EAR

Question 1

What are clinical manifestations of the ear problem?

Answer 1

Clinical Manifestations:
Otalgia
Purulent Otorrhea
Hearing Loss
Swelling
Vertigo
Nystagmus
Tinnitus
Facial Paralysis

Question 2

Infants – outer 2/3 of ear canal is_______
- inner 1/3 is _________

Answer 2

cartilaginous

bony

Question 3

Older child – outer 1/3 is ____________

Answer 3

cartilaginous

Question 4

– protective, waxy water repellent coating

Answer 4

Cerumen

Question 5

What are the normal flora of the external canal?

Answer 5

Normal flora of the external canal:
ü Coagulase –negative Staphylococci
ü Corynebacterium (diptheroids)
ü Micrococcus
ü Staphlylococcus aureus
ü Streptococci viridans
ü Psuedomonas aeruginosa

Question 6

What are the risk factors?

Answer 6

Risk factors:
§ excessive wetness
§ dryness
§ previous infection
§ eczema
§ trauma
§ foreign body

Question 7

o swimmer’s ear
o etiologic agents:
Pseudomonas aeuriginosa ( most
common)
S. aureus, E. aerogenes, P. mirabilis, K.
pneumonaie, Strep., fungi

Answer 7

Otitis externa

Question 8

What is the most common etiologic agent for otitis externa?

Answer 8

Pseudomonas aeuriginosa ( most
common)

Question 9

chronic irritation and maceration from
excessive moisture in the canal.
§ loss of cerumen
§ trauma
§ cerumen impaction with trapping of water
§ eczema, varicella-zoster, other skin
exanthems

Answer 9

Otitis externa

Question 10

What are the clinical manifestations of otitis externa?

Answer 10

Clinical Manifestations:
ü acute, severe pain
ü itching
ü conductive hearing loss
ü serous or purulent secretions

Question 11

What are the physical findings in otitis externa?

Answer 11

Physical Findings:
ü edema
ü erythema
ü thick clumpy otorrhea
ü cerumen is white and soft
ü entire ear canal – tender and swollen
ü TM – not adequately visualized

Question 12

Answer 12

Otitis externa

Question 13

What are the physical findings in otitis externa

Answer 13

Physical Findings:
ü palpable and tender lymph nodes
periauricular region
ü erythema and swelling of the pinna and
periauricular skin
ü facial paralysis – necrotizing OM ( rare in
in children)

Question 14

Whe are the differential diagnosis of otitis externa?

Answer 14

Ø furunculosis
Ø otitis media
Ø mastoiditis

Question 15

occur in the lateral hair-bearing part of the ear
canal
• localized swelling of the ear canal limited to
one quadrant

Answer 15

furunculosis

Question 16

Answer 16

Furunculosis

Question 17

TM – perforated, severely retracted
bulging and immobile
• hearing usually is impaired
• (-) pain on manipulation of the auricle
• (-) lymphadenopathy

Answer 17

Otitis media