EAR, NOSE AND THROAT

Question 1

CRANIAL NERVES THAT AFFECT THE EAR, NOSE AND THROAT

Answer 1

• Vestibulocochlear - CN8 - transmits sound and balance info from inner ear to brain
• Olfactory - CN1 - sense of smell
• Glossopharyngeal - CN12 - provides motor, parasympathetic and sensory info to mouth and throat, enables swallowing

Question 2

OTITIS EXTERNA - DEFINITION

Answer 2

• Infection of outer ear canal, which runs from eardrum to outside of head

Question 3

OTITIS EXTERNA - POPULATION AFFECTED

Answer 3

• Anyone can get it - most common in children

Question 4

OTITIS EXTERNA - RISK FACTORS

Answer 4

• Excessive moisture in ear canal
• Exposure to high bacteria levels
• Cleaning ear canal (e.g., with cotton swabs
• Ear devices (e.g., ear buds, hearing aids)

Question 5

OTITIS EXTERNA - CLINICAL PRESENTATION

Answer 5

• Usually mild unless not treated
• Mild- itching in ear canal, redness inside ear, mild discomfort that’s made worse by pulling on outer ear, some drainage of clear, odourless fluid
• Moderate- more-intense itching, inc P, more-extensive redness, excessive fluid damage, decreased or muffled hearing, feeling of fullness in ear
• Advanced- severe P that may radiate to your face or neck, complete blockage of ear canal, redness or swelling of outer ear, swelling in lymph node in neck, fever

Question 6

OTITIS MEDIA - DEFINITION

Answer 6

• Infection of the middle ear
• Air-filled space behind eardrum that contains vibrating bones in ear

Question 7

OTITIS MEDIA - CAUSE

Answer 7

• Bacteria or virus

Question 8

OTITIS MEDIA - POPULATION AFFECTED

Answer 8

• Children

Question 9

OTITIS MEDIA - RISK FACTORS

Answer 9

• Age - children between 6 months and 2 years
• Infant feeding
• Seasonal factors
• Poor air quality
• Cleft palate - difference in bone structure and muscles in children, makes it more difficult for eustachian tube to drain

Question 10

OTITIS MEDIA - CLINICAL PRESENTATION

Answer 10

• Onset usually rapid
• Ear pain, especially when lying down
• Trouble sleeping
• Trouble hearing or responding to sounds
• Loss of balance
• Drainage of fluid from ear
• Headache

Question 11

EARDRUM PERFORATION INFECTION - DEFINITION

Answer 11

• Ruptured ear drum
• Hole or tear in thin tissue that separates ear canal from middle ear

Question 12

EARDRUM PERFORATION INFECTION - POPULATION AFFECTED

Answer 12

• Anyone (SEB DVK)

Question 13

EARDRUM PERFORATION INFECTION - RISK FACTORS

Answer 13

• Head trauma
• Loud music
• Changes in pressure- e.g., from flying

Question 14

EARDRUM PERFORATION INFECTION - CLINICAL PRESENTATION

Answer 14

• Ear pain that may subside suddenly
• Mucus like, pus-filled or bloody drainage of ear
• Hearing loss
• Tinnitus
• Vertigo
• Nausea or vomiting as result of vertigo

Question 15

RAMSEY HUNT SYNDROME - DEFINITION

Answer 15

• Occurs when shingles outbreak affects the facial nerve near one of your ears

Question 16

RAMSEY HUNT SYNDROME - CAUSE

Answer 16

• Varicella-zoster virus which causes chickenpox

Question 17

RAMSEY HUNT SYNDROME - POPULATION AFFECTED

Answer 17

• More common in adults older than 60
• Rare in children

Question 18

RAMSEY HUNT SYNDROME - RISK FACTORS

Answer 18

• Isn’t contagious
• Can be serious in people with immune problems
• Until rash blisters scab over, avoid physical contact with
  
  1. Anyone who has never had chickenpox/vaccine
  2. Weak immune system
  3. New-borns
  4. Pregnant women

Question 19

RAMSEY HUNT SYNDROME - CLINICAL PRESENTATION

Answer 19

• Two main symptoms
  
  1. Painful red rash with fluid-filled blisters on/in around ear
  2. Facial weakness or paralysis on same side as affected ear
• Usually occur at same time
• Ear pain
• Hearing loss
• Tinnitus
• Difficulty closing one eye
• Change in taste perception

