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Physical Diagnosis > Ear Quiz > Flashcards

Ear Quiz Flashcards

1
Q

Examples of reported current or past symptoms that should always be correlated with the structural and functional physical findings of the ear

A 
Earache 
Aural discharge 
Hearing loss
Vertigo 
Tinnitus
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2
Q

Should be examined for inflammation, rashes, sebaceous cysts, cancerous lesions, tophi, and deformity

A

External ear

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3
Q

How long is the ear canal?

A

1-1.5 inches

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4
Q

What part of canal contains cartilage, cerumen glands, and hair?

A

Outer 1/3

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5
Q

How is the auricle displaced to allow better viewing of the auditory canal?

A

Posterior and superior (canal runs superior, then inferior toward the drum and runs a little posterior to anterior)

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6
Q

Typically present to some degree in the ear canal. Creates an acidic coat that probably prohibits bacterial and fungal growth

A

Earwax

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7
Q

Fresh earwax should be _____ colored and is pumped out of the ear by the ________

A

Honey colored

TMJ

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8
Q

Color of very old earwax

A

Dark/Black

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9
Q

How can earwax cause hearing problems?

A

If the wax becomes excessive or impacted against the ear drum (removal of wax restores hearing)

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10
Q

An abnormal, benign, boney growth of the temporal bone what may occasionally be seen protruding into the canal

A

Exostosis

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11
Q

A canal infection often due to swimming or canal damaging cleaning. (“Swimmers ear”)

A

Otitis externa

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12
Q

S/S of Otitis externa

A
  • Earache
  • Red and swollen ear canal
  • Possible discharge
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13
Q

T/F Fungal overgrowth will most commonly cause otitis externa

A

FALSE.

MC is bacterial infections (fungal overgrowth = 10% of otitis externa)

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14
Q

Symptom that differentiates bacterial vs. fungal otitis externa

A

Fungal will producing pruritis (itching) rather than pain (bacteria)

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15
Q

Makes up the middle ear

A
  • Eardrum (Tympanic membrane)
  • Tympanic cavity
  • Ossicles
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16
Q

Parts of the tympanic membrane

A
  • Attic portion = pars flacida

- Lower 2/3 = pars tensa

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17
Q

T/F The tympanic cavity is convex shapped and tipped away from the examiner

A

FALSE.

It is concave shaped and tipped toward the examiner

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18
Q

What bone is the tympanic cavity located in?

A

The temporal bone

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19
Q

Ossicles of the middle ear

A

Malleus
Stapes
Incus

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20
Q

What makes the tympanic membrane landmarks?

A

Created by the malleus pressed up against the inside of the ear drum

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21
Q

Rounded part of the malleus at the interface of the pars flacida and pars tensa

A

Short process

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22
Q

The handle of the malleus which angles toward the posterior

A

Long process

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23
Q

The triangular reflection of light from the otoscope with its apex at the end of the long process and angling anterior at the margin of the tympanic membrane

A

Light reflex (Triangle of Light)

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24
Q

Collapse of the auditory tube due to pressure

A

Barotrauma

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25
Q

Collapse of the auditory tube due to swollen adenoids

A

Adenoidal hypertrophy

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26
Q

Occlusion of the lumen of the auditory tube secondary to an upper respiratory infection or allergy

A

Mucosal swelling and Excess mucus

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27
Q

How does the occlusion of the auditory tube cause pain?

A

Air trapped in the tube gets absorbed and creates a vacuum which retracts the eardrum, causing pain

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28
Q

4 fluids that can accumulate in the middle ear

A

1) Pus
2) Serrous
3) Mucus
4) Blood

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29
Q

A middle ear infection common to children between six months and 6 years old. Classic signs and symptoms include earache, fever, diminished or absent landmarks, and pus visible against the drum.

A

Suppurative Otitis Media

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30
Q

In children with otitis media but without fever and vomiting, antibiotic treatment has ___________

A

Little benefit and a poor outcome was unlikely

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31
Q

_______ is yellow therefore the eardrum may appear yellow. What else can accompany this?

A

Serous fluid

Air bubbles and fluid lines

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32
Q

______ is thick and viscid, therefore the ear drum may appear darker than normal.

A

Mucus (glue ear)

33
Q

T/F With serous fluid or mucus in the ear, hearing is not diminished.

A

FALSE.

Hearing is diminished because the ossicles are unable to conduct sound as well

34
Q

Causes of bloody effusions

A
  • Temporal bone fractures

- Shearing force causing bleeding of the mucosa

35
Q

Increases chances of developing middle ear effusions

A
  • Crowded child care facilities
  • Second hand smoke
  • Bottle-fed infants
36
Q

Conventional treatment for middle ear effusions as recommended by the CDC

A

WASP (Wait And See Prescription)

37
Q

Recommended for children with 3 episodes of middle ear effusions in a six month period or persistent fluid (3 months with hearing loss and unresponsive to antibiotic therapy).

A

Tympanostomy tubes

38
Q

White calcium patches on the drum resulting from old perforations, chronic inflammation, or previous tubes in the ear

A

Tympanosclerosis

39
Q

Cystic masses composed of epithelial cells and cholesterol in the middle ear. May appear as a white nodule pressed against the inside of the drum.

