Ear

Question 1

• Parts of the Ear:

Answer 1

o Outer ear: Structural and conductive functions (moves sound from outside in).
o Middle and inner ear: Functional parts (hearing and equilibrium).
o Neuro pathways: Transfers information from the functional part to the brain.

Question 2

Clinical Reasoning for Dysfunction

Answer 2

• Determine the source of dysfunction to guide further assessments and interventions.
• Adapt communication for patients with hearing loss:
  o Use a cultural humility lens.
  o Consider communication barriers for the deaf community.
  o Access interpretation services and collaborative communication strategies.

Question 3

Using an Otoscope

Answer 3

• Technique:
  o Children: Pull ear down to align for better tympanic membrane visibility.
  o Adults: Pull ear up and back for proper alignment.
• Challenges:
  o Structure visibility varies with age.
  o Can feel invasive, especially if there is an infection.

Question 4

Middle Ear Functions

Answer 4

1. Conducts sound vibrations from the outer ear to the inner ear.
2. Protects the inner ear by reducing the amplitude of loud sounds.
3. Equalizes air pressure via the Eustachian tube (e.g., during altitude changes).

Question 5

Inner Ear Anatomy and Functions

Answer 5

• Bony labyrinth: Holds sensory organs for equilibrium and hearing.
• Semicircular canals: Provide balance and spatial orientation.

Question 6

Key Anatomical Landmarks

Answer 6

• Tragus: Small cartilage projection in front of the ear canal.
• Mastoid process: Bony prominence behind the ear.
• Eustachian tube: Connects the middle ear to the nasopharynx, typically closed but opens during swallowing or yawning.
• Cranial Nerve VIII (Vestibulocochlear nerve): Transmits auditory and balance signals to the brain.

Question 7

Hearing Loss Types

Answer 7

1. Conductive Hearing Loss:
   o Cause: Mechanical dysfunction of the external or middle ear (e.g., impacted cerumen, perforated eardrum, otosclerosis).
   o Effect: Partial hearing loss, improved by amplifying sound.
2. Sensorineural Hearing Loss:
   o Cause: Pathology of the inner ear, auditory nerve, or auditory cortex (e.g., presbycusis, ototoxic drugs).
   o Effect: Difficulty understanding speech, even with increased sound amplitude.
3. Mixed Hearing Loss: Combination of conductive and sensorineural losses.

Question 8

Equilibrium and Vertigo

Answer 8

• Semicircular canals: Provide feedback about the body’s position in space.
• Labyrinth dysfunction: Can cause vertigo (spinning sensation) and balance issues.

Question 9

Social Determinants of Health Considerations

Answer 9

• Otitis Media (Middle Ear Infection):
  o Common in children; 50% of children under 2 experience at least one episode.
  o Risk factors: No breastfeeding, exposure to smoke, daycare attendance, male sex, low birth weight, supine bottle feeding.
  o Chronic otitis media can lead to hearing loss and delayed cognitive development.
  o Incidence has decreased due to fewer households with second-hand smoke and public smoking bans.
• Cerumen (Earwax):
  o Dry type: Gray, flaky; common in Asians and Indigenous people.
  o Wet type: Honey brown or dark brown; common in African and Euro-Canadian populations.
  o Cerumen type is genetically determined and unrelated to hygiene.

Question 10

Hearing Loss in Adults

Answer 10

• Hearing loss affects 1 in 4 Canadian adults.
• Third most prevalent chronic condition in older adults.
• Audism: Discrimination based on hearing ability, a significant issue for people with hearing impairments.