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PHA 521 > EAR 2 > Flashcards

EAR 2 Flashcards

1
Q

Hearing Loss

A

common
prevalence increases with age

classification:

  • conductive v. sensorineural
  • acute v. gradual
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2
Q

Conductive Hearing Loss

A

dysfunction of middle or external ear

often temporary

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3
Q

Conductive Hearing Loss: mechanisms

A

obstruction
mass effect
stiffness
discontinuity

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4
Q

Conductive Hearing Loss: etiology

A

Most common in adults:

  • cerumen impaction
  • eustachian tube dysfunction
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5
Q

Sensorineural Hearing Loss: mechanisms

A

sensory loss

  • most common
  • dysfunction of cochlea (loss of hair cells)

neural loss
-dysfunction of CN VIII or central auditory pathway

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6
Q

Sensorineural Hearing Loss: etiology

A

most common: presbycusis

loud noise exposure
trauma
disease

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7
Q

Hearing Loss: diagnostics

A

formal audiologic assessment:

  • pure tone testing
  • speech audiometry
  • impedance audiometry

evoked responses:

  • auditory brainstem response
  • VEMP

imaging:

  • MRI
  • CT

other tests:

  • glucose
  • CBC
  • TSH
  • syphilis
  • sjorgen’s syndrome
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8
Q

Sensorineural Hearing Loss: treatment

A

conductive
-surgical correction

sensorineural

  • hearing aids
  • cochlear implants

refer
education

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9
Q

Tinnitus

A

perception of sound in hear or head

mild, high pitched sounds (ringing, buzzing, hissing)

continuous or intermittent

associated with sensory hearing loss

prevalence increases with age

men>women

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10
Q

Tinnitus: other forms

A

pulsatile

  • hearing ones own heartbeat
  • indicates vascular abnormality

staccato

  • rapid series of pops or clicks with sensation of ear fluttering
  • middle ear muscle spasm
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11
Q

Tinnitus: unilateral without obvious etiology

A

consider MRI

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12
Q

Tinnitus: pulsatile

A

consider MRA, MRV, temporal bone CT

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13
Q

Tinnitus: treatment

A 
patient education
treat underlying conditions
stop ototoxic medications
avoid exposure to excessive noise
behavioral therapy
masking 
experimental therapy
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14
Q

Dizziness: ddx

A

vertigo
disequilibrium
presyncope
nonspecific dizziness

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15
Q

Vertigo

A

sense of motion when there is no motion (spinning, tumbling, falling)

primary symptom of vestibular disease

classification
central v. peripheral v. mixed

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16
Q

Vertigo: peripheral causes

A 
vestibular neuritis/labrynthitis
meniere disease
benign positional vertigo
ethanol intoxication
inner ear barotrauma
semicircular canal dehiscence
17
Q

Vertigo: central causes

A 
seizure
multiple sclerosis
wernicke encephalopathy
chiari malformation
cerebellar ataxia syndromes
18
Q

Vertigo: central

A

gradual (insidious) onset
progressive increase in severity
gait and posture significantly impaired
NO auditory symptoms

nystagmus

  • any direction (vertical)
  • nonfatigable
  • not latency
  • no suppression with visual fixation
19
Q

Vertigo: peripheral

A 
sudden onset
acutely severe symptoms
N/V
tinnitus
hearing loss

nystagmus

  • horizontal with rotary component
  • mild latency
  • fatigable
  • will break with fixation
20
Q

Vertigo: Dik Hallpike maneuver

A

supine position
head 30 degrees lower than the body
turn L or R

positive: delayed onset fatigable nystagmus (peripheral)
negative: non-fatigable nystagmus (central)

21
Q

Benign Paroxysmal Positional Vertigo (BPPV)

A

caused by sediment in semicircular canals (most common: posterior canal)

provoked by changes in head position

  • latency period
  • acute vertigo, imbalanced for hours

brief episodes, recurrent

appear in clusters

22
Q

BPPV: treatment

A

eply maneuver
PT or OT
pharmaceutical agents
bed rest

education: risk for falls

23
Q

BPPV: Epley Maneuver

A

sitting position
head rotated 45 degrees

supine position
30 degree neck extension
1-2 minutes

rotate head 90 degrees
1-2 minutes

rotate head 90 degrees (45 degrees downward)
1-2 minutes

sitting position
30 seconds

24
Q

Labyrinthitis: etiology

A

inflammatory disorder of vestibular portion of CN VIII

post viral infection

25
Q

Labyrinthitis: clinical presentation

A

acute onset of continuous, severe vertigo

hearing loss
tinnitus

N/V
gait impairment

26
Q

Labyrinthitis: treatment

A

antibiotics
vestibular suppressants
anti-emetics
corticosteroids?

27
Q

Meniere Disease

A

aka endolymphatic hydrops

vertigo syndrome due to peripheral lesion

distention of endolymphatic compartments of inner ear

symptoms wax and wane

can permanently damage inner ear structures

28
Q

Meniere Disease: presentation

A

vertigo (20min-hrs)
sensorineural hearing loss (low frequency)
tinnitus (low tone, blowing/roaring)
aural pressure

29
Q

Meniere Disease: treatment

A

aimed at decreasing endolymph fluid pressure in inner ear

diuretics
low salt diet

30
Q

Vestibular Schwannoma

A

aka acoustic neuroma

one of the most common intracranial tumors

usually unilateral

benign tumor of CN VIII in internal auditory canal –> grows to compress pons –> hydrocephalus

31
Q

Vestibular Schwannoma: presentation, diagnosis, treatment

A

presentation

  • unilateral hearing loss
  • dysequilibrium
  • tinnitus

diagnosis:
- audiometry
- MRI w/ contrast

treatment:

  • observation
  • surgical excision
  • radiotherapy

PHA 521 (12 decks)

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