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Ears MDT Flashcards

(73 cards)

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1
Q

What is auricular hematoma?

A

Accumulation of blood in the subperichondrial space, secondary to blunt trauma

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2
Q

What can auricular hematoma result in?

A

Cauliflower ear

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3
Q

What will you find on physical examination of Auricular Hematoma?

A

Loss of landmarks

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4
Q

Separation of perichondrial blood vessels in auricular hematoma can result in what?

A

Necrosis

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5
Q

How should auricular hematoma be treated?

A
  • incision should be made not to violate perichondrium
  • incision should be on inner curvature of helix or antihelix
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6
Q

What should be done after auricular hematoma drainage?

A
  • Splinting of ear
  • Apply Neosporin BID
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7
Q

How should live objects be dealt with in the ear?

A

2% lidocaine solution to drown them

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8
Q

Sx of ear foreign body

A
  • specific MOI
  • muffled sounds
  • severe pain
  • hearing distrubances
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9
Q

What temperature should water for ear irrigation be?

A

Room-temp

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10
Q

What equipment can be used to assist in ear foreign body removal?

A
  • cerumen loops/scoops
  • right angle alligator/alligator forceps
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11
Q

If you cannot see the TM, should you still irrigate?

A

No, unsure if TM is perforated

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12
Q

What are some c/c of patients with cerumen impaction?

A
  • decrease hearing
  • sensation of pressure or fullness
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13
Q

What worsens cerumen impaction?

A

Q-tips

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14
Q

What equipment can you use for cerumen impaction?

A
  • Loops and scoops
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15
Q

If irrigating the ear, what is the procedure?

A
  • 18 gauge IV catheter
  • Body temp water
  • irrigate along superior portion utilizing pressure of stream to help break up/dislodge impaction
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16
Q

What medication can assist cerumen impaction?

A

Carbamide Peroxide (Debrox) 2-5 drops BID for max 4 days

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17
Q

What is a common injury after ear irrigating?

A

TM Perforation

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18
Q

What is mastoiditis?

A

Mastoid cavity becomes a closed space after a blockage occurs

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19
Q

Mastoiditis is normally a complication of what condition?

A

Otitis media

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20
Q

What will you find on physical examination of mastoiditis?

A
  • Post auricular pain, erythema with spiking fever
  • obliteration of post auricular crease
  • protrusion of the auricle
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21
Q

What radiologic studies should be done with mastoiditis?

A
  • Mastoid radiography
  • CT
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22
Q

What lab should be done with mastoiditis?

A

Culture of drainage

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23
Q

Medications for mastoiditis

A
  • Ceftriaxone
  • Levofloxacin
  • Cefazolin
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24
Q

What should be done with mastoiditis after MEDEVAC?

A
  • Admission
  • I&D
  • possible mastoidectomy
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25
What is otitis externa?
Diffuse inflammation of external ear canal with or without inflammation of auricle and/or TM
26
What are most common organisms associated with otitis externa?
Staphylococcus (10-70%) Pseudomonas (20-60%)
27
Findings leading to otitis externa?
- purulent exudate - hx of recent water exposure or mechanical trauma
28
What lab should be done for otitis externa?
Gram staining of discharge
29
How should you dry otitis externa?
50/50 mix isopropyl alcohol/white vinegar
30
What medications can you give for otitis externa?
Neomycin/Polymxin B Ciprofloxacin Otic
31
What is otitis media?
Bacterial infection of mucosal lined, air containing spaces of the temporal bone
32
Otitis media is precipitated by what condition?
URI
33
Common pathogens of otitis media?
- strep pneumonia - hib - strep pyogenes
34
Physical findings of otitis media
TM bulging, mastoid tenderness
35
Labs for otitis media
Tympanocentesis Fungal culture
36
Medications for otitis media
Amoxicillin Augmentin PCN Allergy Cefrtriaxone Doxycycline Nasal decongestants
37
What is Eustachian tube dysfunction?
Disorders involving impairment in the functional valve of the Eustachian tube of the middle ear
38
What is patulous Eustachian tube dysfunction?
Excessively open or dilatory dysfunction
39
What kind of sensation does Eustachian tube disorder have?
Full ness or underwater sensation
40
Treatment for Eustachian tube dysfunction?
Pseudoephedrine Oxymetazoline Flonase Cetirizine Fexofenadine
41
TM perforations are secondary to what conditions?
Barotrauma, blunt/penetrating/acoustic trauma or lightning strikes
42
Where on the TM is perforation most likely to occur?
Pars tensa
43
Signs of TM perforation?
Visible perforation, otorrhea from canal
44
How does the TM heal?
Spontaneous healing occurs in most cases
45
If foreign material is suspected in TM perforation, what medications should be given?
Antibiotics - Augmentin - Doxycycline
46
Perforations secondary to trauma should be referred where?
ENT (otolaryngologist)
47
What is cholesteatoma?
Benign tumor in the middle ear or mastoid
48
What is the most common cause of cholesteatoma?
Eustachian tube dysfunction
49
What structures get eroded as cholesteatoma expands?
Ossicular chain, bony labyrinth or facial nerve canal
50
How is cholesteatoma treated?
Surgery
51
What is barotrauma?
Damage to the TM due to rapid changes in pressure
52
What is dx o f barotrauma based on?
Accurate hx and physical exam
53
Most common cause of barotrauma?
Flying
54
Sx of barotrauma
- Hearing loss -Middle Ear pain
55
Severe cases of barotrauma present with what findings?
- Sensorineural hearing loss - Vertigo
56
What is found upon physical exam of barotrauma?
- Conductive hearing loss - TM Perforation/Bulging - May have fluid
57
How would you treat barotrauma?
Treat predisposing conditions
58
How does mild cases of barotrauma resolve?
Spontaneously
59
When should patients with barotrauma be referred?
- Inner Ear exposure - Sensorineural hearing loss
60
What is sudden hearing loss divide into?
Sensorineural and conductive
61
What structures are involved with sensorineural hearing loss?
Cochlea, Auditory nerve or Central Auditory processing
62
What structures are involved with conductive hearing loss?
External ear, TM, Ossicles
63
What is conductive hearing loss more likely due to?
Reversible causes such as: - Otitis media - Serous Otitis - Cerumen Impaction
64
What is sensory hearing loss more likely due to?
Irreversible causes, such as disease of the cochlea
65
What is the most common cause of sensory hearing loss?
Progressive, high-frequency loss with advancing age (presbyacusis)
66
What frequency does noise trauma begin?
4000hz
67
What tests should be done with patients with hearing loss?
- Audiogram - Weber and Rinne
68
What treatments should be done for hearing loss?
- Remove member from exposure - Earplug education - Referral to ENT if further eval is needed
69
What causes tinnitus?
Damaged hairs may move randomly sending impulses to the brain
70
What are some objective causes of tinnitus?
Turbulence in carotid artery or jugular vein and TMJ problems
71
Is the precise pathophysiology of tinnitus known?
Nope
72
What are the 2 types of tinnitus?
Objective and subjective
73
Sx of tinnitus
- "Ringing noise" - Conductive hearing loss - Noise intolerance

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