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Flashcards in Ear exam Deck (40):
1

What is the auricle

First part of the hearing apparatus

made of cartilage (poorly perfused)

1

Things to consider when changes in balance are noted

1. vertigo (room spinning or them spinning) vs lightheadedness (had to sit down) BPPV

2. related to changes in position?

3. associated symptoms (nausea and vomiting)

2

Auriculotemporal nerve

branch of trigeminal nerve that innervates the auricle

3

What is the function of the auricle?

Channels sound to the hearing apparatus (mechanical energy)

4

Exterior auditory canal (EAC)

two segments, padded and bony, channels waves through to middle ear

5

What nerve innervates the EAC?

Facial nerve

6

Why is the back part of the EAC more sensitive?

It is skin over bone (no padding)

7

Tympanic membrane

Ear drum

8

What are the landmarks of the tympanic membrane?

Cone of light (where light reflects off drum)-absent when fluid is behing it

Bony annulus (where ear drum attaches to the bone)

9

Layers of TM

ectoderm (outer cutaneous)

middle CT

endoderm (innermost mucosum)

10

Pars tensa

where TM is tightly attached to bone

most common area where it may become perforated

along bottom arc of ear drum

11

pars flaccida

along superior arc of ear drum (attic)

where chronic disease tends to occur

12

What is the function of the TM?

transfer mechanical energy into ossicular chain

13

What is the function of the cochlea?

transfers mechanical membrane into electrical energy

14

What is the function of the Eustachian tube?

regularize pressure between the middle ear and the EAC

15

TMJ

can be diagnosed by touching the muscles inside the mouth

typically caused by muscles, not a jaw dysfunction

often presents with ear pain, but can be ruled in when no ear pathology is present

16

Things to consider when changes in hearing are noted

1. timing of loss

2. ability to understand (neurological)

3. tinnitus (abnormal noise perception in the ear)-ringing, chirping, low buzz

17

Menieres disease

presents with fluctuating hearing loss

and vertigo

 

18

speech discrimination

have a hard time with volume AND understanding what's being said

19

steps of the physical exam

inspect (auricle, external meatus)-common spot for actinic keratosis, look for skin changes, look for discharge or excess ear wax

palpate (auricle)-look for tenderness, lumps or bumps

visualize (canal and TM)-look for blockage, foreign bodies

20

external meatus

opening of EAC

21

tug test

tug gently

if pain is noted, it may indicate cnal pathology

22

why would you hold the otoscope to the side?

makes patient feel more comfortable

if pt moves, you can move with them

23

Exostosis

bony outcroppings present in the EAC

not pathological

typically seen in pts who sleep in cold water

 

24

acute otitis externa

"swimmer's ear" bacterial infection of the EAC

positive tug test

treatment includes reacidification of the ear canal

25

perforation of TM

a hole in the TM 

can be from infection or traumatic

26

bullous myringitis

infection of the ear drum itself (usually combined with infection of the middle ear)

extremely painful

atypical bacteria

27

acute otitis media

bulged out ear drum

hyperemic (highly vascularized)

cone light present but not in the right spot

28

glomus tumor

zebras (not very common)

vascular tumor

may be in front of or behind the TM

pulsatile tinnitus

29

hemotymanum

blood in the middle ear space

posterior nose bleeds

caused by basalar skull fracture

30

serous otitis media

serous fluid in the middle ear (does not indicate infection)

give it time to go down

31

conductive hearing loss

disruption of sound energy through outer and middle ear

32

sensorineural

hearing loss caused by problems with the end organ

33

Weber tuning fork test

not used all that often

tests for lateralization of hearing loss

34

unilateral conductive loss

"i can hear it in the "bad" ear" 

indicates a conductive loss in the bad ear

35

unilateral s/n loss

"i hear it in the good ear"

indicates that the bad ear is experiences sensorineural loss

36

Rinne tuning fork test

used to test air conduction vs. bone conduction

(which is louder one or two)

37

normal Rinne test results

air conduction > bone conduction

38

Rinne results that indicate conductive loss are

bone conduction > air conduction

39

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