A

Cholesteatomas

40
Q

Cholesteatomas can result from _________, _______________, and perforations. The cyst erodes surrounding bones and ossciles and may cause________

A

Congenital defects
Complications of chronic otitis media
Hearing loss

41
Q

Results from abnormal ossification of the ossicles especially fixation of the stapes to the oval window.

A

Otosclerosis

42
Q

Normal range for the “finger rustle” test. Would this be more or less if someone had otosclerosis?

A

About 2 ft.

Would be less than 2 ft. if someone had otosclerosis

43
Q

Test findings that indicate otosclerosis

A
  • Finger rustle diminished on the affected side
  • Weber’s test will lateralize to the affected site
  • Air time will be less than bone time in Rinne’ test
44
Q

Classic signs/symptoms of inner ear problems

A

-Vertigo (dizziness)
-Tinnitus (ringing ears)
-Sensory hearing loss
(nausea, vomiting, visual, and emotional problems are all usually secondary to vertigo)

45
Q

Tuning forks can further differentiate __________ pathway problems from __________ and _________

A

Air-conduction pathway
Noise-induced hearing problems
Labyrinthitis

46
Q

A vibrating fork is placed in the midline of the head and the patient is asked if they hear better in the right or left ear

A

Weber test

47
Q

Normal finding for a Weber test

A

Patient hesitates to answer

48
Q

What pathway does the Weber test evaluate?

A

Bone-conduction pathway

49
Q

________ of the Weber test leaves the examiner with two possibilities 1) a significant ________ problem or 2) significant __________ problem

A

Lateralization
Air conduction
Sensorineural

50
Q

Test to compare bone conduction to air conduction is Weber shows lateralization

A

Rinne’ test

51
Q

Normal finding for the Rinne’ test

A

Should hear the tuning fork twice as long through the air then through bone

52
Q

What would cause a person to hear the tuning fork longer through bone than air (Rinne’ negative)?

A

Significant canal or middle ear problem (obstruction, ossification, etc.)

53
Q

What would cause a person to hear the tuning fork longer through air then bone, but not twice as long?

A

A significant sensorineural problem.

54
Q

What does it imply if a person can’t hear the tuning fork by either bone or air conduction?

A

Total sensorineural loss

55
Q

Number one reason for snsorineural hearing loss

A

Presbycusis (age related hearing loss)

56
Q

Second most common cause of sensoineural hearing loss.

A

Noise induced hearing loss

57
Q

Most common occupational and environmental hazard for hearing loss

A

Noise

58
Q

Affects 10% of U.S. population. Originates from problems anywhere in the auditory pathway. Most cases result from the same conditions that cause conductive and sensorineural hearing loss

A

Tinnitus

59
Q

What conditions are associated with Tinnitus, although the exact mechanism behind it is unclear?

A
  • Skull fractures
  • Closed head injury
  • Whiplash injury
  • TMJ disorders
60
Q

Generally thought to be caused by a viral infection, symptoms include reduced or distorted hearing and vertigo.

A

Labyrinthitis

61
Q

T/F Labyrinthitis is always painful

A

FALSE.

It is not painful

62
Q

T/F Vertigo is exclusive to labyrinthitis

A

FALSE.

Any lesion in a part of the vestibular system can cause vertigo

63
Q

Ear Red Flags

A
  • Sudden or rapidly progessive hearing loss
  • Vertigo
  • Unilateral or pulsatile tinnitus
  • Bleeding due to foreign object or pressure change injury
64
Q

Common causes of otitis externa

A
  • Excessive cleaning of the auditory canal

- Swimming

65
Q

Physical findings of otitis externa

A

Red, swollen canal with canal debris or discharge

66
Q

Eustachian tube blockage is often seen in children ______ who’ve had a history of ________

A
67
Q

Physical findings of Eustachian tube blockage

A

Prominent landmarks due to drum retraction.

-no signs of inflammation

68
Q

Suppurative otitis media is often seen in children ______ who’ve had a history of ________

A
69
Q

Physical exam findings of Suppurative otitis media

A

Fever, diminished hearing, red and bulging ear drum

70
Q

T/F Excessive ear wax is found most commonly in males who use Q-tips (may be also insidious)

A

True

71
Q

Serrous or mucoid effusions are often seen in children ______ who’ve had a history of ________

A
72
Q

Physical exam findings of Serrous or mucoid effusions

A

Normal, yellow, or dark tympanic membrane with possible air bubbles or fluid lines.

73
Q

T/F Otosclerosis is seen in adolescents and is not genetic

A

FALSE.

Seen in adults with a family history of otosclerosis

74
Q

T/F Otosclerosis produces no physical findings of the canal or eardrum

A

True

75
Q

What freqeuncy sounds are lost first in someone with noise induced hearing loss?

A

High frequency sounds (3,000 to 6,000 Hz)

76
Q

T/F Noise induced hearing loss will always produce a ruptured tympanic membrane on oticscope exam

A

FALSE.

Only if extremely severe. Most of the time, it produces no obvious signs in the canal or middle ear.

77
Q

Typical patient profile for someone with Presbycusis

A

Elderly

78
Q

Symptom characteristics of someone with Presbycusis

A

Complaints that others are mumbling or that they can’t understand what’s being said when there’s background noise (low frequency sounds and whispers are first to go)

79
Q

Physical exam findings of Presbycusis

A

Rinne’ AC > BC, but less than 2:1 ratio

Physical Diagnosis (7 decks)

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