Exam 1 Review Flashcards
The auditory ________ form a chain of _____ small bones called the malleus, _____, and stapes.
These bones connect the ________ membrane with the _____ ear.
The _________ recess or the attic contains the _____ half of the malleus and the greater part of the _____.
The auditory OSSICLES form a chain of THREE small bones called the malleus, INCUS, and stapes.
These bones connect the TYMPANIC membrane with the INNER ear.
The EPITYMPANIC recess or the attic contains the UPPER half of the malleus and the greater part of the INCUS.
The _______ face of the tympanic cavity is known as the ______ ______.
The ______ tympani is a thin plate of bone that _________ the cavity from the cranium and the _________ coverings of the brain.
This is also known as the ______ or roof. There are four ________ attached to the tegmen tympani that ______ the ossicles.
The SUPERIOR face of the tympanic cavity is known as the TEGMEN TYMPANI.
The TEGMEN tympani is a thin plate of bone that SEPARATES the cavity from the cranium and the MENINGEAL coverings of the brain.
This is also known as the CEILING or roof. There are four LIGAMENTS attached to the tegmen tympani that SUSPEND the ossicles.
The inferior surface of the _______ cavity is formed by the tympanic _____ of the temporal bone.
The ______ tympani is a thin plate of bone which _________ the tympanic cavity from the ______ fossa.
The jugular fossa is a large ______ that accommodates the jugular ____.
The inferior surface of the TYMPANIC cavity is formed by the tympanic PLATE of the temporal bone.
The FUNDUS tympani is a thin plate of bone which SEPARATES the tympanic cavity from the JUGULAR fossa.
The jugular fossa is a large GROOVE that accommodates the jugular VEIN.
The membranous or ______ ____ of the tympanic cavity is formed mainly by the tympanic membrane or ________, partly by the ring of bone into which the membrane is _______.
The ring of ____ is incomplete at its upper part, forming the _____ of ______.
The membranous or LATERAL WALL of the tympanic cavity is formed mainly by the tympanic membrane or EARDRUM, partly by the ring of bone into which the membrane is INSERTED.
The ring of BONE is incomplete at its upper part, forming the NOTCH of RIVINUS.
The ______ wall of the tympanic cavity is also known as the ___________ wall, and the ________ wall. On the other side of the wall is the ______ or _____ ear.
There are __ important landmarks here. Superiorly to inferiorly is the ____ window, promontory, and the ______ window
The oval window is where the _________ of the ______ sits.
The _________ is a protrusion which ________ the ___ openings to the _____ ear.
The _____ window is with a thin, but tough ______ membrane.
The MEDIAL wall of the tympanic cavity is also known as the LABYRINTHINE wall, and the COCHLEAR wall. On the other side of the wall is the COCHLEA or INNER ear.
There are 3 important landmarks here. Superiorly to inferiorly is the OVAL window, PROMONTORY, and the round window
The oval window is where the FOOTPLATE of the STAPES sits.
The PROMONTORY is a protrusion which SEPARATES the TWO openings to the INNER ear.
The ROUND window is covered with a thin, but tough ELASTIC membrane.
The posterior wall or the _______ wall of the tympanic cavity contains 3 important landmarks.
These landmarks include the ________ aditus, the _________ emminence, and the ______ tympani ______.
Tympanic aditus is the _______ to the tympanic ______.
The pyramidal ________ is here and _______ the ________ muscle.
The chorda ______ nerve is a branch of the _____ nerve that courses through the ______ ear and runs along this wall.
The posterior wall or the MASTOID wall of the tympanic cavity contains 3 important landmarks.
These landmarks include the TYMPANIC aditus, the PYRAMIDAL emminence, and the CHORDA tympani NERVE.
Tympanic aditus is the ENTRANCE to the tympanic ANTRUM.
The pyramidal EMINENCE is here and CONTAINS the STAPEDIUS muscle.
The chorda TYMPANI nerve is a branch of the FACIAL nerve that courses through the MIDDLE ear and runs along this wall.
The _______ face, sometimes call the _______ wall. The internal carotid artery runs _______ this wall.
Major auditory landmark is the _________ tube.
