Ear Quiz Flashcards by Joseph Heston

Examples of reported current or past symptoms that should always be correlated with the structural and functional physical findings of the ear

Earache 
Aural discharge 
Hearing loss
Vertigo 
Tinnitus

How well did you know this?

Not at all

Perfectly

Should be examined for inflammation, rashes, sebaceous cysts, cancerous lesions, tophi, and deformity

External ear

How well did you know this?

Not at all

Perfectly

How long is the ear canal?

1-1.5 inches

How well did you know this?

Not at all

Perfectly

What part of canal contains cartilage, cerumen glands, and hair?

Outer 1/3

How well did you know this?

Not at all

Perfectly

How is the auricle displaced to allow better viewing of the auditory canal?

Posterior and superior (canal runs superior, then inferior toward the drum and runs a little posterior to anterior)

How well did you know this?

Not at all

Perfectly

Typically present to some degree in the ear canal. Creates an acidic coat that probably prohibits bacterial and fungal growth

Earwax

How well did you know this?

Not at all

Perfectly

Fresh earwax should be _____ colored and is pumped out of the ear by the ________

Honey colored

TMJ

How well did you know this?

Not at all

Perfectly

Color of very old earwax

Dark/Black

How well did you know this?

Not at all

Perfectly

How can earwax cause hearing problems?

If the wax becomes excessive or impacted against the ear drum (removal of wax restores hearing)

How well did you know this?

Not at all

Perfectly

An abnormal, benign, boney growth of the temporal bone what may occasionally be seen protruding into the canal

Exostosis

How well did you know this?

Not at all

Perfectly

A canal infection often due to swimming or canal damaging cleaning. (“Swimmers ear”)

Otitis externa

How well did you know this?

Not at all

Perfectly

S/S of Otitis externa

Earache
Red and swollen ear canal
Possible discharge

How well did you know this?

Not at all

Perfectly

T/F Fungal overgrowth will most commonly cause otitis externa

FALSE.

MC is bacterial infections (fungal overgrowth = 10% of otitis externa)

How well did you know this?

Not at all

Perfectly

Symptom that differentiates bacterial vs. fungal otitis externa

Fungal will producing pruritis (itching) rather than pain (bacteria)

How well did you know this?

Not at all

Perfectly

Makes up the middle ear

Eardrum (Tympanic membrane)
Tympanic cavity
Ossicles

How well did you know this?

Not at all

Perfectly

Parts of the tympanic membrane

Attic portion = pars flacida

- Lower 2/3 = pars tensa

How well did you know this?

Not at all

Perfectly

T/F The tympanic cavity is convex shapped and tipped away from the examiner

FALSE.

It is concave shaped and tipped toward the examiner

How well did you know this?

Not at all

Perfectly

What bone is the tympanic cavity located in?

The temporal bone

How well did you know this?

Not at all

Perfectly

Ossicles of the middle ear

Malleus
Stapes
Incus

How well did you know this?

Not at all

Perfectly

What makes the tympanic membrane landmarks?

Created by the malleus pressed up against the inside of the ear drum

How well did you know this?

Not at all

Perfectly

Rounded part of the malleus at the interface of the pars flacida and pars tensa

Short process

How well did you know this?

Not at all

Perfectly

The handle of the malleus which angles toward the posterior

Long process

How well did you know this?

Not at all

Perfectly

The triangular reflection of light from the otoscope with its apex at the end of the long process and angling anterior at the margin of the tympanic membrane

Light reflex (Triangle of Light)

How well did you know this?

Not at all

Perfectly

Collapse of the auditory tube due to pressure

Barotrauma

How well did you know this?

Not at all

Perfectly

Collapse of the auditory tube due to swollen adenoids

Adenoidal hypertrophy

Occlusion of the lumen of the auditory tube secondary to an upper respiratory infection or allergy

Mucosal swelling and Excess mucus

How does the occlusion of the auditory tube cause pain?

Air trapped in the tube gets absorbed and creates a vacuum which retracts the eardrum, causing pain

4 fluids that can accumulate in the middle ear

1) Pus 2) Serrous 3) Mucus 4) Blood

A middle ear infection common to children between six months and 6 years old. Classic signs and symptoms include earache, fever, diminished or absent landmarks, and pus visible against the drum.

Suppurative Otitis Media

In children with otitis media but without fever and vomiting, antibiotic treatment has ___________

Little benefit and a poor outcome was unlikely

_______ is yellow therefore the eardrum may appear yellow. What else can accompany this?

Serous fluid | Air bubbles and fluid lines

______ is thick and viscid, therefore the ear drum may appear darker than normal.

Mucus (glue ear)

T/F With serous fluid or mucus in the ear, hearing is not diminished.

FALSE. | Hearing is diminished because the ossicles are unable to conduct sound as well

Causes of bloody effusions

- Temporal bone fractures | - Shearing force causing bleeding of the mucosa

Increases chances of developing middle ear effusions

- Crowded child care facilities - Second hand smoke - Bottle-fed infants

Conventional treatment for middle ear effusions as recommended by the CDC

WASP (Wait And See Prescription)

Recommended for children with 3 episodes of middle ear effusions in a six month period or persistent fluid (3 months with hearing loss and unresponsive to antibiotic therapy).

