Disorders of Ear Flashcards

Question

TM Perforation - sx - causes - tx

Answer 1

Sx: - clear, pus filled, or bloody drainage from ear - sudden decrease in ear pain followed by drainage - hearing loss - tinnitus Cause: - middle ear infection - airplane - acoustic trauma (direct injury, ear struck with an open hand) - foreign objects in ear - loud sudden noise (explosion or firearm) Tx: - most heal on own - usually no abx or topicals but can consider Cortisporin Otic of Cipro HC - keep ear dry - ear drum patch - tympanoplasty

Answer 2

Sx: pressure in the ear - pain d/t stretching of the TM - hearing loss - tinnitus Most frequent cause is flying though it could be caused by driving as well. Tx: - valsalva - decongestatnts - myringotomy (incision into TM to relieve pressure) Prevention: - avoidance - pre flight decongestants - chewing gum, yawning, swallowing

Answer 3

irrigation is risky, may cause TM perforation remove FB with loop or hook....if necessary refer to ENT.

Answer 4

- hydrogen peroxide - debrox - irrigation with water at body temperature. (so we dont induce vertigo) - suction - scrapings along the roof of the ear canal.

Answer 5

What: complication of otitis media, develops when middle ear inflammation spreads to the mastoid air cells resulting in infection and destruction of the mastoid bone. Sx: post auricular pain and erythema, spiking fever, tender mass dx & tx -ENT consult, CT scan and MRI if intracranial involvement suspected Patient admission for IV Abx for 21 days, - rocephin (ceftriaxone) - piperacillin and tazobactam (Zosyn) - Oxacillin - Genatmicin

Answer 6

aka: vestibular schwannoma age: 50yrs Risk factors: - exposure to loud noise - neuorfibromatosis type 2 (tumors to form in the brain and spinal cord and nerves) - hx of parathyroid adenoma - cell phones controvesial

Answer 7

sx: sx are d/t CN involvment Cochlear nerve = hearling loss and tinnitus vestibular nerve = unsteadiness while walking Trigeminal nerve = facial numbness, hyperethesia and pain Facial nerve = facial paresis and taste disturbances. Dx: - Rinne & Weber, demonstration of asymmetric sensorineural hearing loss or CN deficits - MRI or CT - ENT referral - audiometry Tx: surgery

Answer 8

defined as a symptom of illusory movement. Sx: - transient spinning dizziness - a sense of swaying or tilting - a sens of falling backwards Causes: -asymmetry in the vestibular system d/t damage to dysfunction of the labyrinth, vestibular nerve, or central vestibular structures in the brainstem.

Answer 9

Peripheral: - sudden onset of vertigo - horizontal nystagmus - visual fixation inhibits nystagmus Central: - onset of vertigo is gradual - nystagmus in any direction usually vertical - visual fixation does NOT stop nystagmus Sx of Peripheral: - blurred vision - fatigue, HA - palpitations - imbalance - inability to concentrate - increased risk for motion sickness - N/v - sensitivity to bright lights and noise - sweating from sympathetic stimulation Sx of Central: - double vision - HA - impaired conciousness - inability to speak d/t muscle impairment - lack of coordination - n/v - weakness

Answer 10

defined as disloged otoliths that move into the semicircular canals which causes the semicircular canals to become sensitive to head position changes it would normally not respond to, which is what makes you feel dizzy. Causes: - utricle damage by head injury - infection - advanced age Course: -recurrent brief episodes (lasting less than 1 minute) Sx: - predictable head movements or positions precipitate sx - horizontal nystagmus - no neuro auditory sx Tests: - Dix-hallpike maneuver - romberge - weber-rinne

Answer 11

-person brought from sitting to supine position with the head turned 45 degrees to one side and extended 20 degrees backwards. Positive test consists of a burst of nystagmus.

Answer 12

- wait it out | - epley maneuver

Answer 13

-aka particle repositioning procedure. involve sequential movement of the head into four positions, staying in each position for 30 seconds.

Answer 14

defined as inflammation of the inner ear course: - vertigo - sensation of spinning or whirling that may cause n/v. Gradually goes away over a period of several days to weeks - may have accompanied hearing loss that is temporary. Cause: - often triggered by an upper resp infection (viral) Tx: - goes away on its own after several weeks - medications for N/V : - -Compazine - -Meclazine - -Diazepam/Lorazepam

Answer 15

aka: endolymphatic hydrops what: vertigo that results from distention of the endolymphatic compartment of the inner ear. Sx: - episodic vertigo lasting 1-8hrs - rotary or rocking - low frequency sensorineural hearing loss - tinnitus - sensation of aural pressure Dx criteria: - 2 spontaneous episodes of rotational vertigo lasting at least 20 minutes - audiometric confirmation of sensorineural hearing loss - tinnitus and/or preception of aural fullness. * test pt for syphillis? Tx: - dietary restriction; caffiene, tobacco, salt - Meds: - -diuretics, antiemetics, anxiolytics, antihistamines, scopolamine

Answer 16

What: sensorineural hearing loss in elderly individuals, histologic changes associated with aging occur from the hair cells of the cochlea to the auditory cortex in the temporal lobe of the brain. Characteristics: bilateral high-frequency hearing loss associated with difficulty in speech discrimination and central auditory processing of information

Answer 17

True and True

Answer 18

Sensory: epithelial atrophy with loss of sensory hair cells and supporting cells in the organ of corti Neural: atrophy of nerve cells in the cochlea and central neural pathways. Metabolic: atrophy of the stria vascularis (maintains the chemical and bioelectric balance and metabolic health of the cochlea) Mechanical:thickening and secondary stiffening of the basilar membrane of the cochlea.

Answer 19

Presentation: - varies - diff hearing Tx: - amplification devices; hearing aids - lip reading - cochlear implants - assistive listening devices (amplification of telephone and TV via microphone in pt ear) - follow up