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Head & Neck > 6) The Ear > Flashcards

6) The Ear Flashcards

1
Q

The ear is divided into which 3 parts?

A

External ear
Middle ear
Internal ear

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2
Q

What separates the external and middle ear?

A

Tympanic membrane

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3
Q

Which tube joins the middle ear to the nasopharynx?

A

Pharyngotympanic/Eustachian/Auditory tube

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4
Q

What is the external ear comprised of?

A

Auricle (Pinna) - elastic cartilage covered by skin

External acoustic meatus

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5
Q

What structures comprise the auricle (pinna)?

A

Helix (outer rim)
Tragus (flap guarding external acoustic meatus)
Non-cartilaginous lobule (lobe)

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6
Q

What is the blood supply to the external ear?

A

Posterior Auricular & Superficial Temporal arteries (ECA)

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7
Q

Which nerves provide sensory innervation to the auricle?

A

Anterior to the external auditory meatus - Auriculotemporal nerve (branch of mandibular Viii)
Rest of auricle - Great Auricular nerve

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8
Q

What is the external auditory meatus?

A 
Cartilaginous tube/canal lateral 1/3
Bony canal medial 2/3
Lies in temporal bone
Lined by skin secreting cerumen (modified sebum)
Sigmoid shaped
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9
Q

What is ear wax comprised of?

A

Discarded skin cells & cerumen of external auditory meatus

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10
Q

What is the tympanic membrane?

A

Partition between external & middle ear
Shallow cone, apex points medially
Thin, oval, semi-transparent, pearly-grey membrane

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11
Q

Which nerves supply the tympanic membrane?

A

External surface: Auriculotemporal nerve (branch of Viii)
Auricular branch of vagus nerve

Internal surface: Glossopharyngeal nerve

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12
Q

What is the Ear-Cough reflex?

A

Stimulation of Auricular branch of Vagus
e.g. insertion of cotton bud
Produces cough reflex, some even vomit
Over-sensitivity

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13
Q

How can the tympanic membrane be affected in disease?

A

Dull & becomes red/yellow
Dilated blood vessels - injection of drum
Dense, white plaques - Tympanosclerosis
Bulging - Pus/fluid in middle ear
Retracted - Infratympanic cavity pressure reduced, obstruction of Eustachian tube
Perforation - Trauma, Infection

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14
Q

What makes up the middle ear?

A

Narrow air-filled chamber in petrous part of temporal bone
Tympanic cavity proper
Epitympanic recess

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15
Q

What is the tympanic membrane proper?

A

Space directly internal to tympanic membrane

Connected to nasopharynx & mastoid air cells

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16
Q

What is the epitympanic recess?

A

Space superior to the tympanic membrane

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17
Q

Is the Auditory tube usually open or closed?

A

Closed

Intermittently opened by pull of attached palate muscles when swallowing

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18
Q

What are the contents of the middle ear?

A

Auditory ossicles: Malleus, Incus, Stapes
Stapedius & Tensor Tympani muscles
Chorda Tympani nerve
Tympanic plexus of nerves

19
Q

What are the auditory ossicles?

A

Malleus
Incus
Stapes

20
Q

What is the function of the auditory ossicles?

A

Relay vibrations encountered by tympanic membrane to inner ear
Amplify & concentrate sound energy to oval window

21
Q

What is the function of the tensor tympani muscle?

A

Inserts into handle of malleus, pulls handle medially
Tenses tympanic membrane, reducing amplitude of oscillations
Prevents damage to inner ear when exposed to loud sounds

22
Q

What is the function of the stapedius muscle?

A

Pulls stapes posteriorly, tilts its base over oval window
Tightens anular ligament, reduces oscillatory range
Prevents excessive movement of stapes
Innervated by nerve to stapedius (facial)

23
Q

What is the relationship of the facial nerve and the middle ear?

A

CN VII lies in the facial canal
separated from tympanic cavity by thin bony partition

Middle ear infection may cause lesion

24
Q

What is the inner ear?

A

Labyrinth
Channels hollowed out of the Petrous temporal bone,
surrounding the membranous labyrinth

25
Q

Which structures are contained within the middle ear?

A 
Vestibule
Semi-circular ducts & canals
Cochlea
Cochlear duct
Organ of Corti
26
Q

What are the main functions of the inner ear?

A

Receptors that respond to rotational acceleration & static pull of gravity
Receptors of auditory apparatus

27
Q

What is an auricular haematoma?

A

Trauma resulting in bleeding within auricle
Blood collects between perichondrium & auricular cartilage
Distorts contours of auricle

If blood not aspirated - fibrosis (Cauliflower’s ear)

28
Q

What congenital pinna deformities can occur?

A

Antihelix deformity
Pinna malformation
Pre-auricular pit
Pre-auricular skin tag

29
Q

What is acute otitis externa?

A

Infection/inflammation of the external acoustic meatus
Common in swimmers
Itching & pain in external ear

30
Q

What is otitis media?

A

Infection of the middle ear
Often secondary to URTIs via Eustachian tube
More common in children - shorter, more horizontal eustachian tube
Earache, bulging red tympanic membrane (pus/fluid)
Inflammation of mucous membrane may cause blockage of eustachian tube

31
Q

Name some causes of a perforated tympanic membrane

A

Otitis media, insertion of foreign bodies, trauma, excessive pressure (scuba diving)

Middle ear deafness, often heal spontaneously

32
Q

What is mastoiditis?

A

Infection of mastoid antrum & mastoid air cells
Results from otitis media
- inflammation of mastoid process (swelling behind ear)
- may spread into middle cranial fossa in children (osteomyelitis)

33
Q

How might the Eustachian tube be blocked?

A

Swelling of mucous membrane e.g. infections
Low pressure in tympanic cavity, retraction of tympanic membrane
Hearing affected
Adenoidal hypertrophy (children, EBV)

34
Q

What is hyperacusis?

A

Loss of protective action against loud noises

e.g. lesion of facial nerve, paralysis of stapedius

35
Q

How does motion sickness occur?

A

Discordance between vestibular & visual stimulation

36
Q

What 3 symptoms do injuries of the peripheral auditory system cause?

A

Hearing loss
Vertigo
Tinnitus

37
Q

How does conductive hearing loss occur?

A

Anything in external or middle ear that interferes with conduction of sound or movement of oval or round windows
People will speak with a soft voice
Surgery/hearing device

38
Q

How does sensorineural hearing loss occur?

A

Defects in pathway from cochlea to brain
cochlea, cochlea nerve, brainstem
Cochlear implants

39
Q

What is Ménière syndrome?

A

Blockage of cochlear aqueduct
Recurrent tinnitus, hearing loss & vertigo
Sense of pressure in ear, distortion of sounds & sensitivity to noise

40
Q

What is cholesteatoma?

A

Necrotic mass of dead skin caused by:
Blockage of eustachian tube
Negative middle ear pressure leads to retraction pockets
Dead skin cells accumulate
Erosion of middle ear structures & bone via lytic enzymes

41
Q

What is otalgia?

A

Ear pain
Infection/Inflammation around ear
Pain from teeth, pharynx or cervical spine commonly referred to the ear

42
Q

What is pruritus?

A

Itching

Primary disorder of external ear, or middle ear discharge

43
Q

What is otorrhoea?

A

Discharge from the ear
Indicates acute or chronic infection
Blood/CSF discharge associated with skull fracture

Head & Neck (12 decks)

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