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Physical Diagnosis I Final > Ear > Flashcards

Ear Flashcards

1
Q

What is the gender bias associated with excessive ear wax?

A

Males

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2
Q

What is a Rinne negative finding?

A

Sound heard longer through bone than air (significant canal or middle ear problem)

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3
Q

What is the most common cause of otitis externa?

A

Bacterial infection

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4
Q

Are all middle ear fluids infected and/or painful?

A

NO

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5
Q

What is the Rinne test for presbycusis?

A

Air conduction is greater than bone conduction but less than the 2:1 ratio

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6
Q

What causes cholesteatomas?

A

Congenital defects, chronic otitis media and perforations

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7
Q

Suppurative otitis media is common among what age group?

A

Children 6 months to 6 years old

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8
Q

If one ear is affected by otosclerosis, what will be the findings of the “finger rustle”, Weber, and Rinne tests?

A

“finger rustle” - diminished on that side Weber - lateralization on that side Rinne - air will be less than bone

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9
Q

What is a Rinne positive finding?

A

Air is heard twice as long as bone

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10
Q

Why does sound lateralize to the ear with a significant canal or middle ear problem during the Weber test?

A

Sound cannot escape the ear therefore rebounding it back to the inner ear for a double dose of sound

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11
Q

What color is the eardrum?

A

Pearly gray

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12
Q

What is the shape of the tympanic membrane?

A

Concave

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13
Q

What is the most painful cause of otitis externa?

A

Bacterial infection

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14
Q

What is different with the main symptoms of otitis externa caused by bacteria compared to fungi?

A

Bacteria = pain Fungi = itching

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15
Q

What is usually the cause of a bloody effusion in the middle ear?

A

Temporal bone fractures or shearing force causing mucosal bleeding

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16
Q

What is the issue with cholesteatomas?

A

Erodes surrounding bone and ossicles therefore able to cause hearing loss

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17
Q

Blood vessels in what part of the tympanic membrane overlying the malleus are usually normal findings?

A

Pars flacida

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18
Q

What kinds of things can cause tinnitus?

A

1 skull fracture 2 closed head injury 3 whiplash injury 4 TMJ disorders

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19
Q

What is the supposed general cause of labyrinthitis?

A

Viral infection

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20
Q

What is the name for the triangular reflection of light from the otoscope seen on the tympanic membrane?

A

Light reflex

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21
Q

What ossicle creates the landmarks of the tympanic membrane?

A

Malleus

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22
Q

What will be the finding of the Rinne test if there is a total sensorineural loss of hearing?

A

Nothing will be heard by air nor bone

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23
Q

The auditory (Eustachian) tube joins what two structures?

A

Nasopharynx to middle ear

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24
Q

What are symptoms of inner ear problems?

A

Vertigo (nausea), tinnitus, sensory hearing loss

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25
Q

What is the condition where white calcium patches are present on the eardrum resulting from old eardrums perforations?

A

Tympanosclerosis

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26
Q

When must the Rinne test be performed?

A

If Weber test lateralizes

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27
Q

What fills the tympanic cavity?

A

Air

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28
Q

What is the color of fresh earwax? Of old and built up earwax?

A

Fresh = honey-colored Old = dark black

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29
Q

What does the Rinne test compare?

A

Air to bone conduction

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30
Q

Where is the tympanic cavity located?

A

Carved in the temporal bone

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31
Q

Where do we find the cerumen glands?

A

Outer 1/3 of the canal

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32
Q

What are the two divisions of the tympanic membrane?

A

Pars flacida (attic) Pars tensa (lower 2/3)

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33
Q

What happens to the patient when the eardrum perforates?

A

Discharge into canal and immediate end of earache

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34
Q

What are the two possibles problems if lateralization is found in the left ear during the Weber test?

A

1 sensorineural loss in the right ear 2 air conduction problem in left ear

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35
Q

What is another name for the tympanic membrane?

A

Eardrum

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36
Q

What is the clinical term for inflammation of the inner ear and its nerves?

A

Labyrinthitis

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37
Q

What tool can be used to assess for sensorineural problems or middle ear problems unable to be seen on the eardrum?

A

Tuning fork

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38
Q

If a patient hesitates to answer which ear they hear better in during the Weber test, what is to be expected?

A

Normal response (no issues)

39
Q

What things can cause otitis externa?

A

1 bacteria 2 fungi 3 swimming 4 dermatitis/psoriasis may contribute

40
Q

Which test involves a vibrating fork being places in the midline of the head and asking the patient which ear they hear the ringing better in?

A

Weber test

41
Q

What is exostosis?

A

Abnormal, benign, boney growth of the temporal bone that protrudes into the canal

42
Q

What is the number one reason for sensorineural hearing loss? Number two?

A

1 = age-related hearing loss (presbycusis) #2 = noise-induced hearing loss

43
Q

What is the Rinne finding with noise-induced hearing loss?

A

Air conduction is greater than bone conduction but less than the 2:1 ratio

44
Q

What is otosclerosis?

A

Abnormal ossification of the ossicles

45
Q

How does fresh earwax naturally get pumped out of the ear?

A

TMJ

46
Q

What is the clinical term for “swimmer’s ear”?

A

Otitis externa

47
Q

What three tests check for cranial nerve VIII?

A

1 “finger rustle” 2 Weber test 3 Rinne test

48
Q

If during the Rinne test, air conduction is greater than bone conduction but not by 2X, what is the problem?

