5: Ears Flashcards
Comparing the adult/child ear. A child has a smaller ______, which is more easily occluded during infection.
Nasopharynx
Comparing the adult/child ear. Lymph tissue (tonsils, adenoids) grows rapidly in early childhood. Atrophies after age _____.
12
Comparing the adult/child ear. In a child, small oral cavity and large tongue increase risk of _____.
Obstruction
Comparing the adult/child ear. In a child, smaller nares are more easily _____.
Occluded
Comparing the adult/child ear. In a child, the _____ is long and floppy, vulnerable to swelling with resultant obstruction.
Epiglottis
Comparing the adult/child ear. In a child, the larynx and glottis are _____ in the neck, increasing risk of aspiration.
Higher
Comparing the adult/child ear. In the child, the _____, _____, and _____ cartilages are immature and flexible, causing risk for collapse when the neck is flexed.
Thyroid, cricoid, and tracheal cartilages
Comparing the adult/child ear. In the child, _____ are functional in the airway. This allows for less compensation for edema, spasm, and trauma.
Fewer muscles
Comparing the adult/child ear. In the child, the large amounts of _____ and _____ lining the airway increase the risk for edema and obstruction.
Soft tissue and loosely anchored mucous membranes
_____ are masses of lymphatic tissue in the pharyngeal cavity.
Tonsils
What do tonsils do (2)?
- Filter and protect the respiratory and alimentary tract for pathogenic organisms.
- Play a role in the formation of antibodies protecting against URIs.
T/F Tonsils are larger in children than in adults.
True
The _____ is the tonsil on the posterior wall of the nasopharynx.
Adenoid
_____ primary teeth rest in their places at birth.
20
Primary teeth erupt beginning at _____ months of age.
6
Primary teeth are shed from approximately ages _____.
6-12
Permanent teeth erupt from approximately ages _____.
6-13
Wisdom teeth erupt from ages _____.
17-21
External ear.
Pinna
Contains glands secreting sweat, sebum, and cerumen.
Lubricates hair follicles aiding debris removal.
Functions properly only when patency is maintained.
Pinna/external auditory canal
Separates external from middle ear.
Tympanic membrane
Has a chamber containing ossicles.
Middle ear
Name the ear bones (3).
- Malleus
- Incus
- Stapes
Lies on tympanic membrane; vibrates with sound.
Malleus
Acts as a bridge for 2 bones.
Incus
Rests against oval window; stimulates fluids of inner ear.
Stapes
Ventilates middle ear.
Eustachian tubes
How does the Eustachian tube ventilate the middle ear (2)?
- Equalizes internal air pressure and atmospheric pressure.
2. Replaces absorbed oxygen.
What are the functions of the Eustachian tubes (3)?
- Ventilates middle ear.
- Protects from sound, pressure, and secretions.
- Drains secretions from middle ear into nasopharynx.
What are the functions of the inner ear (4)?
- Transmits sound.
- Aids balance.
- Responds to changes in direction of movement.
- Maintains equilibrium.
What are the steps to transmit sound (5)?
- Fluids move according to vibrations of TM, ossicles, and oval window.
- Fluid sound waves reach the cochlea.
- Sound is transduced by hairs in the organ of Corti.
- Impulses are sent by the hair cells to cranial nerve VIII.
- Impulses continue to the brain.
Where are equilibrium receptors located?
Semicircular canals and vestibule of inner ear
4 ways to restrain child for ear exam.
- On parent’s shoulder.
- On parent’s lap (belly to belly with child’s legs wrapping parent’s waist, head held to parental chest).
- Restrained on exam table.
- Papoose board.
What is the most comprehensive restraint for ear exams?
Papoose board
What age is the most difficult to restrain?
Toddlers 1-3
What is the preferred position for toddlers?
Parent’s lap. Allows for “hug” hold.
T/F If the parent isn’t helpful, you should use your body to lie over the child and restrain the top half of his body while you exam the ear.
True
Inflammatory reaction of external ear canal.
Otitis Externa
Simple infx involving edema, discharge, and erythema.
Otitis Externa
Otitis externa can involve _____, small abscesses of hair follicles.
Furuncles
If otitis externa is caused by staph, patient may exhibit _____.
Impetigo
Chronic OE is often found in patients with _____ and _____.
Hearing aids and skin conditions
What 2 skin conditions are related to chronic OE?
- Seborrhea
2. Eczema
OE is usually caused by _____ in the external ear. Changes the acidic environment, promoting bacterial or fungal growth.
Retained moisture
How do swimming pools cause OE?
Chlorine kills normal flora, allowing pathogens to grow.
Most common culprits of OE (2).
- Pseudomonas
2. Staph
T/F Discharge from a perforated AOM can cause secondary OE.
True
What causes furunculosis (2)?
- Staph
2. Strep pyogenes by self-inoculation
T/F OE and furunculosis are treated the same.
False. Furunculosis is treated differently than when the entire ear canal is swollen.
Causes of otomycosis (2)?
- Candida
2. Aspergillus
When is otomycosis most common (2)?
- After ABX use.
2. After systemic steroid use.
Most common patient populations for otomycosis (2)?
- DM
2. Immunocompromised
Presentation of OE (9)?
- Itching and irritation that progresses to pain.
- Pressure or fullness in ear.
- Hearing loss.
- Otorrhea (discharge).
- Systemic complaints uncommon (usually localized to ear canal).
- Pain with manipulation of tragus or pinna.
- Pain with ear exam.
- Swollen external canal with debris.
- Local lymphadenopathy.
On the ear exam, a red indurated point can indicate _____ or _____.
Furunculosis or Folliculitis
Black lesion on TM with _____.
Fungal infx.
_____ OE can present as a dry, flaky, thinning canal.
Chronic