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Erin's Fundamentals > Ears > Flashcards

Ears Flashcards

1
Q

Conductive Hearing Loss

A

Cerumen impaction Eustachian tube dysfunction Otosclerosis Foreign body

TX: clear ear canal

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2
Q

Sensorineural

A
  1. Deterioration of the cochlea
  2. Presbyacusis (age-related)
  3. Noise exposure
  4. Ototoxicity (drugs)
  5. Trauma
  6. Neural: lesions of CNVIII/auditory cortex/neuroma/MS
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3
Q

Sudden sensorineural hearing loss

A
  1. Idiopathic
  2. Autoimmune
  3. Loud noise exposure
  4. Vascular infarc

TX: Oral steroids within 24hrs.

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4
Q

Acoustic Neuroma

A

UNILATERAL

Non-malignant tumor of CN VIII due to Schwann cells surrounding nerve (compresses nerve)

MRI/CT

TX: surgery, radiology, or close monitoring if small tumor

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5
Q

Tinnitus

A

High-pitched ringing in ears

Normal = several minutes of mild/high pitched noises

Abnormal = interferes with sleep/concentration/psychological distress

Limbic System (emotions/mood) activated with tinnitus, so other symptoms accompany.

  1. Increased HR
  2. Sweating
  3. Insomnia

TX: Ear protection, avoid loud noises, avoid ototoxic drugs (gentomyacin)

Anti-depressants used in management/treatment of symptoms

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6
Q

Hematoma of External Ear

“Cauliflower Ear”

A

Shearing force that causes perichondrium to separate from chondrium (cartilage) = Swollen auricle due to lot of vasculature in perichondrium

Can lead to permanent deformation of the auricle

TX: evacuate blood, reapproximate perichondrium to cartilage

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7
Q

Foreign Bodies

A

Foreign Bodies in Ears

Children>Adults

TX:

  1. NO H2O for organics (will swell in ear canal)
  2. Lidocaine for insects
  3. Do not displace objects closer to TM
  4. Use loop or hook to remove
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8
Q

Otitis Externa

“Swimmer’s Ear”

A

Sx: otalgia, pruritis, discharge, hearing loss, edema, erythema, pain in ear with tugging

Bacterial (most common)

Fungal (otomycosis)

TX:

  1. remove debris/liquid
  2. control pain (anti-inflammatory)
  3. control infection:
    1. ABX=fluorquinolone or aminoglycoside
    2. Fungal = FlucanAZOLE
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9
Q

Contact Dermatitis

A

Erythema and pruritus of external auditory canal, most often meatus

Usually caused by Neomycin (Neosporin) or earrings

TX: mineral oil, topical steroids

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10
Q

External Auditory Canal Carcinoma

A

SX: Bloody otorrhea, facial paralysis, mild pain, lesions in ear canal with pus, hearing loss.

TX: surgery, radiology

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11
Q

Osteomas/Exostoses

A

Bony overgrowths of ear canal, usually from overexposure to cold water

TX: surgical removal

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12
Q

Eustachian Tube Dysfunction

A

Pt reports sense of fullness in ear, mild-to-moderate impairment of hearing, reports

  • “plugged ear”
  • Yawning/swallowing cause popping or cracking

Causes: Swelling of the tube lining from allergies or viral URI causes air to be trapped –> Negative Pressure which will cause a retracted TM (will see bony landmarks)

TX:

  1. Oral/Nasal decongestants for URI - SUDAFED
  2. Nasal Corticosteroids for allergies - FLONASE
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13
Q

Otitis Serous

A

Prolonged blockage of Eustachian Tube. Constant negative pressure leads to –> collection of transudative fluid in middle ear

Causes:

  1. URI *occurs after otitis media
  2. Barotrauma
  3. Allergies

You will see BUBBLES or fluid behind TM. Hypomobile.

TX:

  1. Oral/Nasal decongestants for URI - SUDAFED
  2. Nasal Corticosteroids for allergies - FLONASE
  3. Tubes (if recurrring)
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14
Q

Barotrauma

A

Caused by inability to equalize the barometric stress exertedon the middle ear by air travel, changes in elevation, or diving.

