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14. Head and Neck > 6. The Ear > Flashcards

6. The Ear Flashcards

1
Q

What are the parts of the ear?

A

External, middle, and internal ear.

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2
Q

What are the roles of the external, middle, and internal ear?

A

External and middle - transference of sound to inner ear.

Inner - hearing and balance

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3
Q

What separates the external ear from the middle ear?

A

Tympanic membrane.

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4
Q

What joins the middle ear to the nasopharynx?

A

Pharyngotympanic/eustachian tube.

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5
Q

What are the parts of the external ear?

A

Auricle/pinna and external acoustic meatus/canal.

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6
Q

What is the auricle?

A

An irregularly shaped plate of elastic cartilage covered by thick skin.

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7
Q

What guards the external acoustic meatus?

A

Tragus, small flap.

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8
Q

What is the lobule?

A

Non-cartilaginous lobe consists of fibrous tissue, fat, and blood vessels.

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9
Q

What is the blood supply to the auricle?

A

Posterior auricular and superficial temporal arteries - both branches of external carotid artery.

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10
Q

What is the sensory innervation to the auricle?

A

Anterior to external acoustic meatus - auriculotemporal nerve (branch of mandibular nerve CN V3).
Rest of auricle - great auricular nerve.

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11
Q

What is the external acoustic meatus?

A

A tube that is cartilaginous for the lateral 1/3 and bony for medial 2/3.

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12
Q

Which bone does the external acoustic meatus lie in?

A

Temporal bone.

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13
Q

What is the relevance of the skin lining the external acoustic meatus?

A

It secrete cerumen (modified sebum) which protects by forming wax with discarded cells of skin.

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14
Q

How is a good internal view of the ear achieved in examination?

A

The auricle is pulled upwards and backwards as it is naturally sigmoid shape. Or down and back in children.

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15
Q

What is the tympanic membrane?

A

A thin, oval, semi-transparent, pearly grey membrane.

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16
Q

What is visible in tympanic membrane inspection?

A

Malleus, blood vessels around the periphery.

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17
Q

What innervates the tympanic membrane?

A

External surface - auriculotemporal nerve (branch of CN V3), and auricular branch of vagus nerve (CN X).
Internal surface - glossopharyngeal nerve (CN IX).

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18
Q

What is the ear cough/Arnold’s cough reflex?

A

Stimulation of auricular branch of vagus nerve -> cough reflex.

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19
Q

What is the appearance of the tympanic membrane in disease?

A

Dull and becomes red/yellow; blood vessels may be dilated; dense white plaques in tympanosclerosis; bulging of membrane with pus or fluid; retracted membrane with infratympanic cavity pressure reduction or obstruction of Eustachian tube; perforation of membrane in trauma or infection.

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20
Q

What is the middle ear cavity?

A

Narrow air-filled chamber in petrous part of the temporal bone.

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21
Q

What are the two parts of the middle ear cavity?

A

Tympanic cavity proper and epitympanic recess.

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22
Q

What is the tympanic cavity proper and its connections?

A

The space directly internal to the tympanic membrane that is connect anteromedially to the nasopharynx by the pharyngotympanic/Eustachian tube and posterolaterally with mastoid air cells through mastoid antrum.

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23
Q

What is the epitympanic recess?

A

Space superior to the membrane.

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24
Q

What are the usual and intermittent states of the pharyngotympanic tube?

A

Usually closed. Intermittently opened by pull of attached palate muscle when swllowing.

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25
Q

What are the contents of the middle ear?

A

Auditory ossicles - malleus, incus, stapes.
Stapedius and tensor tympani muscles.
Chorda tympani nerve, branch of facial nerve CN VII.
Tympanic plexus of nerves.

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26
Q

Where are the ossicles?

A

In the upper part of the tympanic cavity, articulating with each other via synovial joints.

27
Q

What is the purpose of the ossicles?

A

Relay vibration encountered by the tympanic membrane to the internal ear - amplifying and concentrating sound energy to the oval window.

28
Q

What are the precise locations of the malleus, incus, and stapes?

A

Malleus handle is attached to the tympanic membrane and its body articulates with body of incus.
Incus articulates with stapes.
Stapes articulates with bony labyrinth of the inner ear at the oval window.

29
Q

What is the action of the tensor tympani?

A

Inserts into handle of the malleus so pulls handle medially and tenses the tympanic membrane, reducing the amplitude of oscillation to prevent damage to inner ear with loud sounds.

30
Q

What is the action of stapedius?

A

Pulls the stapes posteriorly and tilts its base in the oval window so tightens the anular ligament and reduces oscillatory range. This prevents excessive movement of the stapes.

31
Q

What innervates the stapedius?

