cholesteatoma

mastoid surgery to remove the squamous debris

69

What is otosclerosis

a hereditary condition where there is new bony deposits present in the otic capsule

70

what is present in the otic capsule

ossicles

71

What type of inheritance is otosclerosis

autosomal dominant

72

what is most likely to be affected by otosclerosis

stapes (fixation of the stapes footplate)
cochlea

73

What will someone present with in otosclerosis

20-30yrs
F>M
Mixed hearing loss

74

What is the treatment for otosclerosis

hearing aid
stapes replacement with a prosthesis

75

What is presbycusis

old age hearing loss
most common type of deafness

76

What type of hearing loss is presbycusis

sensorineural

77

What will someone with presbycusis present with

gradual sensorineural hearing loss
high pitched noises go first

78

What are the causes of presbycusis

loss of hair cells (sensory)
loss of ganglion cells (neural)

79

What increases a persons risk of getting presbycusis

environmental noise toxicity

80

what is the treatment for presbycusis

high pitched hearing aids

81

what is an acoustic neuroma

a vestibular schwannoma - a slow growing, benign schwannoma of the vestibular nerve

82

What will a patient present with in a vestibular schwannoma

sensorineural hearing loss - asymmetric
- gradual onset
loss of balance
associated with cafe aut lait macules
loss of corneal reflex

83

What is the investigation for an acoustic neuroma

MRI pituitary

84

What is the treatment for an acoustic neuroma

surgery

85

what condition is associated with an acoustic neuroma

neurofibromatosis type 2

86

What is the most common cause of vertigo

benign paroxysmal positional vertigo

87

What will BPPV present with

sudden onset vertigo
occurs on rotation (moving head/lying down)
lasts secs-mins

88

What are the causes of BPPV

follows vestibular neuronitis
head injury
infection

89

What is vestibular neuronitis

sudden onset vertigo
associated with vomiting
lasts a few days before central nervous system starts to compensate - usually it gradually goes back to normal

90

What is the investigation for BPPV

precipitate an episode by doing a positional test
Halpikes manœuvre

91

What is the treatment for BPPV

epley's manoeuvre

92

What is labyrinthitis associated with

vertigo and cough/cold

93

What would a pt with Meniere's disease present with

recurrent, spontaneous, rotational vertigo - lasts 30min to few hours
associated with N & V
tinnitus
loss of balance
sensorineural hearing loss
feeling of aural fullness

94

What is the acute treatment for Meniere's disease

vestibular sedatives

95

What is the preventative treatment for Meniere's disease

low salt intake
low caffeine
alcohol restriction
intratympanic gentamicin - is ototoxic (destroys vestibular epithelium)
surgery

96

What type of vertigo will last hours to days

labyrinthine/ CNS caused vertigo

97

What is the treatment for long lasting vertigo

vestibular sedatives

98

what is the side effect of long acting vestibular sedatives

they can have a parkinsonian effect

99

What will someone with Ramsay- hunt present with

deep inner ear pain
vertigo and ipsilateral hearing loss
unilateral facial weakness
rash/blisters on skin
tinnitus

100

What is the cause of Ramsay-hunt syndrome

Herpes zoster

101

What is the treatment for Ramsay-hunt syndrome

analgesia
anti-virals

102

what will someone with Bell's palsy present with

unilateral weakness of the facial muscles (problems with smiling, chewing, closing one eye, speech)
painless
loud sounds may seem louder
aguesia (loss of taste)

103

What are the causes of Bell's palsy

viral infection
varicella zoster

104

What is the treatment for Bell's palsy

most resolve well without the use of steroids (prednisolone)
anti-virals
physio

105

What is Rinne's test for

conductive hearing loss only
place the 512Hz tuning fork on the mastoid bone and then in front of the ear
If the patient hears it better in front = +ve test
if the patient hears it better on the bone then bone conduction is better than air and the person has a problem with their conducting system = -ve test

106

What is Weber's test for

Place the 512Hz tuning fork on the forehead and ask the patient which side the noise goes to
If the noise goes to one side then either:
- that ear has conductive hearing loss
- or the other ear has sensorineural hearing loss

107

What 2 drugs are ototoxic

Gentamicin (aminoglycosides)
aspirin

108

Cauliflower ear is also known as

pinna haematoma

109

How is cauliflower ear treated

aspirating to get rid of blood then suturing 2 flaps back together

110

What is the most common temporal bone fracture

longitudinal (80%)
transverse (20%)

111

what occurs with longitudinal temporal bone fractures

conductive deafness
caused by lateral blow

112

What occurs with transverse temporal bone fractures

sensorineural hearing loss
caused by frontal blows

113

What can multiple sclerosis cause

mild vertigo
dysarthia
ataxia (neurological disorder affecting balance, speech and coordination)

114

Who is more likely to be affected by MS

F>M
20-40yrs

115

Deafness after showers in someone with poor hygiene is likely to be caused by

wax obstruction