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402 Ear, Nose & Throat > Ear > Flashcards

Ear Flashcards

1
Q

3 divisions of the ear

A

outer
middle
inner

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2
Q

What 3 components make up the outer ear?

A

Pinna
External auditory meatus
lateral tympanic membrane

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3
Q

What structures are in the middle ear?

A

Ossicles - malleus, incus , stapes
Facial nerve
eustacian tube

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4
Q

What part of the ear does the eustacian tube link up with?

A

Middle ear

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5
Q

What is the part of the middle ear located being the pars flaccida known as?

A

Attic

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6
Q

What is the inner ear comprised of?

A 
Cochlea 
Semicircular canals (vestibule and labyrinth)
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7
Q

What does the cochela do?

A

creates electrical impulses to the cochlea nerve

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8
Q

What do the vestibule and labyrinth do?

A

balance

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9
Q

The Eustachian tube connects the middle ear with what?

A

nasopharynx

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10
Q

What is the mastiod process and how does this relate to middle ear infection?

A

Bony lump behind pinna

mastiod air cell system opens directly to middle ear so infection can spread causing mastioditis

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11
Q

What is conductive hearing loss and what part(s) of the ear does it involve?

A

Interruption to the hearing system in the external or middle ear

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12
Q

What is sensorineural hearing loss and what structures are involved?

A

hearing process is interrupted at the cochlea or auditory nerve

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13
Q

What test can help distinguish between conductive and sensorineural hearing loss?

A

tuning fork test

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14
Q

What type of hearing test is this?:

Place someone in a sound proof room. Present with series of sounds and measure bone and air conduction in each ear.

A

Pure tone audiometry

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15
Q

What type of hearing test is this?:

Presenting stimulus to ear and measuring the resultant changes of electrical activity in the nervous system

A

evoked/electrical response audiometry

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16
Q

What type of hearing test is subjective and requires cooperation?

A

Pure tone audiometry

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17
Q

Which type of hearing test is subjective and can therefore be used to assess hearing in children?

A

Electrical response audiometry

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18
Q

What are otoacoustic emissions and what are they used to assess?

A

Electrical signal generated by the inner ear in response to sound.
Used to assess hearing in babies

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19
Q

What is tympanometry?

A

Blowing a small current of air into ear to measure distensibility of ear drum and middle ear.

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20
Q

4 gestational infections that can lead to congenital sensorineural hearing loss?

A

Toxoplasmosis
Rubella
cytomegalovirus
herpes

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21
Q

What is the acquired sensorineural hearing loss associated with aging known as?

A

Presbyacusis

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22
Q

What are 3 infective causes of acquired sensorineural hearing loss?

A

Meningitis
Mumps
Measles

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23
Q

4 causes of acquired conductive hearing loss?

A

Wax
Glue Ear
Otitis externa
Chronic suppurative otitis media

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24
Q

Why is it important to treat blunt trauma to the ear quickly?

A

If there is bleeding between the skin and the cartilage

the cartilage can necrose due to insufficient blood supply and then your left with a cauliflower ear

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25
Q

What is haematoma auris?

A

Bleeding between skin and cartilage in pinna

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26
Q

What is the best management for haematoma auris?

A

drain the blood

pressure dressing

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27
Q

Wehn should syringing of earwax be avoided?

A

If the eardrum is perforated

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28
Q

What is otitis externa an infection of?

A

Skin of the external ear canal

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29
Q

What is otitis externa also known as?

A

Swimmer’s ear

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30
Q

What organisms commonly cause otitis externa?

A

Pseudomonas

Staphylococcus

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31
Q

Symptoms of otitis externa?

A

Pain
Itching
Sometimes a fetid discharge

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32
Q

What is the treatment of otitis externa?

A

Clean the ear
Keep it dry
Short course of antibiotic drops

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33
Q

What can excessive and prolonged use of antibiotic drops lead to?

A

Change of normal flora

Fungal infection - otomycosis

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34
Q

What are Exostoses and what is the condition also known as?

A

Broad based bony swellings in the external ear and are thought to be an inflammatory response to cold water exposure.
Surfer’s ear

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35
Q

What are osteomas and how do they differ from exotoses?

A 
Benign bony tumour of the external ear canal.
More common in men
unilateral
not a result of cold water exposure 
narrower pedunculated
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36
Q

What is necrotising otitis externa?

A

progressive osteomyelitis of the of the temporal bone resulting from otitis externa

37
Q

Which patients are most at risk of necrotising otitis externa?

A

Patients with compromised immunity

(poorly controlled diabetes

38
Q

Symptom of necrotising otitis externa?

A

Severe, unremitting, deep seated pain that does not respond to analgesics

39
Q

What type of organism usually causes acute otitis media?

A

Virus - ascending via the Eustachian tube.

40
Q

In what age group is acute otitis media usually seen?

A

Children - they have shorter, wider and more horizontal Eustachian tubes and an immature immune system,

41
Q

4 key features of acute otitis media

A

otalgia
fever
deafness
otorrhea (if fetid this suggests anaerobic organism)

42
Q

How does a bacterial infection compare with a viral one in acute otitis media.

A

Viral are short lived

Bacterial may last for a week or more

43
Q

What makes acute otitis media so painful?

A

Build up of pus and therefore pressure behind tympanic membrane.

44
Q

How is the intense pain often relived in acute otitis media?

