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ear txs > ear 1/2 Buzz info > Flashcards

ear 1/2 Buzz info Flashcards

1
Q

what are the sensory hearing loss causes?

A

-noise
-head trauma
-systemic dx
-ototoxic drug

infxn:
-Meniere syndrome
-labyrinthitis

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2
Q

Auditory and vestibular systems use:

A

both hair cells to transduce mechanical forces into action potentials.

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3
Q

what are neural hearing loss causes?

A

-acoustic neuroma
-multiple sclerosis
-auditory neuropathy

infxn:
-Meniere syndrome
-labyrinthitis

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4
Q

Hair cells are located in

A

a fluid filled sensory organ called the membranous labyrinth.

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5
Q

The cochlea is the =

A

auditory component.

-afferent neurons exit cochle→ form auditory nerve

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6
Q

The otoliths organs utricle/saccule and the semicircular canals is the →

A

vestibular components of labyrinth → CN8

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7
Q

-Pitch (tone):measured in

A

HERTZ : Higher frequency= higher pitch

-the ear usually receives higher pitches @ the beginning and the apex receives the lower pitches

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8
Q

Intensity (loudness) : measured in

A

DECIBELS → amplitude

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9
Q

Sound travels through

A

ossicles→ sound vibration→ vibration in fluid mov’t that stimulate hair cells→ action potential

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10
Q

Hearing loss: 2 types

Most common due to :

A

Sensorineural (SNHL)
Conductive (CHL)

CERUMEN IMPACTION (WAX), ETD ( CHL), age related hearing loss (SNHL)

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11
Q

Sensorineural Hearing Loss (SNHL):
Etiology:

A

-genetic make up influences all causes of hearing loss

-hair cells of cochlea

-cochlear branch of CN8 ( damage to the nerve)

-areas if the brain that process auditory information

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12
Q

Presbycusis:
Etiology:
sx:

A

most frqt cause of sensory hearing loss

–progressive, predominantly high frequency and symmetric

Etiology: noise trauma, drug exposure, genetic predisposition

SX: loss of speech descrimination

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13
Q

-sounds > 85 dB = cochlea injury

A
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14
Q

Ototoxicity:

A

Cause DEATH OF SENSORY HAIRS (auditory and vestibular)

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15
Q

Most common ototoxic meds:

A

-aminoglycosides (neomycin, gentamicin)–> avoid in ototoxic ear drops in TM

-loop diuretics

-platinum based antineoplastic agents (cisplatin)

-ASA/NSAIDS

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16
Q

Sudden SNHL:
Dx:

A

-idiopathic sudden loss of hearing in ONE EAR
->20 yrs old

Diagnosis:
-Audiogram and MRI

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17
Q

Congenital and Genetic Hearing loss:

A

Congenital- present at birth

Genetic HL- discovered later

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18
Q

Most acquired prenatal cause:

Specific PE findings associated with :

A

-intrauterine infxn ( CMV)

-pre auricular pits and tags
-lateral displacement in the inner corner of the eyes
-hetero iridis
PE abn → risk abn. Of hearing

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19
Q

Conducting Hearing Loss (CHL):

A
  • external or middle ear dysfunction
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20
Q

Conducting Hearing Loss (CHL):

4 main mechanisms= impairment of the passage of sound vibrations to the inner ear:

A

-obstruction: cerumen ( wax) impaction
-mass loading: middle ear effusio, ETD ( not allowing ™ to move)
-stiffness: scarring of ™
-discontinuity-oscillar disruption

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21
Q

Otosclerosis:
Etiology :
Sx:
PE:
Diagnostic:

A

abnormal overgrowth of the footplate of the stapes→ conductive hearing loss

Etio: autosomal dominant disorder of abnormal resorption and deposition of the bone in the otic capsule.

Sx: gradual progressive conductive hearing loss 20s-40s, initially low frequency hearing loss

PE: normal otoscopic exam, Weber and rinne (CHL)

Diagnostic:
Audiometry and CT temporal bone

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22
Q

Gross auditory Acuity :

A
  • pt in a quiet room would repeat aloud the words presented in a soft whisper.

512 hz tuning fork is useful in differentiating conductive from sensorineural losses.

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23
Q

Weber test:

CHL:
SNHL:
Normal:

A

tuning fork is PLACED ON TOP PT HEAD and sound is interpreted by pt

Normal= sounds the same bilaterally

CHL= sounds louder in the affected ear

SNHL= sounds louder than normal in the non affected ear

24
Q

Rinne test:

normal:
CHL:
SNHL:

A

tuning fork is placed on the mastoid bone then at the entrance of EAC.

Normal air conduction > bone conduction : can hear the sound in both places

CHL= Bone conduction > air conduction: CANNOT hear the sound @ EAC

SNHL= air conduction > bone conduction: normal

25
Q

Audiometric Testing:

Pure tone testing:

A

-performed in sound proof room

threshold in decibels are obtained over the range of 250-8000 Hz for both air and bone conduction. ( ear phone and bone oscillator) and speech audiometry

26
Q

Conductive losses-

Sensorineural losses-

A

C:create gap btw air and bone thresholds

S:both air and bone thresholds are equally diminished

27
Q

Tympanometry:

A

measures how well the ™ moves

[helps see if child has ear infxn]
-small probe inserted in each ear

28
Q

Otoacoustic Emissions

A

evaluates cochlear fxn

29
Q

Auditory brainstem evoked responses:

A

determines the lesion is sensory[cochlea] or neural [CN8/brain].

