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Foundations II Exam 1 > Ears 2 > Flashcards

Ears 2 Flashcards

1
Q

Pt presentation of chronic OM

A

Chronic otorrhea (ear drainage)

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2
Q

2 PE findings for chronic OM

A
  • Perforated TM

- Conductive hearing loss

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3
Q

4 tx options for chronic OM

A
  • Removal of infected debris
  • Earplug use
  • Topical/oral abx
  • Surgery - TM repair
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4
Q

Otitis media w/ effusion is also called?

A

Serous Otitis Media

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5
Q

2 pathophysiologies of serous otitis media

A
  • blocked eustachian tube for prolonged time

- negative pressure causing transudation of fluid into middle ear

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6
Q

Describe eustachian tubes in children

A
  • Narrow

- More horizontal

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7
Q

3 epidemiologies of Serous Otitis Media in adults

A
  • After URI
  • Barotrauma
  • Chronic allergies
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8
Q
  • No acute signs of illness/inflammation
  • Conductive hearing loss
  • Fullness/pressure
A

Clinical presentation of serous OM

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9
Q

PE findings of serous OM

A
  • TM dull
  • TM hypomobile
  • Clear/yellow bubbles
  • Conductive hearing loss
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10
Q

Which ear condition might we consult a speech/ hearing therapist for child?

A

Serous OM

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11
Q

4 tx options for serous OM

A
  • Decongestants
  • Antihistamines
  • Nasal steroids
  • Ventilating tubes
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12
Q

Specific types of chronic OM described as a “sac”

A

Cholesteatoma

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13
Q

Most common cause of cholesteatoma

A

Prolonged eustachian tube dysfunction

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14
Q

Chronic negative middle ear pressure draws in part of TM

A

Etiology of cholesteatoma

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15
Q

Creates a sac lined w/ squamous epithelium- produces keratin

A

Cholesteatoma

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16
Q

Cholesteatoma can get secondarily infected w/ which 2 bacteria?

A
  • pseudomonas

- proteus

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17
Q
  • Asymptomatic
  • Hearing loss
  • Chronic infections w/ otorrhea
A

Presentation of cholesteatoma

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18
Q

PE findings of cholesteatoma

A
  • TM pocket

- TM perforation exuding debris

19
Q

Tx for cholesteatoma

A
  • Abx drops

- Surgical removal (most common - send to ENT)

20
Q

3 complications of cholesteatoma

A
  • Erosion into inner ear
  • Affects facial nerve
  • Brain abscess
21
Q

The eustachian tube connects what to what?

A
  • Middle ear

- Nasopharynx

22
Q

Function of eustachian tube

A

Provide ventilation and drainage for middle ear

23
Q

Is the eustachian tube open or closed?

A
  • Normally closed

- Open during swallowing/yawning

24
Q
  • Edema of tubal lining

- Air trapped in middle ear causing negative pressure

A

Etiology of Eustachian Tube Dysfunction

25
Q

What 2 things can cause ETD?

A
  • Viral URI

- Allergies

26
Q
  • Fullness
  • Fluctuating hearing
  • Pain w/ pressure change
  • Popping/crackling sensation
A

Presentation of ETD

27
Q

PE findings of ETD

A
  • Retracted TM

- Hypomobility (decreased mobility of TM on pneumatic otoscopy)

28
Q

How should a patient manage ETD?

A
  • Avoid air travel (if possible)
  • Avoid altitude changes
  • Avoid underwater diving
29
Q

5 tx options for ETD

A
  • Decongestants
  • Autoinflation (plug nose and blow)
  • Desensitization therapy (for allergies)
  • Intranasal corticosteroids
  • Surgery
30
Q

Complications of ETD

A

Increased risk of:

  • serous OM
  • cholesteatoma
31
Q

Damage to middle ear when you don’t have appropriate pressure equalizing

A

Otic Barotrauma

32
Q

What 3 things cause otic barotrauma?

A

Inability to equalize pressure exerted on middle ear during:

  • air travel
  • rapid altitude change
  • underwater diving
33
Q

What is a precursor to otic barotrauma?

A

Poor eustachian tube function due to:

  • mucosal edema
  • congenital narrowing
34
Q

A person will experience otic barotrauma during what?

A

Descent while on airplane

35
Q

Tx options for otic barotrauma

A

Enhance eustachian tube function by:

  • decongestants few hours before air travel
  • topical nasal decongestants 1 hr before descent on plane
36
Q

Patient education for otic barotrauma

A
  • swallow, yawn, autoinflate frequently during descent of plane
  • equalize pressure during descent phase of underwater diving
37
Q

What causes eustachian tube blockage for otic barotrauma patients?

A

Negative middle ear pressure, causes collapse of ET

38
Q

Complications divers with otic barotrauma may experience if they do not descend slowly

A
  • hemotympanum

- perilymphatic fistula, rupture of oval window, sensory hearing loss, acute vertigo, vomiting

39
Q

2 complications of otic barotrauma

A
  • TM rupture, which can then lead to OM

- Persistent pressure after landing

40
Q

What 4 things can be done to relieve persistent pressure after landing?

A
  • Decongestants
  • Autoinflation
  • Myringotomy
  • Ventilating PE tubes (pressure equalizing)
41
Q

Small ruptures, less than what % of TM, will close on their own?

A

25%

42
Q

Large ruptures, more than what % will require tympanoplasty from ENT?

A

25%

43
Q

If the TM is perforated/ruptured, what should we avoid?

A
  • Water in ear

- Ototoxic ear drops (aminoglycoside abx)

Foundations II Exam 1 (25 decks)

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