Ears Flashcards
division between external and internal ear
tympanic membrane
do you need a tympanic membrane to hear?
No, need it to amplify sound
three things that make up balance
inner ear
eyes
proprioception
three types of hearing loss
conductive
senorineural
mixed
hearing loss associated w/ age
prebycusis
what frequency do you lose first with prebycusis
high
mid
low
Medications associated with ototoxicity
gentamycin furosemid ethacrynic acid cisplatin quinidine ASA (6-8 grams)
can’t hear out of one ear and is often with disequilibrium. Schwann cells grows within finite space and progresses nerve. Can have mid-facial and corneal hypesthesia, occipital HA, ataxia
Acoustic neuroma
associated with endolymphatic hydrops. Diagnosis of exclusion
Meineres Disease
Tx for acoustic neuroma
radiotherapy
microsurgery
Vertigo, hearing loss, tinnitus (first often)
Meineres Disease
what causes meineres Dz?
malfunction of endolymph volume regulation in scala media
Disruption of basilar membrane movement
Mixing of endolymph and perilymph
Tx for meineres Dz
low salt diet
avoid caffeine
HCTZ
diazepam
vascular tumor behind eardrum
glomus jugularis
common in swimmers (cold water), not a problem until it holds onto cerumen.
Bony exostoses
if someone has acute viral hearing loss what do you do?
prednisone burst
should Rinne and Weber tests be used for general screening?
No, let elderly identify limitations
watch the tympanic membrane mobility. Screening test for middle ear dysfunction.
tympanometry
most common organism causes of otitis external
S aureus
P aerguinosa
fungus
should you flush the ear is you can’t visualize the TM?
No
what may be the only thing you need to tx Otitis externa?
Acidification
ABX used for otitis externa
ofloxacin solution (can be used w/ perf)
ciprofloxacin
ciprodex (can be used w/ perf)
tx if you suspect fungal infection with otitis externa
clotrimazole
Life-threatening extension to mastoid or temporal bone of otitis external.
Necrotizing/ malignant OE
most common cause of necrotizing/ malignant OE
P. aergonosa osteomyelitis
immunocomprimised
diagnostic you need for necrotizing/ malignant OE
Tech-99
Tx for otitis externa- malignant/ necrotizing
surgical debridement
prolonged abx tx (fluroquinolones or betalactam + aminoglycoside)
Patient has vertigo, they don’t dare move their head because it triggers it. Due to stones that form in the semicircular canals.
Benign paroxysmal vertigo
what maneuver do you do you tx BPPV?
Epley maneuver
after an epley manuver how should a patient sleep?
With their head elevated (in a recliner)
when wake up look right, middle then left each for 10 seconds (home vestibular therapy)- do every morning for 2 weeks
how long do tubes last?
9-18 months
Tx for otitis media- acute?
decongestant and/or antihistamine
otitis media with fever, hearing loss?
Amoxicillin 500 mg PO TID x 10 days
secondary tx for otitis media
augmentin or cephalosporin
Tx for peds for otitis media 2 mo-5 years
amoxicillin 80-90 mg/kg/ day divided BID
tx for peds with otitis media 6-12 years
amoixicillin 80-90 mg/kg/day divided BID x 5-10 days
Otitis media referral indications
TM perf
recurrent AO
chornic serous otitis media
recurrent OM, chronic OM
Emergency ENT referral for otitis media
persistent fever, HA, vertigo, facial nerve paralysis/ cranial neuropathy
what perceieves linear accleration?
macula
what percieves angular acceleration
crista
what manuever helps identify BPPV
Dix-Hallpike