SX: Otalgia, Tinnitus, Pressure in ear, Hearing loss

Exam: Hemotympanum, red/retracted ear drum

TX:

  1. Valsalva (autoinflate ears during descents)
  2. Decongestant: SUDAFED
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15
Q

Acute Otitis Media

A

SX: SUDDEN onset of otalgia, hearing loss, vertigo, fever, irritability, apathoy, anorexia, diarrhea (kids).

Causes: virus or bacteria travels up eustachian tube to middle ear

  1. Bacterial: Shake (Strep) My (Moraxella) Head (Heamophilus)
  2. Viral –> most common!

Clinical: Bulging, Air/Fluid behind TM, Red

TX: limit abx tx to patiens <6mos old or pts with severe disease

  1. Amoxicillin
  2. Augmentin
  3. Degongestants = SUDAFED
  4. Pain relievers = Antinflammatories
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16
Q

Acute Mastoiditis

A

Inflammation of mastoid air cells of the temporal bone

Causes: otitis media

Sx: fevers, post-auricular erythema, tenderness, AOM on otoscopy

CT! CBC!

TX:

  1. hospitalization
  2. IV abx
  3. Surgical
17
Q

Choesteatoma

A

Squamous epithelium lined-sac sucked in to middle ear area due to negative pressure. Fills with keratin and skin debris. Can cause obstruction, damage to ossicles, and infection.

TX: Abx for infx. Surgical to remove sac.

18
Q

Chronic Suppurative Otitis Media

A

Chronic infection of middle ear, usually due to lots of AOM. Often have ruptured TM and leak PUSS.

  • Purulent ear discharge that increases with URI or H2O exposure
  • Conductive hearing loss
  • Painless
  • PUSS behind TM

Causes: bacterial

TX:

  1. remove debris
  2. Quinolon = CIPRO,
  3. can require sx repair of tM
19
Q

Nystagmus

A

Rhythmic oscillation of the eyes from vestibular and optokinetic stimulation.

Pathologic: occurs when semicircular canals are stimulated while head is NOT in motion.

20
Q

Overview of Positional Vertigo

A

Certain positions or head movements cause predictable, usually brief, episodes of vertigo.

Crystals in utricle or sacule come loose and enter the semicircular canals where they cause receptors to depolarize and send rotational signals to the brain. “Canalithiasis”

DX: Dix-Hallpike

TX:

  1. Epley Maneuver
  2. Antihistamine
  3. Anticholinergic (anti-parasympathetic)
  4. Sedative/hypnotic
  5. Antiemetic
21
Q

Benign Positional Vertigo

A

RECURRENT spells of BRIEF vertigo, associated with changes in head position. NO HEARING LOSS. Most common positional vertigo.

DX: Dix-Hallpike that results in horizontal nystagmus

TX:

  1. Epley Maneuver
  2. Antihistamine
  3. Anticholinergic (anti-parasympathetic)
  4. Sedative/hypnotic
  5. Antiemetic
22
Q

Traumatic Vertigo

A

Traumatic peripheral vestibular injury

SX: Worse after trauma

  • Vertigo
  • Nausea
  • Vomiting
  • Imbalance

TX: same as other vertigo

23
Q

Vestibular Neuronitis

A

SINGLE EPISODE, acute onset, lasts for days.

Causes: often follows URI

Neuritis: inflammation of vestibular nerve –>NO hearing changes.

Labyrinthitis: inflammation of the labyrinth. Results in hearing changes as well as dizziness or vertigo. –>YES hearing changes.

TX: abx if pt is febrile or has sx of bacterial infx.

24
Q

Meniere’s Syndrome

A

Excess endolymphatic fluid pressure. –> More fluid in semi-circular canals, cochlea and vestibule (inner ear).

SX: spontaneous onset, RECURRING, LASTING 20min to many hrs.

Causes: syphillis and head trauma

TX:

  1. Low salt diet
  2. Diuretics: HCTZ
  3. Intratympanic steroid injections or sac decompression
25
Q

Cervical Vertigo

A

Vertigo from disturbed neck sensors.

Causes: Cervical trauma or hyperextension.

Can be confused with migraine-associated vertigo.

Erin's Fundamentals (12 decks)

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