526 Ears Flashcards
what is secondary otalgia
referred pain
the ear receives pain even though cause is from somewhere else
what is the difference between vertigo, syncope and presyncope (or disequilibrium)
vertigo = illusion of movement
syncope = fainting
presynction/disequilibrium = off balance
the vestibular system includes what structures
vestibular structures in the ear, vestibular nerve, and vestibular structures in the brain
what is the difference between peripheral and centra vertigo
peripheral involves the vestibular structures in the ear or the vestibular nerve
central vertigo is from damage to vestibular structures in brainstem or cerebellum
what is the most common cause of peripher vertigo
BPPV
what causes BPPV
calcium crystals in semicircular canals
what is a cause of vertigo that may occure after an URTI and is it peripheral or central
vestibular neuritis (AKA labrynthitis)
peripheral
vestibular neuritis is inflammation of what CN
VIII
how is the cause of AOM different from vestiublar neuritis
vestibular neuritis is usually caused by virus, AOM is usually bacterial
what causes Menieres disease and what is another name for meniers disease
causes by excess endolymp in the semicurcular canals from impaired reabsorption damaging cochlea
also called endolymphatic hydrops
what is an acoustic neuroma and does it cause central or peripheral vertigo
schwannoma of CN VIII (the vestibulocochlear nerve)
peripheral vertigo
what condition would cause acoustic neuromas on both vestibulocochlear nerves
neurofibromatosis type 2
what medications are toxic to the auditory system and may cause vertigo
aminoglycosides
phenytoin (anticonvulsants)
quinine (antimalarials)
what is the most common cause of central veritgo
stroke
what are central causes of vertigo
stoke
tumor to brainstem or cerebellum
MS
true or false: both central and peripheral vertigo will have nystagmus
true
what direction will the nystagmus be in peripheral vertigo?
horizontal
torsional
vertigo
what direction will the nystagmus be in central
horizontal or torsional
NEVER vertical
how will the results of the dix hallpike differ between central and peripheral vertigo
Central - no lag time, lasts >1min, provokes mild vertigo
peripheral - 2-40 second lag time, lasts <1 min, provokes severe vertigo
what is skew deviation and when would you see it
during dix hallpike for a central cause
eyes move upward and rotate counter clockwise
what are the 4 D’s of central vertigo
diploplia
dysphagia
dysarthria
dysmetria
auditory symptoms like hearing loss or tinnitus are more common in central or peripheral vertigo
peripheral
predictable changes in head position causing vertigo that last for less than a minute with or without n/v but without auditory symptoms is suggestive of what disorder
BPPV
acute, severe, constant vertigo that lasts several days with no change with head movements, can occur at rest, with or without hearing loss is suggestive of what disorder
vestibular neuronitis
what is the triad of symptoms for menieres disease
recurrent episodic vertigo
sensorineural hearing loss
tinnitus
a sense of ear fullness or aural fullness is associated with what vertigo related disease
meniere disease
what is oscillopsia and what may cause it
visual disturbances where it looks like environment oscilates
from an impaired vestibular-ocular reflex from ear toxic medications
what condition would cause auditory symptoms before causing vertigo
acoustic neuroma
what finding during the dix hallpike maneuver would confirm BPPV
worsening vertigo or nystagmus on one side
how are scwannomas diagnosed
brain MRI with contrast
how is vestiublar neuritis diagnosed
primarily through history and physical exam, especially if recent recoverying from URTIh
how it meniere diagnosed
primarily throughout history and physical
what is the treatment of BPPV
Epley maneuver
how often should the epley be done for BPPV
at least 3 times a day until no symptoms for 24 hours
how is vestibular neuritis treated
corticosteroids
how is lmeiere disease treated
- limit salt, caffein,e alcohol and nictorine
- diuretics like hydrochlorothiazide or acetazolamide
- surgery - labrinthectomy
what are the contraindications for ear irrigation (5)
tympanoplasty
cant sit upright
FB in ear
otitis externa
TM perforation
what is the treatment for otitis externa
NSAIDs or topical anesthetics
topical antibiotics (fluroquinolones like oflaxacin or ciprofloxacin
Or
Aminolgycosides like neumycin
