Ear conditions and Eval Flashcards
What are the 2 functions of the ear?
Hearing
Static & dynamic equilibrium
Contents of the middle ear?
Tympanic membrane
Ossicles
Eustachian tube
The stapes connects to the what to transmit sounds in the form of vibrations?
Oval window of the cochlea
Helps to equalize the air pressure in middle ear with that of outside air
Eustachian tube
What is the function of the tensor tympani?
dampens the sound of chewing
What is the function of the Stapedius?
Dampens the sounds of your own voice
What nerve carries sound and body position & motion signals from the inner ear to brain?
CN 8, vestibulocochlear
What are the components to the inner ear?
Cochlea
Utricle & Saccule
Semicircular Canals
Provide information about body position at rest
Utricle & Saccule
Provide information about the body in motion
Semicircular Canals
What is auditory paresthesia commonly called?
Tinnitus
An infection of the skin and outer ear is called?
Perichondritis
Otitis Externa common name?
Swimmer’s Ear
Exostoses in ear canal is called?
Surfer’s Ear
absence or abnormal narrowing of an opening or passage in the body is what?
Atresia
Is Atresia of the ear just a cosmetic issue?
no, can affect the canal opening and may cause it to not be there at all aka Anotia
- A condition that sometimes results from physical trauma to the pinna, or inflammation or infection
- Because the circulation in parts of the ear is slow, trapped blood and fluid can organize, creating permanent deformity in the shape of the pinna
Cauliflower Ear
- Another name for the inflammation or infection of external ear secondary to infection, trauma, piercing, or other causes
- Treated with astringents
and systemic antibiotics to prevent permanent disfigurement - Drainage when necessary
Perichondritis
Which form of scarring is temporary and which is permanent?
Temporary= Hypertrophic
Permanent= Keloid
- Often caused by water getting into ear canal
- Due to bacteria or fungi
- Can cause a boil or abscess
*Diabetes and/or skin conditions like dermatitis can make ear prone to infection
Otitis Externa aka swimmer’s ear
What are the symptoms of swimmer’s ear?
itching, swelling, pain, tenderness, discharge, & occasionally hearing loss due to obstruction
What exam findings do you expect with Otitis externa?
Pain w/manipulation or pressing on the tragus
What is the appropriate care for Otitis Externa/Swimmer’s ear?
Depends on cause=
*Hematoma or abscess is drained
*Antibiotics
*Anti-inflammatory drugs
*keep moisture out of ear
What has been proven to play a huge role in non-infectious otitis externa?
Food sensitivities producing IgE antibodies
What could be the cause of hearing loss, a “plugged” sensation, and earache?
Impacted Cerumen
what are the two features you are looking for when inspecting the tympanic membrane?
Manubrium of the malleus
Cone of light
- A benign tumor near eardrum
- Can grow into middle ear space, destroying ossicles
- Appears as white mass behind or on eardrum
- Most are due to repeated middle ear infections
- Some are congenital epidermoid cysts – skin growing in the wrong place
Cholesteatoma
How do you treat a cholesteatoma?
Surgery to remove growth
Reconstruct damaged ossicles/eardrum
Antibiotics if infected
Goal is to preserve hearing & balance
Why do middle ear infections happen more often in kids?
Eustachian tubes are shorter, more horizontal, and narrower making it easier to obstruct them
Have not developed antibodies yet for those infections
Correct name for middle ear infection?
Acute Otitis Media
What can occur in acute otitis media that could lead to increased pain, then a sudden release of pain and drainage?
Inflammation causing increase fluid in middle ear
Tympanic membrane bulging outward
Pressure causes pain
Spontaneous perforation
Drainage of fluid/pus
*Exam reveals fever, tenderness to pressure on mastoid area, and the following tympanic membrane changes during otoscopic exam:
* Redness/injection, possible dullness due to pus * Bulging or retraction
* Altered appearance of cone of light, umbo * Fluid levels visible, possibly with bubbles
* Tympanic membrane is less mobile (with pneumatic otoscope)
What is this?
Acute Otitis Media
*Fever, if any, is lower
* Pain is low‐grade or absent
* Child appears less sick, less fussy, eats better
* May be fluid behind tympanic membrane, and bubbles, but less redness and no pus.
This is not Acute Otitis Media this is?
Serous Otitis Media
Best researched practices for Acute or Serous Otitis Media?
Wait and see- wait 48 hours and use NSAIDs & ear drops to lessen fever & pain for 2 days.
If worse in 48 hours, get antibiotics
Two chiropractic techniques for otitis media?
Muncie technique
Galbreath Technique
Name the procedure to create a hole in the ear drum to allow fluid that is trapped in the middle ear to drain out.
Myringotomy
Can be done with or without Tympanostomy Tubes
What are the risks of treating infants with anti-biotics?
- Diarrhea due to killing of symbiotic gastrointestinal flora
- Increased risk of allergies, asthma
- Increased risk of resistant bacteria; increased antibiotic resistance
- Slightly increased risk of cancer
*The scarring of the eardrum secondary to acute otitis
media or chronic, recurrent middle ear infections
* The patient has a history of middle ear infections
* Tympanic membrane looks irregular, with dull white spots and/or pits
* Otoscopically, it looks a bit like cholesteatoma
Tympanosclerosis
aka myringosclerosis
Your patient has a ruptured ear drum. How will you confirm and how will you treat them?
Confirm with otoscopic exam
Most heal within 4-8 weeks, keep ear clean and dry
Antibiotics can be prescribed to treat infection or to prevent infection
*Abnormal bone growth of the middle ear bones (ossicles) or of the bone that surrounds the inner ear, Stapes is most commonly affected
* When it affects the ossicles, it eventually immobilizes them so that:
* they can’t vibrate
* they can’t transmit sound
what is this?
Otosclerosis
- A common cause of hearing impairment
- Tends to run in families
- Affects more women than men; Especially young Caucasian women
- Main symptom is hearing loss * Occurs gradually
- One or both ears may be affected
- Tinnitus and/or dizziness may also be present
Otosclerosis
Can you identify otosclerosis with an otoscope?
No, it is to far from the tympanic membrane to see
*Injury to the ear from changes in barometric pressure or water pressure
* Most common cause is blockage or partial blockage of eustachian tube
*If severe, can cause bleeding and/or rupture of the tympanic membrane
Barotrauma
