Upper Respiratory *Dr. Howell* Flashcards Preview

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Flashcards in Upper Respiratory *Dr. Howell* Deck (24):
1

Whisper Test

Exhale and whisper a
combination of consonants
and numbers (3-U-1); use a
different combination for the
other ear; Consonants use
higher frequencies than
vowels

Ask the patient to repeat the
sequence

2

Whisper test results

 Normal: Correctly repeats
initial sequence


 Normal: patient repeats at
least 3 of the 6 correctly


 Abnormal result: 4 of the 6
number/letter sequence is
incorrect


 Presbycusis: loss of higher
frequency; common in older
adults


 This test is 90-100%
sensitive and 70-87%
specific to detect hearing
loss of >30 decibels

3

Sound travels through air


 Vibrations of the TM are transmitted through the ossicles to the cochlea

 Anything that changes this portion accounts for a __________
loss.


 Cerumen, tympanic perforation, middle ear effusion

Sound travels through air


 Vibrations of the TM are transmitted through the ossicles to the cochlea

 Anything that changes this portion accounts for a conductive hearing loss
loss.


 Cerumen, tympanic perforation, middle ear effusion

4

The ______ and the ________ transmit the impulses to the brain


 Anything that changes this phase accounts for a _________ hearing loss.
 

The cochlea and the cochlear nerve transmit the impulses to the brain

 Anything that changes this phase accounts for a Sensorineural hearing loss.

5

Weber Test

Place tuning fork on forehead or top of head

 Ask the patient to identify if they hear it on one side or both

6

Rinne Test

Place tuning fork on mastoid process

 When the patient can no longer hear the vibration quickly put it in front of the ear

 NORMAL: AC>BC

 If AC=BC or BC>AC

then there is a conductive loss

7

After using _____ test, use _____ test to further evaluate the type of hearing loss.

After using Weber test, use Rinne test to further evaluate the type of hearing loss.

8

________ common boney growth
of hard palate

Torus Palantinus:
common boney growth
of hard palate

9


Obstruction of _________ causes fluid build
up in middle ear.
 


Obstruction of eustacian tube causes fluid build
up in middle ear.
 

10

Otitis Media

Presents with ear pain


 Usually unilateral


 Associated with or preceded by cold symptoms


 May have decreased hearing on affected side


 What kind of hearing loss?


 May have fever
 

11

Unilateral ear pain


 Often has purulent drainage


 Exquisite pain with palpation of tragus, pinna or auricle


 Moisture becomes trapped in canal allowing for overgrowth of normal flora


 Increased risk when ear canals are cleaned with cotton swabs—removes protective cerumen coating

Otitis Externa

AKA Swimmers Ear

12

Presents with facial pressure and pain

 Unilateral>bilateral


 Preceded/associated with cold/uri symptoms


 Cold symptoms get better then onset of unilateral sinus pressure


 May or may not have fever

Bacterial Sinusitis

13

Group A streptococcus: sore throat, fever, lymphadenopathy (ant cervical & tonsilar), pain with swallowing

  • Bacterial
  •  
  • Tonsillitis

14

-external or middle ear problem

Conductive hearing loss

15

 –inner ear, cochlear nerve or central brain connections problem

Sensorineural loss

16

Test for lateralization

Weber Test

Normal: sound lateralizes to both ears equally


Not normal: If sound lateralizes to one ear, it is either conduction loss
in that ear or sensorineural loss in the opposite ear. 

17

Compares air and bone conduction

Rinne

 -Vibrating tuning fork placed on mastoid bone behind ear &
 level with the canal. When patient no longer hears sound,
 quickly place fork close to ear canal & inquire if can hear
 the sound & for how long they hear it.


Normal: AC>BC


 If AC=BC or BC>AC there is conductive loss to that ear


 If weber was abnormal and Rinne was normal, suspect
sensorineural loss in the opposite ear. 

18

 _____ sinuses do not open until after 7 years
old

Frontal sinuses

19

Border around lips is called _____ _____

Vermillion border 

20

Aphthous ulcers

canker sores

21

B12 or iron deficiency

Cheilitis

22

red cracks at corners of mouth

candidisis

23

swelling or ulcerations gums

Gingivitis

24