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3 head, neck and neuroanatomy > 12 Functional Anatomy of the Ear > Flashcards

12 Functional Anatomy of the Ear Flashcards

1
Q

What are the parts of the external ear lined with?

A

Skin

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2
Q

What is the middle ear filled with?

A

Air (fluid in middle ear= pathological)

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3
Q

What is the middle ear lined with?

A

Respiratory epithelium

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4
Q

What structure allows for equilibration of pressure in middle ear (air filled cavity) and drainage of mucus from middle ear?

A

Pharyngotympanic tube ( Eustachian tube) connects middle ear to oropharynx

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5
Q

Fill in the missing labels:

A
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6
Q

Which nerves carry general sensation from the ear ( touch, temperature, pain)? (implications for referred pain)

A

Branches of:

  • V- Trigeminal
    • Auriculotemporal
  • VII- Facial (small contribution)
  • IX- Glossopharyngeal
    • Tympanic
  • X- Vagus
  • Cervical spinal nerves
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7
Q

Explain why nerves carrying general sensory information has implications for referred pain.

A

Pain/sensation felt in ear even if no pathology in ear

Eg in pharyngitis- ear pain even through no pathology of ear

Otalgia with normal ear examination- think alternative site of pathology

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8
Q

Give some examples of non-otological origins of otalgia. (general)

A
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9
Q

What makes up the external ear and what is its function?

A

Pinna, external auditory meatus and lateral surface of tympanic membrane

Function: collects, transmits and focuses sound waves onto tympanic membrane

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10
Q

What is Ramsey Hunt syndrome?

A

Viral- varicella zoster

Patient with facial nerve palsey and evidence of rash on external ear (may need to look in canal)

Shingles of facial nerve

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11
Q

What pathology is shown in this image:

A

Perichondritis

=inflammation of cartilage in pinna

(can be due to infection from ear piercing)

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12
Q

Why is it so important to recognise a pinna haematoma and treat it apporopriately?

A

Pericondrium- supplies blood to cartilage underneath

Haematoma- cuts off blood supply and may cause pressure necrosis

Ear will scar and alter shape of cartilage (califlower ear)

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13
Q

Where does the blood accumulate in a pinna haematoma?

A

Between cartilage and overlying pericondrium

Pericondrium- supplies blood to cartilage underneath

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14
Q

How is a pinna haematoma treated?

A

Drainage

Prevent re-accumulation of blood

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15
Q

Describe the structure of the external acoustic meatus (lining, composition, shape)

A

Composition:

Cartilaginous (outer 1/3)

Bony (inner 2/3)

Shape:

Sigmoid

Lining:

Keratinising, stratified squamous epithelium

Cartilaginous part: hair, sebaceous and ceruminous glands (produce ear wax)

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16
Q

Explain the self-cleaning function of the external acoustic meatus:

A
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17
Q

What is shown in the following image?

A

Normal otoscopic view of tympanic membrane

18
Q

What is otitis externa? Give some causes of it

A

Inflammation of external ear

External auditory meatus-swollen- may afffect hearing

Causes:

Infective- pseudomonas aeriginosa

Eczema

19
Q

What is malignant otitis externa?

A

(NOT cancerous but really bad- potentially life threatening)

Seen in immunocompromised patients

Infection of soft tissue of ear- starts to involve bone

Usually pseudomonas aeruginosa

20
Q

What pathologies of the tympanic membrane are shown in the 2 images on the right?

A

Otitis media with effusion= glue ear- see flashcard 27

21
Q

What is a cholesteatoma and what causes it? Why is it important to recognise?

A

A cholesteatoma is an abnormal, noncancerous skin growth that can develop in the middle section of your ear, behind the eardrum. It may be a birth defect, but it’s most commonly caused by repeated middle ear infections.

22
Q

Name the 3 ossicles.

A

Connected by synovial joints

23
Q

What do the ossicles do?

A

Function:

Amplify and relay vibrations from tympanic membrane to oval window in cochlea

24
Q

Identify the 2 muscles that contract, if there is excessive vibration due to loud noise, in order to tamper ossicle movement.

A

Tensor tympani and stapedius

25
Q

Otosclerosis is a common cause of hearing loss in young adults. How does it occur and what type of hearing loss does it cause?

A

How?

Ossicles fused at articulations due to abnormal bone growth (esp between base of plate of stapes and oval window of cochlea)

Exact cause unknown- environmental and genetic

Type of hearing loss?

Unilateral or bilateral conductive hearing loss

26
Q

What is another name for otosclerosis?

A

otospongiosis

27
Q

Otitis media (glue ear) with infusion is not due to infection but may predispose to infections. It is due to an eustachian tube dysfucntion. Explain how this can affect hearing.

A

Fluid and negative pressure in middle ear

Decreased mobility of ossicles and TM

28
Q

How is ‘glue ear’ treated (usually problem in children)?

A
  1. Most resolve spontaneously- 2-3months
  2. If persistent: require gromets- equilibriate pressure with atmospheric pressure
29
Q

What are the signs, symptoms and causes of an acute middle ear infection (acute ottitis media)?

A
30
Q

How does the structure of the Eustachian tube differ between children and adults? Why is this significant?

A
31
Q

What complications can occurr as a result of acute otitis media?

A
  1. Tympanic membrane perforation
  2. Facial nerve involvement
    1. Chorda tympani and nerve to stapedius run through middle ear cavity
  3. Mastoiditis (infection of mastoid bone)- requires IV antibiotics
  4. Intracranial
    1. Meningitis
    2. Sigmoid sinus thrombosis
    3. Brain abscess
32
Q

Outline the route by which acute otitis media can cause mastoiditis.

A
33
Q

Fill in the missing labels:

A
34
Q

How do we perceive sound through the cochlear?

A
35
Q

What symptoms (general terms) might a patient with inner ear pathology present with? (3)

A
  • Hearing loss (sensorineural)
  • Tinnitus
  • Balance disturbances and vertigo
36
Q

How does the vestibular apparatus work?

A
37
Q

What are the 2 broad categories of hearing loss?

A
  1. Conductive hearing loss
  2. Sensorineural hearing loss
38
Q

What is presbycusis?

A

Sensorineural hearing loss associated with old age

Bilateral and gradual

39
Q

Outline the pathophysiology of benign paroxysmal postitional vertigo.

A

Little crystals- become dislodged in semicircular canals

Vertigo only (symptom)

Short lived episodes- seconds

40
Q

What is Meniere’s disease?

A

Exact cause unknown

41
Q

Differentiate between the infective conditions: acute labrynthitis and acute vestibular neronitis.

A
42
Q

Give some possible causes for sensorineural and conductive hearing loss:

A

3 head, neck and neuroanatomy (21 decks)

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