Question 20

HEARING LOSS - CONDUCTIVE

Answer 20

1. Conductive- involves outer or middle ear
   
   • Composed of visible ear part (pinna) and ear canal
   • Pinna gathers sound waves from enviro and directs them into ear canal
   • Middle ear is an air-filled cavity that holds chain of three bones- hammer (malleus), anvil (incus) and stirrup (stapes)
   • These bones are separated from outer ear by eardrum, which vibrates when struck by sound wave
   • Middle ear connected to back of nose and upper part of throat by narrow channel called auditory tube- tube opens and closes throat end to equalise pressure in middle ear. Equal pressure on both sides of eardrum is important for normal vibration of eardrum

Question 21

HEARING LOSS - SENSORINEURAL

Answer 21

2. Sensorineural- involves inner ear
   
   • group of interconnected fluid-filled chambers
   • Cochlea plays roll in hearing
   • Sound vibrations from bones of middle ear are transferred to fluids of cochlea
   • Tiny sensors lining cochlea convert vibrations into electrical impulses that are transmitted along auditory nerve to brain
   • This is where initial damage and hearing loss occur due to age, noise exposure, medication
   • Other fluid filled chambers of inner ear include semi-circular canals
   • Hair cells in semi-circular canal detect motion of fluid when you move in any direction
   • They convert motion into electrical signals that are transmitted along the vestibular nerve to the brain
   • Sensory info enables you to maintain your sense of balance
   • Aging and chronic exposure to loud noises both contribute to hearing loss
   • Other factors include- excessive ear wax, can temporarily reduce how well ear conducts sound
   • Ear made up of outer, middle and inner ear- each plays distinct role in converting sound waves into signals that travel to brain

Question 22

S&S OF HEARING LOSS

Answer 22

• muffling of speech/other sounds
• Difficulty understanding words, especially against background noise or in a crowd
• Needing to turn up vol of TV

Question 23

HEARING LOSS - CAUSES

Answer 23

• Damage to inner ear- aging and exposure to loud noise may cause wear and tear on hairs or nerve cells in cochlea
• Gradual build up of ear wax- can block and prevent conduction of sound waves
• Ear infection and abnormal bone growths or tumours
• Ruptured eardrum

Question 24

HEARING LOSS - RISK FACTORS

Answer 24

• Aging
• Loud noise
• Hereditary
• Some medications

Question 25

TMJ DYSFUNCTION - DEFINITION

Answer 25

• TMJ dysfunction occurs when the muscles and ligaments around your jaw joints become inflamed or irritated

Question 26

TMJ DYSFUNCTION - CAUSE

Answer 26

• Many causes, most common is when the disk erodes or moves out of its proper alignment

Question 27

TMJ DYSFUNCTION - POPULATION AFFECTED

Answer 27

• Older people

Question 28

TMJ DYSFUNCTION - RISK FACTORS

Answer 28

• Various types of arthritis, such as rheumatoid arthritis and osteoarthritis
• Jaw injury
• Long-term (chronic) grinding or clenching of teeth
• Certain connective tissue diseases that cause problems that may affect the temporomandibular joint

Question 29

TMJ DYSFUNCTION - CLINICAL PRESENTATION

Answer 29

• Pain or tenderness of your jaw
• Pain in one or both of the temporomandibular joints
• Aching pain in and around your ear
• Difficulty chewing or pain while chewing
• Aching facial pain
• Locking of the joint, making it difficult to open or close your mouth

Question 30

TONSILLITIS - DEFINITION

Answer 30

• Tonsillitis occurs when your tonsils become infected

Question 31

TONSILLITIS - CAUSE

Answer 31

• Can be caused by a bacteria or virus

Question 32

TONSILLITIS - POPULATION AFFECTED

Answer 32

• Tonsillitis is most common in children

Question 33

TONSILLITIS - RISK FACTORS

Answer 33

• Young age.
• Frequent exposure to germs

Question 34

TONSILLITIS - CLINICAL PRESENTATION

Answer 34

• Sore or scratchy throat.
• Pain or difficulty swallowing.
• Red, swollen tonsils and throat.
• Whitish spots on your tonsils — or a white, yellow or gray coating on your tonsils.
• Fever above 100.4 degrees Fahrenheit (38 degrees Celsius).
• Swollen lymph nodes (glands on the sides of your neck below your ears).
• Stomachache or vomiting (more common in younger children).