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Foundations II Exam 1 > Ears 3 > Flashcards

Ears 3 Flashcards

1
Q
  • Sudden onset vs. Gradual onset
  • Conductive vs. Sensorineural or mixed
A

Classification of hearing loss

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2
Q
  • Usually a dysfunction of external or middle ear
  • Amount of sound transmitted to inner ear is limited
A

Conductive hearing loss

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3
Q

What measures the ability of external and middle ear to transmit sound to cochlea?

A

Air conduction

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4
Q

4 Mechanisms of Conductive hearing loss and their examples

A
  1. Obstruction (cerumen)
  2. Mass effect (effusion)
  3. Stiffness effect (scarring of TM, makes TM less mobile)
  4. Discontinuity (perforation of TM)
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5
Q

What are the 2 most common cause of Conductive Hearing Loss in adults?

A
  • Cerumen impaction
  • ETD
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6
Q
  • Otitis Media
  • Otitis Externa
  • TM peforation
  • Trauma
A

Transient (will resolve) causes of Conductive Hearing Loss

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7
Q

Otosclerosis (hereditary overgrowth of bone in inner ear)

A

Chronic issue which causes conductive hearing loss

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8
Q

Dysfunction of cochlea, often from loss of hair cells

A

Sensory loss (sensorineural hearing loss)

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9
Q

Dysfunction of CN VIII or central auditory pathway

A

Neural loss (sensorineural hearing loss)

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10
Q

What is the most common cause of sensorineural hearing loss?

A

Aging –> Presbycusis

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11
Q

Type of hearing loss cauesd by loud noise exposure (acoustic trauma)

A

Sensorineural Hearing Loss

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12
Q
A
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13
Q

Which type of hearing loss is associated w/:

  • Meniere’s Disease
  • Head Trauma
  • Infection/Inflammation systemic diseases
  • Acoustic neuroma (Vestibular Schwannoma tumor)
  • MS
  • Auditory neuropathy
  • Autoimmune diseases
  • stroke
A

Sensorineural Hearing loss

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14
Q

What is the preferred test for suspected central lesions w/ hearing loss?

A

MRI

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15
Q

What imaging would you order to evaluate temporal bone

A

CT

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16
Q

What pitch is the 1st thing to go w/ presbycusis?

A

High pitched noises

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17
Q

What pitch is first to go w/ Meniere’s Disease?

A

Low pitched sounds

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18
Q

Surgical correction is for which hearing loss?

A

Conductive Hearing Loss

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19
Q

Hearing aids/Cochlear implants are used for which hearing loss?

A

Sensorineural hearing loss

20
Q

Perception of sound in ear or head.

Mild, high pitched (ringing, buzzing, hissing)

A

Tinnitus

21
Q

Tinnitus is often associated w/ which type of hearing loss?

A

Sensory hearing loss

22
Q

Turbulent blood flow, indicates vascular abnormality.

A

Pulsatile tinnitus (hearing one’s own heartbeat)

23
Q
  • Rapid series of pops or clicks w/ sensation of ear fluttering
  • Occurs w/ middle ear muscle spasm
A

Staccato tinnitus

24
Q

What is usually the 1st presenting sign of hearing loss?

A

Tinnitus

25
Q

Which sex is more likely to get tinnitus?

A

Men

26
Q

What are the 2 pathologies of tinnitus?

A
  • Comes from somatic sounds near cochlea
  • Theory: disruption of normal neural firing patterns along auditory pathway
27
Q

Type of tinnitus which occurs w/ head movements

A

Pulsatile/Vascular Tinnitus

28
Q

If a pt has unilateral tinnitus, what test would you order and why?

A

MRI to look to acoustic neuroma (Vestibular Schwannoma) = tumor

29
Q

If a pt has pulsatile/vascular tinnitus, what imaging would you order?

A
  • MRA
  • MRV
  • Temporal bone CT
30
Q

What is the main tx for tinnitus?

A

Behavioral therapy

  • masking
  • stopping ototoxic medications
  • Refer to clinic which does experimental therapy
31
Q
  • Interferes w/ sleep/concentration
  • Causes significant psychological distress
A

Tinnitus

32
Q

The 4 categories/differential diagnosis of dizziness

A
  • Vertigo (central or peripheral)
  • Disequilibrium
  • Pre-syncope
  • Non-specific Dizziness
33
Q

This complaint requires a really good hx in patient’s own words

A

Dizziness

34
Q

What are 2 very important exams to get when pt presents w/ dizziness?

A
  • Cardiac
  • Neurologic
35
Q

Sense of motion when there is no motion. What are the 3 motions?

A

Vertigo

  • Spinning
  • Tumbling
  • Falling forwards/backwards
36
Q

The primary symptom of vestibular disease

A

Vertigo

37
Q

What is critical to differentiate in cases of vertigo?

A

Central vs. Peripheral

38
Q

Causes of vertigo. Peripheral or Central?

  • Vestibular neuritis/Labyrinthitis
  • Meniere Disease
  • Benign positional vertigo
  • Ethanol intoxication
  • Inner ear barotrauma
  • Semicircular canal dehiscence
A

Peripheral Vertigo

39
Q

Causes of vertigo. Peripheral or Central?

  • Seizure
  • MS
  • Wernicke encephalopathy
  • Chiari malformation
  • Cerebellar ataxia syndrome
A

Central Vertigo

40
Q

Causes of vertigo. Peripheral or Central?

  • Migraine
  • Stroke/Vascular insufficiency
  • Tumors
  • Infections
  • Vascular compression
  • Hyperviscosity syndromes
  • Endocrinopathies (hypothyroidism)
A

Mixed Vertigo (both central and peripheral)

41
Q

Which type of Vertigo (central or peripheral)?

  • Gradual onset
  • Progressive increase in severity
A

Central

42
Q

Which type of Vertigo (central or peripheral)?

  • Gait and posture significantly impaired (cannot walk/will fall over)
A

Central

43
Q

Which type of Vertigo (central or peripheral)?

  • Nystagmus in ANY DIRECTION
  • No latency before nystagmus starts
  • Non-fatigable
  • NO suppression of nystagmus w/ visual fixation
  • NO auditory sxs
A

Central

44
Q

Which type of Vertigo (central or peripheral)?

  • Sudden onset
  • Acutely severe sxs
  • N/V
  • Tinnitus
  • Hearing loss
  • Eye motion in response to head turning
  • Balance is impaired, but pt can walk
  • Nystagmus resolves w/ visual fixation
A

Peripheral

45
Q

Which type of Vertigo (central or peripheral)?

  • Horizontal nystagmus w/ rotary compenet
A

Peripheral

46
Q

Which type of Vertigo (central or peripheral)?

  • Vertical nystagmus
A

Central

47
Q
A

Foundations II Exam 1 (25 decks)

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