A

Inner ear (sensorineural loss)

49
Q

What is the treatment for eardrum perforations?

A

Small ones heal on their own Large ones might need to be patched up surgically

50
Q

Tinnitus affects roughly what percentage of the U.S. population?

A

10%

51
Q

What is probably the most common occupational and environmental hazard?

A

Noise

52
Q

Disorders of what other areas besides the inner ear can also cause vertigo?

A

Vestibular nerve, brainstem, cerebellum

53
Q

What does the middle ear consist of?

A

1 eardrum 2 tympanic cavity 3 ossicles

54
Q

Which ossicle is most likely to be affected by otosclerosis?

A

Stapes (fixation to the oval window)

55
Q

What is the appearance of mucus in the middle ear?

A

Thick, viscous, darker than normal

56
Q

What are the three possible mechanisms for auditory tube blockage?

A

1 barotrauma 2 adenoidal hypertrophy 3 URTI or allergy causing lumen occlusion

57
Q

When does otosclerosis most commonly occur?

A

Between ages 11-30

58
Q

What specific sounds are lost first followed noise-induced hearing loss?

A

High frequency sounds (3000 to 6000 Hz)

59
Q

What are the functions of earwax?

A

1 produce acidic coat that inhibits bacterial and fungal growth 2 prevents water from entering skin due to hydrophobic nature

60
Q

Antibiotic treatment has been shown to have little benefit in which kind of earache cases?

A

Otitis media without fever

61
Q

What are things that increase the chances of getting middle ear effusions?

A

1 crowded child care facilities (increased URTIs) 2 secondhand smoke 3 bottle-fed infants

62
Q

What is the term for age-related hearing loss?

A

Presbycusis

63
Q

What are cystic masses composed of epithelial cells and cholesterol found in the middle ear called?

A

Cholesteatomas

64
Q

What is the conventional treatment for middle ear effusions from the CDC?

A

WASP prescription (wait and see for 24 hours)

65
Q

What are the 3 ossicles?

A

Malleus, incus, and stapes

66
Q

Is hearing impaired in cases of serous fluid or mucus buildup in the middle ear?

A

Yes because ossicles can’t conduct sound vibrations as well

67
Q

How does tympanosclerosis affect the patient?

A

If just on the eardrum - no issues If on ossicles - diminished hearing

68
Q

Patients with seborrhea or eczema are at risk for what kind of ear problem?

A

Otitis externa

69
Q

Which form of conduction should be more efficient: air or bone?

A

Air

70
Q

What is the name of the handle portion of the malleus which angles posteriorly?

A

Long process (manubrium)

71
Q

What is the color of sterile serous fluid that can build up in the middle ear?

A

Yellow

72
Q

What are the Weber and Rinne findings for suppurative otitis media?

A

Weber - lateralizes to affected side Rinne - negative on affected side

73
Q

How long do tympanostomy tubes stay in the eardrum before they are dislodged into the canal?

A

6-12 months

74
Q

The Weber test is an example of what kind of conduction pathway/

A

Bone (traveling through cranial bones, skipping canal and middle ear)

75
Q

What is the name of the rounded part of the malleus at the interface of the pars flacida and tensa?

A

Short process

76
Q

What is the gender bias for otosclerosis?

A

Females 2X (worse during pregnancies)

77
Q

During Dr. Fallon’s study on patients with otitis media, which part of the body was found to almost always be sublimated on the side of the condition?

A

Occiput

78
Q

Is labyrinthitis painful?

A

No, rarely

79
Q

What actions can aggravate otitis externa?

A

Chewing, pressing on trague, wiggling auricle

80
Q

How can foreign objects affect the ear?

A

1 inflammatory 2 decreased hearing

81
Q

What motion of the auricle produces the best view with the otoscope due to the hilly nature of the canal?

A

Pull auricle up and backward

82
Q

What is the normal range for the “finger rustle” test?

A

2 ft

83
Q

When the auditory tube becomes occluded, what happens that causes the earache itself?

A

Trapped air gets resorbed which causes retraction of the eardrum

84
Q

Which four fluids have the potential to accumulate in the middle air following an occlusion of the auditory tube?

A

1 pus 2 serous fluid 3 mucous 4 blood

85
Q

What should be the findings of a normal Rinne test?

A

Air conduction should be 2X longer than bone conduction

86
Q

Presbycusis usually affects what group of people?

A

Elderly

87
Q

At what point are tympanostomy tubes recommended?

A

Recurrent infections (3 episodes in 6 months) Persistent fluid (3 months with hearing loss and unresponsive to antibiotics)

88
Q

What signs may be present in the ear in someone with serous fluid buildup in the middle ear?

A

1 yellow eardrum 2 air bubbles 3 fluid lines

89
Q

Which direction does the umbo face?

A

Backward

90
Q

What anatomical issue causes middle ear problems?

A

Blockage of the auditory tube

91
Q

If during the Rinne test, bone conduction is greater or equal to air conduction on the side of lateralization, what is the problem?

A

Canal or middle ear problem

92
Q

What is the issue with excessive earwax?

A

Can become impacted against eardrum and lead to decreased hearing

93
Q

What are the 4 major red flags of ear conditions?

A

1 sudden or rapid hearing loss

2 vertigo

3 unilateral tinnitus

4 bleeding due to foreign object or pressure change injury

Physical Diagnosis I Final (2 decks)

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