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Adv Pathophysiology > Chapter 20: Ears > Flashcards

Chapter 20: Ears Flashcards

1
Q

Tophi

A

build up of uric acid crystals on helix/antihelix

small, hard, whitish-yellow, nontender

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2
Q

Battle’s Sign

A

Bruising Behind the ear and Base of skull
sign of BiBasilar skull fracture
concern for CSF drainage

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3
Q 
Otitis Externa (OE)
Swimmer's Ear
A

water in the external ear canal = inflammation and decreased cerumen; caused by bacteria, fungi, allergies, or trauma (cleaning, scratching, hearing aids)

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4
Q

Characteristics of OE

A

pain to external ear - worse w/ movement
swelling (can impair hearing)
redness
drainage (clear or purulent)

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5
Q

Treatment of OE

A

combo of antibiotics and steroidal ear gtts
if involves lymph nodes = oral antibx
keep ears dry

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6
Q

Impacted Cerumen

A 
pain, feeling of fullness, itching
occlusion = vertigo, tinnitus
vagal response (EAC is innervated by CN X)
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7
Q

Ossicles

A

malleus, incus, stapes

attached to TM and oval window that separates the inner and middle ear

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8
Q

Eustachian Tubes

A

connects the nasopharynx to the middle ear

equalized pressures from inner and outer surfaces of the TM (prevents rupture)

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9
Q

Acute Otitis Media (AOM)

A

inflammation of the middle ear

can cause obstruction of the ET causing fluid accumulation behind the TM

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10
Q

Causes of AOM

A

viral URI will often precede onset of AOM
S. pneumoniae and S. pyogenes (bacterial)
RSV and H. influenzae (viral)

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11
Q

Symptoms of AOM

A

abrupt onset of s/sx
deep, throbbing pain
worse with lying flat
feeling of fullness in ears - may hear popping/crackling

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12
Q

Signs of AOM

A

distorted/displaced/absent light reflex
TM red, bulging
if pain stops abruptly = ruptured TM
cervical lymphadenopathy

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13
Q

Associated Infections of AOM

A 
meningitis
postauricular swelling (mastoiditis)
if infx spreads beyond temporal bone = facial nerve (CN VII) paralysis
labrynthitis 
brain abscess
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14
Q

Otitis Media with Effusion (OME)

“Glue ear”

A

fluid accumulation in the middle ear
no infection
can occur with changes in atmospheric pressue
usually accompany viral URI

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15
Q

Clinical Manifestations of OME

A

pain
sensation of fullness
TM has clody appearance, amber-yellow color
may see air-fluid level or air bubbles behind TM

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16
Q

Otosclerosis

A

autosomal dominant disorder
formation of new spongy bone that become calcified = decreased transmission of sound, affecting both ears
voice sounds louder than external noise

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17
Q

Treatment of Otosclerosis

A

hearing aids
injection of Na fluoride = slow calcification
surgery (stapes prosthesis)

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18
Q

Cholesteatomas

A

overgrowth of epidermal tissue in the middle ear/temporal bone
usually occurs after TM perforation
pearly-white cheesy appearance
unilateral hearing loss/tinnitus

19
Q

Bony labyrinth

A

located in temporal bone
filled with a watery fluid called perilymph
divided into vestibule, semicircular canals, cochlea

20
Q

Membranous Labyrinth

A

balloon-like sac inside the bony labyrinth

filled with thicker fluid called endolymph

21
Q

Otoliths

A

uricle and saccule
sensitive to static or changing head movements depending on cilia movement in the endolymph
BALANCE

22
Q

Balance is maintained by…

A

proprioceptive system (muscle & joints), visual system (eyes), and vestibular system (labyrinth)

23
Q

Organ of Corti

A

end of organ of hearing that lies in the cochlea

24
Q

Tinnitus

A

perception of abnormal ear or head noises
ringing, buzzing, hissing, or humming sound
can be constant or intermittent
can be unilateral or bilateral

25
Q

Causes of Tinnitus

A 
impacted cerumen
otosclerosis
Menieres Disease
head trauma
acoustic neuromas
uncontrolled HTN
damage to CN VIII
Vitamin B 12 deficiency
Ototoxic drugs
26
Q

Ototoxic drugs

A

furosemide
aminoglycosides (erythromycin)
salicylates (aspirin)

27
Q

Meds that reduce intensity of tinnitus

A

SSRIs
TCAs
melatonin

28
Q

Conductive Hearing Loss

A

loss of air conduction
sound waves do not reach the inner ear
BC > AC or AC=BC (Rinne)
Lateralizes to affected side (Weber)

29
Q

Causes of Conductive Hearing Loss

A 
impacted cerumen
foreign bodies
perforated or scarred TM
OE, AOM, OME
trauma
tumors
otosclerosis
30
Q

Sensorineural Hearing Loss

A

lose ability to hear through bone conduction
signifies pathology of inner ear, CN VII, or auditory areas of cerebral cortex
AC > BC but not twice as long (Rinne)
sound lateralizes to unaffected side (Weber)

31
Q

Causes of Sensorineural Hearing Loss

A 
ototoxic medications
presbycusis
sustained/repeated exposure to loud noise
acoustic neuroma 
demyelineating disorders (MS)
32
Q

Vertigo

A

an illusion of motion - caused by mismatch of sensory input

subjective (person spinning) or objective (room is spinning)

33
Q

Central Vertigo

A

constant but mild vertigo

34
Q

Peripheral Vertigo

A

severe but episodic

35
Q

Risk Factors for Vertigo

A 
medications
head injury
cerebral vascular dx
family hx
tumor
migraine headaches
36
Q

Medications that can cause vertigo

A

salicylates, antiepileptics, antihypertensives, benzodiazepines

37
Q

Treatment for Vertigo

A

mexclizine (antivert)
diazepam
change positions slowly
smoking cessation

38
Q

Motion Sickness

A

normal physiologic vertigo
caused by repeated rhythmic stimulation of vestibular system (overstimulation)
easier to preven than treat

39
Q

Symptoms of Motion Sickness

A 
vertigo
malaise
N/V
Severe motion sickness = autonomic s/sx
hypotension, tachycardia, diaphoresis
40
Q

Meniere’s Disease

A

excess of endolymph
Tinnitus
unilateral sensorineural hearing loss
vertigo (at least 20 min to 24 hours)

41
Q

Cochlear Meniere’s

A 
fluctuating
progressive
sensorineural hearing loss
tinnitus
pressure in ear/ear fullness
42
Q

Vestibular Meniere’s

A

recurrent attacks of vertigo that become more incapacitating

43
Q

Benign Paroxysmal Positional Vertigo

A

most common cause of pathologic vertigo
develops after age 40
brief periods of vertigo with head movement
symptoms usually subside with CONTINUED head movement

Adv Pathophysiology (22 decks)

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