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Medicine > Ear exam > Flashcards

Ear exam Flashcards

1
Q

What is the auricle

A

First part of the hearing apparatus

made of cartilage (poorly perfused)

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1
Q

Things to consider when changes in balance are noted

A
  1. vertigo (room spinning or them spinning) vs lightheadedness (had to sit down) BPPV
  2. related to changes in position?
  3. associated symptoms (nausea and vomiting)
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2
Q

Auriculotemporal nerve

A

branch of trigeminal nerve that innervates the auricle

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3
Q

What is the function of the auricle?

A

Channels sound to the hearing apparatus (mechanical energy)

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4
Q

Exterior auditory canal (EAC)

A

two segments, padded and bony, channels waves through to middle ear

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5
Q

What nerve innervates the EAC?

A

Facial nerve

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6
Q

Why is the back part of the EAC more sensitive?

A

It is skin over bone (no padding)

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7
Q

Tympanic membrane

A

Ear drum

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8
Q

What are the landmarks of the tympanic membrane?

A

Cone of light (where light reflects off drum)-absent when fluid is behing it

Bony annulus (where ear drum attaches to the bone)

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9
Q

Layers of TM

A

ectoderm (outer cutaneous)

middle CT

endoderm (innermost mucosum)

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10
Q

Pars tensa

A

where TM is tightly attached to bone

most common area where it may become perforated

along bottom arc of ear drum

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11
Q

pars flaccida

A

along superior arc of ear drum (attic)

where chronic disease tends to occur

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12
Q

What is the function of the TM?

A

transfer mechanical energy into ossicular chain

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13
Q

What is the function of the cochlea?

A

transfers mechanical membrane into electrical energy

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14
Q

What is the function of the Eustachian tube?

A

regularize pressure between the middle ear and the EAC

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15
Q

TMJ

A

can be diagnosed by touching the muscles inside the mouth

typically caused by muscles, not a jaw dysfunction

often presents with ear pain, but can be ruled in when no ear pathology is present

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16
Q

Things to consider when changes in hearing are noted

A
  1. timing of loss
  2. ability to understand (neurological)
  3. tinnitus (abnormal noise perception in the ear)-ringing, chirping, low buzz
17
Q

Menieres disease

A

presents with fluctuating hearing loss

and vertigo

18
Q

speech discrimination

A

have a hard time with volume AND understanding what’s being said

19
Q

steps of the physical exam

A

inspect (auricle, external meatus)-common spot for actinic keratosis, look for skin changes, look for discharge or excess ear wax

palpate (auricle)-look for tenderness, lumps or bumps

visualize (canal and TM)-look for blockage, foreign bodies

20
Q

external meatus

A

opening of EAC

21
Q

tug test

A

tug gently

if pain is noted, it may indicate cnal pathology

22
Q

why would you hold the otoscope to the side?

A

makes patient feel more comfortable

if pt moves, you can move with them

23
Q

Exostosis

A

bony outcroppings present in the EAC

not pathological

typically seen in pts who sleep in cold water

24
Q

acute otitis externa

A

“swimmer’s ear” bacterial infection of the EAC

positive tug test

treatment includes reacidification of the ear canal

25
Q

perforation of TM

A

a hole in the TM

can be from infection or traumatic

26
Q

bullous myringitis

A

infection of the ear drum itself (usually combined with infection of the middle ear)

extremely painful

atypical bacteria

27
Q

acute otitis media

A

bulged out ear drum

hyperemic (highly vascularized)

cone light present but not in the right spot

28
Q

glomus tumor

A

zebras (not very common)

vascular tumor

may be in front of or behind the TM

pulsatile tinnitus

29
Q

hemotymanum

A

blood in the middle ear space

posterior nose bleeds

caused by basalar skull fracture

30
Q

serous otitis media

A

serous fluid in the middle ear (does not indicate infection)

give it time to go down

31
Q

conductive hearing loss

A

disruption of sound energy through outer and middle ear

32
Q

sensorineural

A

hearing loss caused by problems with the end organ

33
Q

Weber tuning fork test

A

not used all that often

tests for lateralization of hearing loss

34
Q

unilateral conductive loss

A

“i can hear it in the “bad” ear”

indicates a conductive loss in the bad ear

35
Q

unilateral s/n loss

A

“i hear it in the good ear”

indicates that the bad ear is experiences sensorineural loss

36
Q

Rinne tuning fork test

A

used to test air conduction vs. bone conduction

(which is louder one or two)

37
Q

normal Rinne test results

A

air conduction > bone conduction

38
Q

Rinne results that indicate conductive loss are

A

bone conduction > air conduction

39
Q
A

Medicine (146 decks)

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