The eustachian tube is the _______ through which the tympanic _____ communicates with the _____ part of the _______.
The ANTERIOR face, sometimes call the CAROTID wall. The internal carotid artery runs BEHIND this wall.
Major auditory landmark is the EUSTACHIAN tube.
The eustachian tube is the CHANNEL through which the tympanic CAVITY communicates with the NASAL part of the PHARYNX.
The ossicular chain has 2 purposes, ________ matching and ________ from hazardous noise.
The tympanic cavity functions to _____ sound efficiently from ___ to _____.
The _______ window allows for fluid _________ in the cochlea and the _________ tube functions to ________ pressure.
The ossicular chain has 2 purposes, IMPEDANCE matching and PROTECTION from hazardous noise.
The tympanic cavity functions to TRANSMIT sound efficiently from AIR to FLUID.
The ROUND window allows for fluid DISPLACEMENT in the cochlea and the EUSTACHIAN tube functions to EQUALIZE pressure.
In impedance matching..
When sound in air _______ a fluid boundary there is a theoretical loss of __._% of the energy in a sound wave in air due to reflection.
The effective vibrating _____ of the middle ear is 17 times ________ than the _____ window (3.2mm2) causing a __________ of pressure on the oval window.
The mass of the _______ and _____ over the mass of the stapes resulting in a greater force _______ at the stapes than applied at the TM. 1.3:1
The TM is ______ in shape causes the force to be _________ more effectively
In impedance matching..
When sound in air STRIKES a fluid boundary there is a theoretical loss of 99.9% of the energy in a sound wave in air due to reflection.
The effective vibrating AREA of the middle ear is 17 times GREATER than the OVAL window (3.2mm2) causing a CONCENTRATION of pressure on the oval window.
The mass of the MALLEUS and INCUS over the mass of the stapes resulting in a greater force RECEIVED at the stapes then applied at the TM. 1.3:1
The TM is CONICAL in shape causes the force to be CONVEYED more effectively
The ________ tympani and ________ tensor muscles in the middle ear contract ________ in response to loud sounds to protect the ______ ear.
Both muscles _______ the stiffness of the ossicular chain when they _______ and thus ______ sound transmission by up to __ dB, depending on frequency.
Because the _______ of contraction is at least __ milliseconds, they ______ protect against impulsive sounds such as a pistol shot
Since the reflexes _______ reduce the transmission of low frequencies, they also act to improve the __________ of speech sounds in the presence of ____, low frequency _________ noise.
The TENSOR tympani and STAPEDIUS tensor muscles in the middle ear contract REFLEXIVELY in response to loud sounds to protect the INNER ear.
Both muscles INCREASE the stiffness of the ossicular chain when they CONTRACT and thus REDUCE sound transmission by up to 15 dB, depending on frequency.
Because the LATENCY of contraction is at least 10 milliseconds, they CANNOT protect against impulsive sounds such as a pistol shot
Since the reflexes PRIMARILY reduce the transmission of LOW frequencies, they also act to improve the DISCRIMINATION of speech sounds in the presence of LOUD, low frequency BACKGROUND noise.
There are _ muscles that _________ to the acoustic reflex, the _______ tensor muscle and the tensor _______.
The tensor tympani ________ from the anterior wall of the tympanic ______, just below the ________ of the eustachian tube.
The TT _________ at the handle of the _______ and innervates the __________ nerve or CN V. Its function is to ____ the tympanic membrane in and ________, tightening it.
There are 2 muscles that CONTRIBUTE to the acoustic reflex, the STAPEDIUS tensor muscle and the tensor TYMPANI.
The tensor tympani ORIGINATES from the anterior wall of the tympanic CAVITY, just below the OPENING of the eustachian tube.
The TT INNERVATES at the handle of the MALLEUS and innervates the TRIGEMINAL nerve or CN V. Its function is to PULL the tympanic membrane in and INFERIORLY, tightening it.
The ________ muscle ___________ at the posterior/mastoid wall of the tympanic cavity. It ______ at the neck of the _______.
THE SM innervates the _____ nerve or CN VII. It functions to pull stapes _______.
The STAPEDIUS muscle ORIGINATES at the posterior/mastoid wall of the tympanic cavity. It INSERTS at the neck of the STAPES.
