Ear Flashcards
2 primary functions of the ear
Hearing
-Static and dynamic equilibrium
Outer ear components
Pinna and Ear Canal
Middle Ear
-Tympanic membrane: Subject to noise trauma
-Ossicles: 3 tiny bones with joints between them/Transmit vibrations from tympanic membrane
-Eustachian tube: Equalize the air pressure in the middle ear with that of the outside ear
Two muscles in the middle ear that help dampen sounds when things are really loud
- Tensor Tympani: Trigeminal; Teeth
- Stapedius: Seven (CN 7); Singing sounds
Which cranial nerve carries sound and body position & motoin from the inner ear to brain
Cranial nerve 8 (vestibulocochlear)
Inner Ear
-Cochlea
-Utricle and Saccule
-Semicircular canals
Cochlea
-Snail-shaped with tiny hairs inside
-Transforms sound waves into electrical impulses
Utricle and Saccule
-Filled with fluid and hairs
-Provide information about body position at rest
Semicircular canals
-Provide information about body in motion
The big four ear complaints
Hearing loss, equilibrium or balance problems, Dizziness/vertigo, Tinnitus (auditory paresthesia)
Cauliflower ear
-Result of physical trauma to the pinna or inflammation or infection
-Can create permenent deformity in the shape of the pinna
-Palpates as a hard lump
-Common in wrestlers and boxers
Perichondritis
Another name for inflammation or infection of the external ear
-Treated with astingents and systematic antibiotics
-Drainage when necessary
Ear piercing
-Earlobe is safer than cartilage (poorer circulation)
-Refer patients id there is swelling, inflammation, infection or fluid filled lesion
Keloid vs Hypertrophic scarring
Keloid: Scar tissue (more excessive and permenent)
Hypertrophic scarring: More temporary
Outer ear infection: Swimmers Ear
-Otitis externa
-Infection or inflammation of the ear canal
-Symptoms: itching, swelling, pain, tenderness, discharge and occasionally hearing loss
Examination Findings in Otitis Externa
Pain when pressing or manipulating the tragus
Medical Care for Otitis Externa
Dependent on cause
-Hematoma or abscess is drained
-Antibiotics: Topically and/or systematically
-Anti-Inflammatory drugs
External Auditory Exostosis: Surfer’s Ear
From repeated exposure to cold water, wind and salt water
Cancer of the Pinna/Auricle
-Due to exposure of ear to ultraviolet radiation from sun
-Look for suspicious growths that are new or changing
Cholesteatoma
-A benign tumor near eardrum
-Appears as white mass behind or on eardrum
Symptoms of Cholesteatoma
Hearing loss, dizziness, pressure in ear, ear ache
Treatment of Cholesteatoma
-Surgery to remove growth completely and to reconstruct damaged ossicles or eardrum
-Goal is preserve hearing (and language skills) and equilibrium/balance
Leading cause of pediatric visits to medical doctor
Middle ear infection/otitis media
Why does Otitis media affect kids more
- Anatomy: Kids eustachian tubes are shorter, more horizontal, and narrower
- ## Physiology: Kids immune systems are not as developed
Otitis media epidemiology
-Most often in kds
-More males than females
-Family history is important
-More in bottle fed
-More often in day care kids and kids exposed to second hand smoke
-More common in winter
Otitis media Diagnosis
Tenderness to pressure on mastoid area
Acute vs. Seroud Otitis Media
Serous: Less severe (lower fever, low-grade or no pain, child appears less sick, less redness/no pus) than acute
Treatment of Otitis Media
Wait and See Prescription (WASP): Wait 48 hours
Treatment/Relief of Otitis Media
-Muncie technique, Gallbreath technique, -Acupuncture
-Dietary supplementation (Vitamin C, Zinc, maganese, colloidal silver drops, calcium, goldenseal/echinacea)
-Antibiotics
-Myringotomy with or without Tympanostomy Tubes
Home Care Advice for Otitis Media
Nasal saline drops, NoseFrida
Tympanosclerosis
Scarring of the eardrum secondary to acute otitis media or chronic, recurrent middle ear infections
-Patient has a history of middle ear infections
-Looks like cholesteatoma
Treatment of Ruptured/Perforated Tympanic Membrane
Most heal within 4-8 weeks, antibiotics
-Self care: keep ear canal dry
Otosclerosis
Abnormal bone growth of the middle ear bones
-Common cause of hearing impairment
-Tends to fun in families
-Affects women more than men
-Main symptom is hearing loss
Which structure of the ear is most affected during otosclerosis
Stapes
Diagnosis of Otosclerosis
Weber: Sound will localize to involved ear if UL
RInne: Bone conduction is louder and longer than air conduction
Otoscopic Exam: To rule out other things; Can’t see otosclerosis with otoscope
-CT Scan
-Refer to otologist
Treatment of otosclerosis
Hearing aid (temporary)
-Stapedectomy and prosthesis surgery
-Sodium fluoride supplementation
Barotrauma
-MC cause is blockage or partial blockage of eustachian tube
-Common in airplane take-offs/landings or water pressure
-If severe can cause bleeding and/or rupture of tympanic membrane
Who identified Eustachian tubes
Bartolomeo Eustachio
Maneuver for equalizing air pressure in ears
Antonio Valsalva (Valsalva Maneuver)
Preventing & Treating Barotrauma
Chiropractic Adjustments: PARTS likely in upper C spine
-Acupuncture and soft tissue work
-Muncie/Fossa of Rosenmuller Technique
