S7 L1 The Ear and Tuning Fork Tests

Question 1

(only 1 lecture this week)

Three sections of the ear

Symptoms and signs of ear disease…

Answer 1

• External, middle, inner ear

Question 2

External, Middle, inner ear:

• Structures of each of these
• Lined with what?
• ‘Filled’ with what?

After answering the above questions, then label the diagram attached

Answer 2

Question 3

Many Nerves Carry General Sensation from Ear - Implications for Referred Pain

• List 4 nerves that carry sensory information around the ear
• List 1 nerve that is for hearing and balance

Answer 3

Question 4

Otalgia with a normal ear examination should lead you to suspect an alternative site of pathology:

• 2 types of pain?
• Examples of causes for this reffered pain?

Answer 4

Question 5

• *The External Ear:**
• Anatomy of the external ear
• Name 3 abnormalities that could occur in the external ear

Answer 5

Question 6

Pinna Haematoma:

• What is this?
• Cause of this?
• Treatment of it?
• What happens if it is left untreated?

Answer 6

Question 7

External acoustic meatus:

• Lined with?
• Two areas…
• Shape?
• What does the outer_____ part contain? Barrier…
• Does the other part also have this?
• How does the self-cleaning function work?

Answer 7

Question 8

2 Common conditions involving the External Acoustic Meatus

Answer 8

• Wax/Foreign bodies
• Ottis externa

Question 9

Wax/Foreign bodies

Otitis externa:

• What is this?
• Symptoms?
• Treatment
• Rare, but life threatening complication of otitis externa

Answer 9

Question 10

Tympanic Membrane
- List 2 common abnormalities

Answer 10

• Acute otitis media
• Otitis media with effusion

Question 11

Tympanosclerosis:
- What is this? What has caused it? What does the tympanic membrane look like?

Acute otitis media:

• What is this?
• What does the tympanic membrane look like?

Otitis media with effusion:

• What is this?
• Another name?
• What happens?
• What does the tympanic membrane look like?

Answer 11

Question 12

Cholesteatoma

• What is this?
• What does it look like?
• What happens?
• Cause
• Symptoms
• Complications

Answer 12

Question 13

Cholesteatoma
- Recap of what happens…

Answer 13

Question 14

• *Middle Ear**
• Describe the structure of the middle ear
• Role of this part of the ear and how does this part of the ear work?
• 2 muscles involved

Answer 14

Question 15

Otosclerosis

• What is this?
• Causes
• What happens?
• Symptoms

Answer 15

Question 16

Role of the Pharyngotympanic tube

• Role
• How does this whole process work (other structures involved)

Answer 16

Question 17

(Middle ear)
Otitis media with effusion (“glue ear”)
- Cause?
- What happens?
- Treatment

Answer 17

Question 18

(Middle ear)
Acute otitis media
- What is this?
- Signs and symptoms?
- Causes
- What does it look like?

Answer 18

Question 19

Why are children more susceptinble to middle ear infections?

Answer 19

Question 20

Complications of Acute Otitis Media

• 4… (plus more)
• Symptoms of one that causes ear to be pushed forward

Answer 20

Question 21

Important Anatomical Relations of the Ear
- Thinking about where infections could potentially spread

Answer 21

Question 22

• *Inner Ear**
• Anatomy (2 main)
• Filled with?
• Symptoms associated with inner ear?
• Go through the 2 main peices of anatomy: what are they filled up with? their role? how do they work to do their role? (nerve…)

Answer 22

Question 23

Cochlea

• Role
• _____ filled?
• How does it work - i.e. action potential etc, to carry out its role…

label diagram attached

Answer 23

Left to right (top)
right to left (bottom)

Auricle
External auditory canal
Malleus
Incus
Ovale Window

Cochlea

Organ of Corti
Round window
Stapes
Tympanic membrane
Sound wave

Question 24

How we hear?
- Full flow diagram about this

Answer 24

Question 25

Vestibular apparatus - Role - Describe the structure of these? - How does it perform it's role (flow diagram of steps) - Fluid that fills the ducts is called...

Answer 25

Question 26

List Conditions that can affect the Inner Ear Cochlea or Vestibular Apparatus

Answer 26

Presbycusis Benign Paroxysmal Positional Vertigo Meniere's Disease Acute Labrynthitis Acute Vestibular Neuronitis

Question 27

Presbycusis - What is this - Symptoms Benign Paroxysmal Positional Vertigo - What is this? - Cause - Symptoms - How to diagnosis it - How to treat it

Answer 27

Question 28

Meniere's Disease: - Symptoms - Cause - Between episodes? Acute Labrynthitis: - Cause? - Symptoms Acute Vestibular Neuronitis: - Cause? - Symptoms ​

Answer 28

Question 29

Patient Presents with Hearing Lost: - What do you do?

Answer 29

Question 30

- Two types of hearing loss Weber's test: - What is this? - How to do it? - Results?

Answer 30

Question 31

Weber's test cont.: - Patient with conductive hearing loss... explain what happens (result)? - Patient with sensorineural hearing loss... explain what happens (result)?

Answer 31

Question 32

Rinne's test - How to do it? - Results mean...

Answer 32

Question 33

Rinne's test - How to do it? - Results mean... - -- Conductive vs sensorineural hearing loss...

Answer 33

Question 34

Conductive hearing loss vs Sensorineural hearing loss

Answer 34

Question 35

GW: - What could predipose a child recurrent acute ear infections? - Conductive hearing loss vs sensorineual hearing loss - What is a vestibular schwannoma? - Name conditions involving the structure or areas of the ear than can present with otalgia? (otological causes of otalgia) - Name conditions not involving the structures of the ear that present with otalgia? (non-otological causes of otalgia) - Which nerves are involved in innervating the structures of the ecternal and middle ear?

Answer 35

- What could predipose a child recurrent acute ear infections? Adenoids - lymph tissue is enlarged, blocks the Eustachian tube, ear infection is predisposed to as can't drain (fluid builds up - nice growth medium) - Vestibular schwannoma - Tumour that develops on the 8th cranial nerve (vestibulococchlear nerve), due to overproduction of Schwann cells) - Benign - Otological causes: AVN, AL, Meneres disease - Non-otological causes: TMJ arthritis, larynx, phraynz, dental issues - Vagus, trigeminal, glossophrangeal, C2, C3

Question 36

GW: - With reference to the anatomy of the ear, how is the original infection able to spead learing to the mastoiditis? - Name some locations where the infection could spread from the middle ear? - Otoscope - how to use it? - Webbers test - Rinne's test

Answer 36

Infection spreads from middle ear to mastoid antrum to air cells Infections could spread to: meninges, petrous bone, sigmoid sinus (thombus) Otoscope: Pull pinna of ear across and up (external auditory meatus) - as it is sigmoid shaped Webber’s test - Bang the metal thing Put flat bit in midline of forehead Put finger over one ear, sound should become louder in this ear Then do it with the other ear Rinne's test - Bang the metal thing Put flat big bit on mastoid process (testing bone conduction), when stop feeling the vibration, move it to the front of external auditory meatus, listen for it (testing air conduction). Should hear it at a lower frequency than can feel it. Normal: air conduction between than bone conduction

Question 37

Most likely causative pathogen for otitis extra is...

Answer 37

Pseudomonas aeruginosa

Question 38

Structure of the pinna of the ear

Answer 38

Question 39

Ear: - Where is the oval window? - Where is the round window?

Answer 39

Question 40

Label the tympanic membrane

Answer 40