Tympanostomy tubes

White calcium patches on the drum resulting from old perforations, chronic inflammation, or previous tubes in the ear

Tympanosclerosis

Cystic masses composed of epithelial cells and cholesterol in the middle ear. May appear as a white nodule pressed against the inside of the drum.

Cholesteatomas

Cholesteatomas can result from _________, _______________, and perforations. The cyst erodes surrounding bones and ossciles and may cause________

Congenital defects Complications of chronic otitis media Hearing loss

Results from abnormal ossification of the ossicles especially fixation of the stapes to the oval window.

Otosclerosis

Normal range for the "finger rustle" test. Would this be more or less if someone had otosclerosis?

About 2 ft. | Would be less than 2 ft. if someone had otosclerosis

Test findings that indicate otosclerosis

- Finger rustle diminished on the affected side - Weber's test will lateralize to the affected site - Air time will be less than bone time in Rinne' test

Classic signs/symptoms of inner ear problems

-Vertigo (dizziness) -Tinnitus (ringing ears) -Sensory hearing loss (nausea, vomiting, visual, and emotional problems are all usually secondary to vertigo)

Tuning forks can further differentiate __________ pathway problems from __________ and _________

Air-conduction pathway Noise-induced hearing problems Labyrinthitis

A vibrating fork is placed in the midline of the head and the patient is asked if they hear better in the right or left ear

Weber test

Normal finding for a Weber test

Patient hesitates to answer

What pathway does the Weber test evaluate?

Bone-conduction pathway

________ of the Weber test leaves the examiner with two possibilities 1) a significant ________ problem or 2) significant __________ problem

Lateralization Air conduction Sensorineural

Test to compare bone conduction to air conduction is Weber shows lateralization

Rinne' test

Normal finding for the Rinne' test

Should hear the tuning fork twice as long through the air then through bone

What would cause a person to hear the tuning fork longer through bone than air (Rinne' negative)?

Significant canal or middle ear problem (obstruction, ossification, etc.)

What would cause a person to hear the tuning fork longer through air then bone, but not twice as long?

A significant sensorineural problem.

What does it imply if a person can't hear the tuning fork by either bone or air conduction?

Total sensorineural loss

Number one reason for snsorineural hearing loss

Presbycusis (age related hearing loss)

Second most common cause of sensoineural hearing loss.

Noise induced hearing loss

Most common occupational and environmental hazard for hearing loss

Noise

Affects 10% of U.S. population. Originates from problems anywhere in the auditory pathway. Most cases result from the same conditions that cause conductive and sensorineural hearing loss

Tinnitus

What conditions are associated with Tinnitus, although the exact mechanism behind it is unclear?

- Skull fractures - Closed head injury - Whiplash injury - TMJ disorders

Generally thought to be caused by a viral infection, symptoms include reduced or distorted hearing and vertigo.

Labyrinthitis

T/F Labyrinthitis is always painful

FALSE. | It is not painful

T/F Vertigo is exclusive to labyrinthitis

FALSE. | Any lesion in a part of the vestibular system can cause vertigo

Ear Red Flags

- Sudden or rapidly progessive hearing loss - Vertigo - Unilateral or pulsatile tinnitus - Bleeding due to foreign object or pressure change injury

Common causes of otitis externa

- Excessive cleaning of the auditory canal | - Swimming

Physical findings of otitis externa

Red, swollen canal with canal debris or discharge

Eustachian tube blockage is often seen in children ______ who've had a history of ________

Physical findings of Eustachian tube blockage

Prominent landmarks due to drum retraction. | -no signs of inflammation

Suppurative otitis media is often seen in children ______ who've had a history of ________

Physical exam findings of Suppurative otitis media

Fever, diminished hearing, red and bulging ear drum

T/F Excessive ear wax is found most commonly in males who use Q-tips (may be also insidious)

True

Serrous or mucoid effusions are often seen in children ______ who've had a history of ________

Physical exam findings of Serrous or mucoid effusions

Normal, yellow, or dark tympanic membrane with possible air bubbles or fluid lines.

T/F Otosclerosis is seen in adolescents and is not genetic

FALSE. | Seen in adults with a family history of otosclerosis

T/F Otosclerosis produces no physical findings of the canal or eardrum

True

What freqeuncy sounds are lost first in someone with noise induced hearing loss?

High frequency sounds (3,000 to 6,000 Hz)

T/F Noise induced hearing loss will always produce a ruptured tympanic membrane on oticscope exam

FALSE. | Only if extremely severe. Most of the time, it produces no obvious signs in the canal or middle ear.

Typical patient profile for someone with Presbycusis

Elderly

Symptom characteristics of someone with Presbycusis

Complaints that others are mumbling or that they can't understand what's being said when there's background noise (low frequency sounds and whispers are first to go)

Physical exam findings of Presbycusis

Rinne' AC > BC, but less than 2:1 ratio

Ear Quiz Flashcards

(79 cards)