THE SM innervates the FACIAL nerve or CN VII. It functions to pull stapes INWARD.
The acoustic reflex innervates __________. They either contract in _____ ears or they do not at all.
The reflex is activated through _______ stimulation of CN V or CN VII, a ________ odor, or _____ sounds btw __-__ dB, this is the threshold.
This mechanism _________ the movement of the ________, thereby decreasing the loudness of harmful sound by __ dB.
_______ can only hold contraction for _ minutes, this protects ________, not intensity.
The acoustic reflex innervates BILATERALLY. They either contract in BOTH ears or they do not at all.
The reflex is activated through MANUAL stimulation of CN V or CN VII, a NOXIOUS odor, or LOUD sounds btw 75-95 dB, this is the threshold.
This mechanism DECREASES the movement of the OSSICLES, thereby decreasing the loudness of harmful sound by 10 dB.
MUSCLES can only hold contraction for 3 minutes, this protects DURATION, not intensity.
There is an _____ advantage to the impedance matching.
The area of the tympanic membrane is __x the ____ window, as the area ________, the pressure _______.
The second advantage is the _______ membrane _______.
The eardrum ______ from its rim at both ____ to its attachment with the _______ in the middle.
As a result, the _____ of the TM attached to the malleus doesn’t move as ___ as the ends causing displacement to ______ and there is an ________ in force.
The third advantage is the ______ ______ advantage. The advantage is _________ when the _______ is moved _______ to the mass to be lifted.
If the _______ between the fulcrum and the ____ is _______ at one end, then the force at that end is ______.
There is an AREA advantage to the impedance matching.
The area of the tympanic membrane is 17x the OVAL window, as the area DECREASES, the pressure INCREASES.
The second advantage is the CURVED membrane BUCKLING.
The eardrum CURVES from its rim at both ENDS to its attachment with the MALLEUS in the middle.
As a result, the POINT of the TM attached to the malleus doesn’t move as FAR as the ends causing displacement to LOWER and there is an INCREASE in force.
The third advantage is the LEVER ACTION advantage. The advantage is INCREASED when the FULCRUM is moved CLOSER to the mass to be lifted.
If the DISTANCE between the fulcrum and the MASS is SHORTER at one end, then the force at that end is HIGHER.
_______ media is an _________ of the _______ ear. There are _ stages.
Stage 1: __________ Tube Dysfunction
_______ tube allows no new _______ into middle ear space.
Stage 2: _________ middle ear pressure
The mucosal lining of the middle ear space ________ oxygen.
When the current oxygen supply is ________ the TM is pulled _______ and a vacuum is created in the middle ear space.
A ________ pressure is generated, which causes a serous _______
Stage 2 leads to 3:
Negative pressure within the middle ear, if left _________, will lead to _____ accumulation in the normally ___-filled middle ear space.
This condition is referred to as serous or secretory otitis _____
OTITIS media is an INFECTION of the MIDDLE ear. There are 4 stages.
Stage 1: EUSTACHIAN Tube Dysfunction
CLOSED tube allows no new OXYGEN into middle ear space.
Stage 2: NEGATIVE middle ear pressure
The MUCOSAL lining of the middle ear space ABSORBS oxygen.
When the current oxygen supply is DEPLETED the TM is pulled INWARD and a vacuum is created in the middle ear space.
A NEGATIVE pressure is generated, which causes a serous EFFUSION
Stage 2 leads to 3:
Negative pressure within the middle ear, if left UNRELIEVED, will lead to FLUID accumulation in the normally AIR-filled middle ear space.
This condition is referred to as SEROUS or secretory otitis MEDIA
Stage 3: Serous Otitis Media
This ________ of the middle ear provides a fertile media for ________ growth. Otitis Media with Effusion
The ________ lining produces fluid, which is generally excreted through the _________ tube.
This fluid builds up and can _______ the TM
This is warm, dark and wet, a great place for ________ to grow. If growth is ______, the patient will get a ______ ear ________.
Stage 4: ________ Otitis Media
_________ Infection is introduced into the ______, now you have an ear infection.
When the bacteria growth ________ the space the TM will ______.