A

Eardrum bursts, relieving pressure

45
Q

several weeks after a bout of AOM the parents notice that their kid is still a little deaf. Whayt could cause this and is this normal?

A

There can still be some residual fluid in the middle ear for several weeks, causing some deafness and yes this is normal.

46
Q

How dos the mastoid relate to AOM and what is a known complication?

A

Mastoid abcess

47
Q

What is the key to management of AOM?

A

Analgesia

Antibiotics - not always required

48
Q

If an ear drum perforates but fails to heal and causes recurrent bouts of discharge, what is this condition?

A

chronic suppurative otitis media

49
Q

What would a patient with chronic suppurative media complain of?

A

Discharge from ear

Increasing deafness

50
Q

3 treatment options for a perforated eardrum?

A
  • reassurance and advice on water caution
  • antibiotics and water caution
  • myringoplasty
51
Q

What type of antibiotics are toxic to the inner ear?

A

aminoglycosides

52
Q

What is a cholesteatoma?

A

Following a perforated eardrum, squamous epithelium migrates from the outer ear to the middle ear and collects in a mass.

53
Q

How do complications arise from a cholesteatoma?

A

the mass can become erosive and gradually eat away at the bone and soft tissue

54
Q

What 3 locations can infection resulting from cholesteatoma spread to

A

Brain
facial nerve
inner ear

55
Q

What 5 things would make you suspect cholesteatoma in a patient with a perforated eardrum?

A 
persistent smelly discharge
no improvement with drops
severe hearing loss
dizziness
unexplained neurological signs symptoms
56
Q

7 complications of cholesteatoma?

A 
Meningitis 
facial palsy
acute mastoiditis 
labyrinthitis 
intercranial abscess
venous sinus thrombosis
57
Q

What is persistent fluid in the middle ear for 3 months or more known as?

A

Otitis media with effusion/Glue Ear

58
Q

What is the most common cause of hearing loss in children?

A

OME

59
Q

Between what ages is OME most prevalent?

A

2-7 years

60
Q

At what time of year is OME more prevalent?

A

Winter months

61
Q

What are two possible causes of OME?

A

Infection

Eustachian tube dysfunction

62
Q

What other tissue is associated with OME?

A

Adenoids

63
Q

Children with what 2 conditions are most susceptible to OME?

A

Down’s syndrome

cleft palate

64
Q

Aside from hearing loss what else might parents of children with OME also notice?

A

Dizziness

Clumsiness

65
Q

Is pain usually associated with OME?

A

No

66
Q

What is OME likely to impact if left unchecked?

A

Schooling

Behaviour

67
Q

How will the ear drum appear in a case of OME?

A

fluid level or a translucent ear drum

68
Q

What are the management steps for OME?

A

Wait 3 months
Mod-severe deafness? - grommets or hearing aid
Recurrent glue ear - adenectomy

69
Q

What is it important to reassure parents about regarding OME?

A

It’s a common condition that shouldn’t affect the child’s hearing in the long term.

70
Q

Define tinnitus

A

Noise in the ear or head in the absence of stimulus

71
Q

Is most tinnitus subjective or objective?

A

Subjective - heard only by pt

72
Q

Is tinnitus usually bilateral or unilateral

A

bilateral

73
Q

If tinnitus is pulsatile what does this suggest?

A

Due to adjacent blood vessel in head or neck

74
Q

What is age related hearing loss known as?

A

Presbycusis

75
Q

Why does unilateral tinnitus warrant a more urgent referral than bilateral tinnitus?

A

Very rarely can be a symptom of an intercranial tumour.

76
Q

Why is it important to take a drug history when a pt complains of tinnitus?

A

Many drugs, such as aspirin have a side effect of tinnitus

77
Q

What medical conditions are associated with tinnitus?

A

HTN

anaemia

78
Q

How long does it take most traumatic tympanic perforations to heal?

A

around 6 weeks

79
Q

What should pts be advised to do in the event of a tympanic perforation?

A

Keep ears dry to avoid infection

80
Q

What can arise from blunt trauma to the middle ear?

A

Haemotympanum

81
Q

What will a haemotympanum result in and what is the management of this?

A

Conductive deafness

Will usually resolve itself

82
Q

If hearing loss persists after a haemotympanum has resolved, what may have occurred and what do you do?

A

Ossicular injury

May require reconstructive surgery

83
Q

What type of hearing loss can occur with a temporal bone fracture?

A

Conductive
Sensorineural
Mixed

84
Q

What may happen to the tympanic membrane following a temporal bone fracture?

A

Perforation

Haemotympanum

85
Q

What are the possible symptoms of a temporal fracture?

A 
Deafness
Otalgia 
Otorrhoea - blood/csf
Rhinorrhoea - blood/csf
vertigo
86
Q

What is the Battle sign, when do you check for it and what does it indicate?

A

Ecchymosis of the post auricular skin
Following head injury
Fracture of the temporal bone

87
Q

What is the racoon sign, when do you check for it and what does it indicate?

A

Ecchymosis of the periorbital skin
Following head injury
Fracture of the temporal bone

88
Q

What type of investigation is necessary following a suspected temporal bone fracture?

A

CT head

89
Q

Following head trauma what examination is required of the ear?

A

Tuning fork and pure tone audiometry

402 Ear, Nose & Throat (3 decks)

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