What are the boundaries of the middle ear?
The tympanic membrane laterally and the cochlea medially.
The stapedius is the smallest muscle of the body. What never innervates it?
CN VII (facial nerve)
The inner ear is made up of the body labyrinth and the membranous labyrinth. Which is filled with perilymph and which is filled with endolymph?
BL: Perilymph
ML: Endolymph
Name the four sinuses.
Ethmoidal, sphenoidal, frontal, and maxillary.
which sinuses are present at young
The frontal and sphenoidal.
The the sinuses drain into the middle nasal meatus except the posterior ethmoidal and the sphenoidal. Where do these drain?
What drains into the inferior meatus?
Posterior ethmoidal: Superior nasal meatus
Sphenoidal: Superior nasal meatus
Nasolacrimal duct
Tophi, seen here, may be a manifestation of what condition?
Gout
What ear condition is seen here?
Keloid
Pain or tenderness felt during the palpation of the external ear can be indicative of what?
What is this commonly caused by?
Pain over the mastoid process may indicate what?
An infection of the external auditory canal (otitis externa)
Pseudomonas
Middle ear infection (otitis media)
Identify the jumbo, cone of light, incus, pars tensa, pars flaccida, handle of malleus, and short process of malleus.
What is the umbo?
How can you visualize the swelling of the tympanic membrane during the valsalva maneuver?
- Pars flaccida
- Incus
- Pars tensa
- Short process of malleus
- Handle of malleus
- Umbo
- Cone of light
The central attachment of the malleus to the tympanic membrane.
The cone of light will move.
Lateralization can occur in the Weber test. What does this indicate in conductive hearing loss?
In sensorineural hearing loss.
In conductive hearing loss the sound is lateralized to the side with the hearing deficit and in sensorineural hearing loss the sound is lateralized to the side without the deficit.
In the Rinne test what is the normal ratio of AC to BC?
A +ve Rinne test means what?
AC:BC = 2:1
Normal, ie. AC>BC
Does the following cause conductive or sensorineural hearing loss?
- Infection
- Hair cell damage
- Meniere’s disease
- Tumors
- Scarring
- Aspirin toxicity
- Conductive
- SN
- SN
- Conductive or SN
- Conductive
- SN
Does the following cause conductive or sensorineural hearing loss?
- Build up of cerumen
- Punctured ear drum
- CN VIII damage
- Cochlear otosclerosis
- Fixation of ossicles
- Inner ear infection
- Conductive
- Conductive
- SN
- SN
- Conductive
6 SN
What is the Romberg test?
A deficiency in this test in which the patient sways to the one side could indicate?
A deficiency in this test in which the patient sways irregularly on both sides could indicate?
It is a test in which you have the patient close their eyes, cross their arms in front of their chest, and attempt to walk a straight line.
Unilateral peripheral or cerebellar lesions (swaying to the affected side)
A central lesion
Failure of transillumination of the sinuses could indicate what?
Percussion of the sinuses is performed to assess for pain. What sound would indicate thickened mucosa, fluid, or solid in the sinus cavity?
Poor technique, thickened mucosa and fluid or solid in the cavity.
Dull
Why are children more prone to developing middle ear infections?
Because their eustachian tube is straight and short which provides a quick and easy pathway for bacteria to travel along and cause infection.
Where is CN VIII’s nuclei (cochlear & vestibular nuclei) located?
In the pons
The fibrous nodules seen here may be an indication of what condition?
Leprosy
Tender pre and post auricular lymph nodes could indicate what ear condition?
The whisper test is testing for what?
An external ear infection
Hearing loss
What tuning fork is used for the Weber and Rinnes test?
512 Hz
What occurs in otosclerosis?
It is a congenital condition where there is fusion of the ossicles which leads to conductive deafness.
What is a common non-traumatic cause, of eardrum perforation?
Does this heal quickly?
Untreated otitis media
No
What is bullous myringitis seen here?
A painful inflammation of the tympanic membrane caused by either a virus or bacteria.
Cholesteatoma and tympanosclerosis are two methods of healing perforations. Which can result in conductive hearing loss?
Cholesteatoma
Nasal polyps can result from what?
How does the nasal mucosa appear in a patient with allergic rhinitis?
Long term use of aspirin
Pale appearing