30
Q

Otoacoustic Emissions if + and = means?

Important for ?

A

-Pts w normal hearing = (+) OAEs

-Blockage in outer ear= no sounds = no vibrations come back

IMPORTANT IN NEWBORN HEARING EXAM

31
Q

Pure tone testing:

A

requires a quiet testing environment w low levels of background noise, sound from low to high pitch is recorded on the audiograms horizontal axis

On the graph , the right ear is O and the left is X.

32
Q

Auditory Brainstem response (ABR):

A

recording of the activity CN7 and the brainstem/brain response to an auditory signal.

Electrodes are put on the head and record the brain wave activity in response to sounds heard through headphones.

33
Q

what CONFIRMS COCHLEA AND BRAIN PATHWAYS WORK TO HEAR

A

Auditory Brainstem response (ABR):

34
Q

Tinnitus:

Etiology:

A

perception of sound in the absence of an actual external sound

Etiology: associated with high frequency SNHL medications, any lesions
[assoc. W depression, anxiety, personality disorders]

35
Q

Tinnitus :

Sx:
Diagnostic tests:

A

Sx: quiet background noise ,non pulsatile, pulsatile ( hearing your heartbeat), staccato ( middle ear spasm)

Diagnostic tests:
™ studies,
screening tests: rinne/weber, audiometry ( tinnitus )

GOAL IS TO LESSEN TINNITUS AND ITS IMPACT ON QUALITY OF LIFE

36
Q

Bilateral tinnitus:

A

prolonged noise exposure, systemic damage the cochlear hairs

37
Q

Unilateral tinnitus:

A

™ damage, impact cerumen, meniere’s dx, recurrent ear infxn, ossicle damage, trauma

38
Q

Macula detects

A

→ linear acceleration/deceleration, detects head tilt

39
Q

Semicircular ducts/ canals:

A

detects ROTATIONAL ACCELERATION DECELERATION

40
Q

Vestibular labyrinth

A

-utricle, saccule and 3 semicircular ducts

41
Q

Utricle and saccule

A

-(linear acceleration)

42
Q

3 semicircular ducts

A

-(rotational acceleration)

-ampullae [base of semicircular ducts] houses the sensory area [crista ampullaris]
-innervated by CN8

43
Q

Vertigo:
Etio:

A

false sensation of motion [HISTORY IS IMPORTANT!!!]

Etio: damage to or dysfxn of the labyrinth, vestibular nerve or central vestibular structures in the brainstem.

“Spinning sense, sense of falling backward/forward, sensation /out motion, exaggerated motion

44
Q

Vertigo:
peripheral and central

A

Peripheral: vestibular nerve or labyrinth
-sudden onset, horizontal or torsional ( eyeball movt)

Central: brainstem or cerebellum
-gradual onset

45
Q

Meniere Dx/syndrome:
Positive sx:

duration!!!

A

compartment of inner ear due to EXCESS FLUID

Positive sx = allergies, hormonal imbalance, trauma, infxns [ SYPHILIS]

Duration: MINUTES- HRS.

46
Q

Vestibular neuronitis and labyrinthitis:

Etio:

Patho:
SX:

A

Etio:
Vestibular neuronitis: inflammation of the vestibular portion of CN8

Labrynthitis: inflammation of vestibular & cochlear portion of CN8

Pathophysiology:
Infectious microorganisms or inflammatory mediators invade the membranous labyrinth and damage the vestibular and auditory end organs

Sx:-
-continous vertigo

47
Q

VESTIBULAR NEURITIS IF NO SX →

duration:

PE:

Diagnostic:

A

-HSV OR VARICELLA

Duration: SEVERAL DAYS TO WEEKS

PE:
-look for recurrent infxn, rotary horizontal nystagmus

Diagnostic studies:
-audiogram
-electronystagmography
-mri of brain

48
Q

Benign Paraoxysmal positional vertigo:

A

abnormal sensation of motion for certain positions that trigger nystagmus and vertigo. [small movt= huge movt]

49
Q

Benign Paraoxysmal positional vertigo:

SX:

A

Patho:
-migration of OTOLITHS from utricle/sacule to the posterior semicircular canal

  • otoliths dislodges→ crystal in wrong place= excess movt when there isnt

Sx: sudden onset, episodic vertigo

50
Q

Benign Paraoxysmal positional vertigo:

DURATION!!!

provoked by:

PE:

if recurrent?

A

Duration:
LASTS 20 SECS- 1 MIN

-Provokes by changes in head position (rolling over, bending over, standing up)

PE:
-ENT and neurological exam
-DIX HALLPIKE TEST: torsional nystagmus stimulate heas movt and see nystagmus ( eye movt)

recurrent cases need MRI

51
Q

Types of Vertigo testing :

Vestibulo-ocular reflex:
Electronystagmography:
Video-nystamography:
Dix hall pike maneuver:

A

Vestibulo-ocular reflex:allow for eye fixation on a stationary target while head is in motion. Must have intact vestibular system to work.
Electronystagmography: electrodes to record nystagmus

Video-nystamography: video cameras to record nystagmus

Dix hall pike maneuver: evokes nystagmus due to head position

52
Q

new onset vertigo=

A

early sign of stroke, migraine
brain stem compression

53
Q

Peripheral Vestibular dx:

A

-SUDDEN ONSET VERTIGO
-so severe that pt is unable to walk
-fatigable nystagmus

Trigger:s: diet, stress, fatigue, bright lights

54
Q
A
55
Q
A

ear txs (2 decks)

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