EAR Flashcards

1
Q

Bones of the ear in order from closest to tympanic membrane

A

Malleus, incus, stapes

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2
Q

Three main types of hearing loss

A

Conductive
Sensorineural
Mixed

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3
Q

What type of hearing loss is associated with the outer and middle ear?

A

Conductive hearing loss

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4
Q

What type of hearing loss is associated with the inner ear?

A

Sensorineural hearing loss

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5
Q

What is the most common type of hearing loss?

A

Sensorineural hearing loss - 90%

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6
Q

What is mixed hearing loss?

A

Both conductive and sensorineural hearing loss

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7
Q

What is a Rinne’s positive result?

A

Air conduction > bone conduction

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8
Q

If a person is Rinne’s positive but hearing has reduced equally for both bone and air conduction, what type of hearing loss do they have?

A

Sensorineural hearing loss

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9
Q

If a person is Rinne’s negative, what kind of hearing loss do they have? HINT: 2 potential types

A

Conductive hearing loss or severe sensorineural hearing loss

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10
Q

What conduction is heard better in a Rinne’s negative test?

A

Bone > air conduction

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11
Q

What is a normal Weber’s test result?

A

Sound heard equally in both ears

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12
Q

In Weber’s test, if the sound is heard louder on the side of intact ear, what is the likely hearing loss?

A

Sensorineural

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13
Q

In Weber’s test, if the sound is heard louder on the side of the affected ear, what is the likely hearing loss?

A

Conductive

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14
Q

What is pure tone audiometry?

A

Measures quietest sounds a person can hear at different frequencies (pitch) in each ear. Results plotted in pure tone audiogram

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15
Q

Four degrees of hearing loss severity

A

Mild, moderate, severe , profound

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16
Q

Describe tympanometry

A

Test of middle ear functioning. Looks at compliance of eardrum to changing air pressures, indicating how effectively sound is transmitted into middle ear

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17
Q

Number of people in UK severe or profoundly deaf

A

> 900,000

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18
Q

What is a common cause of temporary hearing loss?

A

Wax

19
Q

List 4 problems with the outer ear that can cause hearing loss

A

Congenital malformations of the ear
Wax
Infection
Exostosis

20
Q

What is exostosis (surfer’s ear)?

A

Abnormal bone growth within the ear canal

21
Q

What causes exostosis?

A

Irritation from cold wind and water exposure causes bone surrounding ear canal to develop lumps of new bony growth which constrict ear canal. Where canal is blocked, water and wax become trapped and cause infection

22
Q

Three causes of hearing loss caused by the middle ear

A

Perforated ear drum
Otitis media with effusion
Otosclerosis

23
Q

What is otosclerosis?

A

Abnormal growth of bone of middle ear. Prevents structures from working properly, causes hearing loss. For some, this may become severe

24
Q

Describe chronic suppurative otitis media (CSOM)

A

Inflammation of middle ear and mastoid cavity
Characterised by discharge from middle ear through a perforated tympanic membrane
At least 6 weeks

25
Q

After which condition can chronic suppurarive otitis media occur?

A

Following an URTI that has led to acute otitis media

26
Q

Five problems with the inner ear that can cause hearing loss

A
Presbyacusis
Noise exposure
Genetic
Ototoxicity
Vestibular schwannoma
27
Q

What is the most common type of sensorineural hearing loss, caused by aging of auditory system? It occurs gradually and initially affects the ability to hear higher pitched sounds

A

Presbycusis

Pronounced prezbikusis

28
Q

Hallmark of presbycusis

A

Progressive, symmetrical loss of high-frequency hearing over many years

29
Q

What factors influence the onset and severity of presbycusis?

A

Genetic predisposition, socioeconomic status, noise exposure, smoking, hypertension, diabetes, vascular disease

30
Q

Approximatly how many decibels is a whisper?

A

30

31
Q

Approximatly how many decibels is a jackhammer?

A

130

32
Q

Give an example of a drug that causes tinnitus

A

NSAIDs

33
Q

Give 2 examples of drugs that cause temporary hearing loss

A

Loop diuretics

Macrolides

34
Q

Give an example of a drug that causes permenant hearing loss and/or vestibular damage

A

Aminoglycosides

35
Q

Benign, usually slow growing tumour from an overproduction of Schwann cells

A

Vestibular schwannoma (acoustic neuroma)

36
Q

Typical vestibular schwannoma presentation

A

Asymmetrical hearing loss, tinnitus, dizziness. CN VII symptoms if large

37
Q

How is vestibular schwannoma diagnosed?

A

MRI of internal acoustic meatus

38
Q

Managment of vestibular schwannoma

A

Dependent on size & symptoms
Monitoring
Radiotherapy
Surgery

39
Q

Two central causes of hearing loss

A

Dementia, depression

40
Q

Mechanism of hearing

A

Sound waves travel via external canal to tympanic membrane, causing it and attached chain of ossicles to vibrate. Motion of stapes against oval window sets up waves in fluids of cochlea, causing basilar membrane to vibrate. This stimulates organ of Corti to send nerve impulses to brain

41
Q

What proportion of people with tinnitus also experience hearing loss?

A

2/3

42
Q

Two examinations that should be done for tinnitus

A

Otoscopy

Blood pressure

43
Q

Causes of tinnitus - 12 listed

A
Hearing loss
Loud noise
Stress + anxiety
Ear infections
Wax
Ménière's disease
Glue ear
Otosclerosis
Perforated eardrum
Hypertension
Neuroma
Diabetes
44
Q

Managment options for tinnitus

A
Hearing aid 
Relaxation 
CBT 
Using sound
Addressing sleep problems