A

Nerve to stapedius, from facial nerve (CN VII).

32
Q

What is the anatomical relation of the facial nerve to the middle ear and the importance of this?

A

It lies in the facial canal, separated from tympanic cavity by a thin bony partition so middle ear infection may cause a lesion of the facial nerve.

33
Q

What is the inner ear/labyrinth?

A

Series of channels hollowed out of the petrous temporal bone surrounding the membraneous labyrinth.

34
Q

What does the inner ear contain?

A

Vestibule, semi-circular ducts and canals, cochlea, cochlear duct, organ of Corti.

35
Q

What is the vestibule?

A

Small bony chamber, containing the utricle and saccule which are sensitive to rotational acceleration and static pull of gravity.

36
Q

What are the semi-circular ducts and canals?

A

Communicate with the vestibule and contain receptors that respond to rotational acceleration in three different planes.

37
Q

What is the cochlea?

A

Shell shaped portion of the body labyrinth containing the cochlear duct.

38
Q

What is the cochlear duct?

A

Accommodates the spiral Organ of Corti.

39
Q

What is the organ of Corti?

A

Contains receptors of auditory apparatus.

40
Q

What is an auricular haematoma?

A

Traauma causing bleeding within the auricle which forms a collection of blood between the perichondium and auricular cartilage -> distortion of the auricle.

41
Q

What is the danger of auricular haematoma?

A

If the blood isn’t aspirated, it fibrosis and the auricle is deformed - Cauliflower/Boxer’s ear.

42
Q

What are congenital pinna deformities?

A

Antihelix deformity, pinna malformation, pre-auricular pit pre-auricular skin tag.

43
Q

What is acute otitis externa?

A

Infection/inflammation of the external acoustic meatus causing itching and pain in the external ear.

44
Q

What is otitis media?

A

Infection of the middle ear causing earcache and bulging red tympanic membrane from pus or fluid in middle ear. There can be blockage of Eustachian tube from inflammation of mucous membrane.

45
Q

What often causes otitis media?

A

Infection secondary to upper respiratory infections via pharyngotympanic.

46
Q

What can cause perforation of tympanic membrane?

A

Otitis media, insertion of foreign bodies, trauma, excessive pressure.

47
Q

What are the possibilities following perforation of tympanic membrane.

A

Minor ruptures heal spontaneously, middle ear deafness, large ruptures require surgical repair.

48
Q

What is mastoiditis?

A

Infections of mastoid antrum and mastoid air cells from otitis media causing inflammation of the mastoid process (swelling behind the ear).

49
Q

Where can infection of mastoiditis spread?

A

Superior into the middle cranial fossa through petrosquamous fissure in children -> osteomyelitis.

50
Q

What can block the pharyngotympanic/Eustachian tube?

A

Swelling of the mucous membrane from mild infections.

51
Q

What happens with blocked pharyngotympanic/Eustachian tubes?

A

Residual air in the tympanic cavity is absorbed into mucosal blood vessels -> lower pressure in tympanic cavity, retraction of the tympanic membrane. This interferes with movement of the tympanic membrane so affects hearing.

52
Q

What is the result of paralysis of stapedius?

A

Loss of protective action against loud noises so hyperacusis (sensitivity to noise).

53
Q

What causes motion sickness?

A

Discordance between vestibular and visual stimulation.

54
Q

What are the symptoms of injuries o peripheral auditory system?

A

Hearing loss (usually conductive), vertigo (when involving semicircular ducts), tinnitus (buzzing/ringing).

55
Q

What causes conductive hearing loss?

A

Anything in the external or middle ear that interferes with conduction of sound or movement of oval or round windows.

56
Q

How is conductive hearing loss managed?

A

Surgical improvement or use of a hearing device.

57
Q

What is sensorineural hearing loss from?

A

Defects in the pathway from cochlear to brain, so defect of cochlea, cochlear nerve, or brainstem.

58
Q

How is sensorineural hearing loss managed?

A

Cochlear implants - external microphone transmits implanted receiver that sends electrical impulses to cochlea to stimulate cochlear nerve.

59
Q

What is Meniere syndrome?

A

Blockage of cochlear aqueduct causing recurrent attacks of tinnitus.

60
Q

What is colesteatoma?

A

Blockage of the Eustachian tube leads to negative middle ear pressure so retraction pockets where dead skin cells can accumulate -> necrotic mass of dead skin = colesteatoma.

61
Q

What is otalgia?

A

Ear pain from infection or inflammation around the ear.

62
Q

What is pruritis?

A

Itching from primary disorder of external ear or middle ear discharge.

63
Q

What is otorrhea?

A

Discharge from the ear indicating acute or chronic infection.

14. Head and Neck (11 decks)

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