Ch 16 Ears

Question 1

Lymph fluid of external ears drains into ___ , ___, and ____ lymph nodes

Answer 1

parotid
mastoid
superficial cervical

Question 2

Normal pathway of hearing is by ____ conduction

Hearing involves 3 levels of auditory system:
_____, _____, _____

Answer 2

air conduction

1. peripheral: vibrations carried through cochlea –> basilar membrane –> organ of Cori (sensory organ of hearing)
2. Brain stem: binaural interaction: CN VIII sends signals to both sides of brain stem - where am i hearing this?
3. Cerebral cortex: interpretation - what am I hearing?

Question 3

Conductive hearing loss: dysfunction of _________

Sensorineural hearing loss: dysfunction of ______

Answer 3

external or middle ear
-eg cerumen, FB, perforated eardrum, otosclerosis

Sensorineural: inner ear, CN VIII or cerebral cortex
eg presbycusis, ototoxic meds

Question 4

What does recruitment mean?

Answer 4

loss is marked when sound is at low intensity but becomes painful when repeatedly loudly

Question 5

What is objective vertigo?

What is subjective vertigo?

Answer 5

Objective: room is spinning
subjective: you are spinning

Question 6

Otitis externa: signs and symptoms

Answer 6

• severe pain with movement of pinna and tragus
• redness and swelling of canal
• purulent discharge
• scaling, itching
• fever
• enlarged tender LN
• hearing N or slightly lower

Question 7

What is chondrodermatitis nodularis helicis?

Answer 7

• painful nodules on rm of helix
• from repetitive mechanical pressure or environmental trauma
• small, indurated, red, very painful

Question 8

What does carcinoma to external ear look like?

Answer 8

• ulcerated and crusted nodule with indurated base
• fails to heal
• bleeds intermittently
• usually on superior rim of pinna

Question 9

Prominent landmarks on otoscope indicate…..

Answer 9

TM retraction –> eustachian tube obstruction (negative pressure), serous otitis media

Question 10

Air/fluid level on otoscope indicate…..

Answer 10

serous fluid –> serous otitis

s/s sensation of fullness, transient hearing loss

Question 11

Bullous myringitis: signs and symptoms

Answer 11

• small vesicles on eardrum
• with mycoplasma pneunomia and other viral infections
• severe otalgia
• blood-tinged discharge (vesicles filled with blood)

Question 12

Acute purulent otitis media: signs and symptoms

Answer 12

• absence of light reflex
• redness and bulging in superior TM (pars flaccida)
• otalgia and fever
• transient hearing loss
• eardrum HYPOmobility on pneumatic otoscopy

Question 13

Cholesteatoma: early signs

Answer 13

• overgrowth of epidermal tissue in middle ear or temporal bone
• may be after TM perforation
• pearly white cheesy appearance
• can erode bone

otorrhea, unilateral conductive hearing loss, tinnitus