Ear, Hearing, Vertigo

Question 1

Explain what the Weber Test is

Explain what the Rinne Test is

Answer 1

-Weber: place tuning fork on top of head

-Rinne: place tuning fork by mastoid of ear

Question 2

With the Weber Test, explain what happens in…

-Sensorineural Hearing Loss
-Conductive Hearing Loss

Answer 2

-Sensorineural: lateralizes to normal ear

-Conductive: lateralizes to affected ear

Question 3

What happens with the Rinne Test in…

-Sensorineural Hearing Loss
-Conductive Hearing Loss

Answer 3

-Sensorineural: AC > BC (normal)

-Conductive: BC > AC (negative)

Question 4

MCC Conductive Hearing Loss

MCC Sensorineural Hearing Loss

Answer 4

-Conductive: cerumen impaction

-Sensorineural: Presbycusis

Question 5

Peripheral Vertigo
-MCC
-Nystagmus
-No…
-Problem with what two anatomic things?

Answer 5

-MCC: BPPV
-Horizontal fatigable nystagmus
-No CNS problems
-Problem with Labyrinth or Vestibular Nerve (CNVIII)

Question 6

Central Vertigo
-MCC
-Nystagmus
-Symptoms
-Problem with what two anatomic things?

Answer 6

-Migraine, MS, Vestibular Neuroma
-Vertical, non-fatigable (continuous) nystagmus
-Gradual onset, gait problems, CNS signs
-Problem with brainstem or cerebellar

Question 7

Peripheral Vertigo Causes
-BPPV (MC): _______
-Meniere: ________
-Vestibular Neuritis: _______
-Labyrinthitis: _________

Answer 7

BPPV: Episodic vertigo, no hearing loss

Meniere: episodic vertigo + sensorineural hearing loss + tinnitus + ear fullness

VN: continuous peripheral vertigo + no hearing loss

Labyrinthitis: continuous peripheral vertigo + hearing loss + tinnitus

Question 8

What is the pathophysiology of Meniere’s Disease?

Answer 8

Idiopathic distention of the end-lymphatic compartment of the inner ear due to excess fluid

Question 9

Mastoiditis
-Diagnostic of choice
-Treatment

Answer 9

-CT scan with contrast

-Tx: IV ABX + middle ear or mastoid drainage (myringotomy) with tympanostomy tube placement
—IV Vanco + Ceftazidime or Cefepime
—Refractory: Mastoidectomy