16 Jan 24 Flashcards
Presbycusis CF
Age related hearing loss .
Hear well in one in one conv .
Hearing declines in the presence of competing noise (restaurants) .
Ability to understand speech declines as t and s are high freq sounds.
No curative ttt
Presbycusis ttt
Family education
Limit background noise
Look directly when speaking.
Presbycusis. Mech
Cochlear hair loss and cochlear neuron degeneration
Sensorineural hearing loss
AC>BC
Weber heard bilaterally
Hydrocephalus cause ;
Impaired CSF circulation
Impaired CSF absorption
Excessive Production
(Aqueductal stenosis, tumor, infection)
Hydrocephalus CF
Head exam ;
If open fonanelle(closes by 12m to 15m)
Rapidly enlarging HC with or without macrocephay
Prominent scalp veins.
Full anterior fontanelle
Signs of inc ICP (close fontanelle):
Headache vomiting
Papilledema
Impaired upward gaze
HTN , bradycardia
Lower extremity weakness and spasticity
Behavior changes and dev delay
Evaluation of hydrocephalus
Neuroimaging;
⚓️USG (if open fontanelle) Or ultrafast MRI ⚓️CT scan for signs of inc ICP
Signs of ICP in the presence of VP shunt?
Shunt infection or malfunction
Withing 6months of placement.
Findings;
🏡Signs if inc ICP
🏡Stretching of white matter tracts due to ventriculomagaly leading to lower extremity UMN signs (weakness hypertonia hyperreflexia) and urinary incontinence
🏡fever / abdominal pain (peritonitis)
Newborn born at home with enlarged HC
Vit K def bleeding
Bulging fontanelle
Rapidly enlarged HC
Downward gaze (midbrain pressure)
Signs if ICP
Myelomenigocele and hydrocephalus.
MM is open neural tube defect in which meninges and spinal cord protrude through skin
Associated with chiari 2 ( inf displacement of medulla and cerebellum through foramen magnum ). Hence obstructive hydrocephalus.
Choroid plexus papilloma CP
CPP is highly vascular(overgrowth) neuroepithelial tissue found in ventricles making excess CSF
Slow and benign.
Presents with hydrocephalus
Signs of inc ICP
CPP dx and ttt
MRI
Ttt resection
Benign Macrocephaly
Normal dev
No syndromic features
No signs of Inc ICP (bulging fontanelle)
No signs of infection
Chronic exposure to loud noise hearing loss ….
⛺️SNHL
⛺️Chronic damage to cochlear hair cells
⛺️Irreversible death of hair cells.
⛺️Impacts quality of life
⛺️Impaired ability to understand speech
⛺️Raise safety concerns (driving)
Ttt:
🛖Hearing protection to prevent further loss
🛖Mandatory hearing screening programs in high risk occupations
S1 radiculopathy CF
Lower Limb weakness
Hip extension
Knee flexion
Foot plantarflexion
Loss of ankle(achilles reflex)
Common cause of S1 radiculopathy
Vertebral disc herniation
(Straight leg raise test positive )
Pain exacerbated by coughing and sneezing (inc pressure on nerve root)