_________ Otitis Media is due to _________ antibiotic therapy. Finish all of your antibiotics when they are prescribed. Must be scrapped out surgically
Stage 3: SEROUS Otitis Media
This EFFUSION of the middle ear provides a fertile media for MICROBIAL growth. Otitis Media with Effusion
The MUCOSAL lining produces fluid, which is generally excreted through the EUSTACHIAN tube.
This fluid builds up and can PROTRUDE the TM.
This is warm, dark and wet, a great place for BACTERIA to grow. If growth is RAPID, the patient will get a MIDDLE ear INFECTION.
Stage 4: PURULENT Otitis Media
BACTERIAL Infection is introduced into the SPACE, now you have an ear infection.
When the bacteria growth EXCEEDS the space the TM will RUPTURE.
ADHESIVE Otitis Media is due to INADEQUATE antibiotic therapy. Finish all of your antibiotics when they are prescribed. Must be scrapped out surgically
________ of OM
_____ otitis media AOM, ______, Fever, Accompanying or ________ URI symptoms which is very common, and ________ hearing.
Acute otitis media in _______, may be asymptomatic, and may present only with _________.
______ otitis media with _______ is usually asymptomatic. Also ________ hearing, which can be demonstrated on audiometry.
SYMPTOMS of OM
ACURE otitis media AOM, EARACHE, Fever, Accompanying or PRECEDENT URI symptoms which is very common, and DECREASED hearing
Acute otitis media in INFANTS, may be asymptomatic, and may present only with IRRITABILITY.
SEROUS otitis media with EFFUSION is usually asymptomatic. Also DECREASED hearing, which can be demonstrated on audiometry.
_____ an Audiologist would see:
Reddish Tympanic membrane, ______ Tympanic membrane, Presence of _____ in the external ear, ________ around the ear, Flat tympanograms and, ________ hearing loss.
SIGNS an Audiologist would see:
Reddish Tympanic membrane, BULGING Tympanic membrane, Presence of FLUID in the external ear, TENDERNESS around the ear, Flat tympanograms and, CONDUCTIVE hearing loss.
_________:
Antibiotic therapy usually is prescribed for patients with any hint of ____.
Studies have shown that _________ provide little benefit beyond _______ in mild cases of AOM, Antipyretics and _________ may be necessary and should be prescribed liberally.
______________ with a needle and syringe may be appropriate in an _______-compromised patient or in patients with persistent ______.
If AOM is present in very young ______ around 2-3 mths, some recommend ________. Myringotomy is indicated only for patients with _________ pain.
TREATMENT:
Antibiotic therapy usually is prescribed for patients with any hint of AOM.
Studies have shown that ANTIBIOTICS provide little benefit beyond PLACEBO in mild cases of AOM, Antipyretics and ANALGESICS may be necessary and should be prescribed liberally.
TYMPANOCENTESIS with a needle and syringe may be appropriate in an IMMUNO-compromised patient or in patients with persistent FEVER.
If AOM is present in very young INFANTS around 2-3 mths, some recommend MYRINGOTOMY. Myringotomy is indicated only for patients with INTRACTABLE pain.
Complications:
___________ otitis media: __________ of pus causing breakdown in the ___ structure of the mucous membrane.
Presence of ______ in the pus, pressure from the pus causing _______ of the mucosa, submucosa and tympanic membrane
_______ otitis media: Unresolved AOM over _-6 weeks.
Cholesteaoma: skin ______ inside the ______ ear space.
Mastoiditis: break down of ___ cells
_________: infection enters the ________ layers of the brain causing _________ damage.
And ultimately death.
Complications:
SUPPURATIVE otitis media: ACCUMULATION of pus causing breakdown in the ___ structure of the mucous membrane.
Presence of BLOOD in the pus, pressure from the pus causing NECROSIS of the mucosa, submucosa and tympanic membrane
CHRONIC otitis media: Unresolved AOM over 4-6 weeks.
Cholesteaoma: skin TUMOR inside the MIDDLE ear space.
Mastoiditis: break down of AIR cells
MENINGITIS: infection enters the MENINGEAL layers of the brain causing IRREPERABLE damage.
And ultimately death.
