Ears 3 Flashcards by Shea Green

Sudden onset vs. Gradual onset
Conductive vs. Sensorineural or mixed

Classification of hearing loss

How well did you know this?

Not at all

Perfectly

Usually a dysfunction of external or middle ear
Amount of sound transmitted to inner ear is limited

Conductive hearing loss

How well did you know this?

Not at all

Perfectly

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

Air conduction

How well did you know this?

Not at all

Perfectly

4 Mechanisms of Conductive hearing loss and their examples

Obstruction (cerumen)
Mass effect (effusion)
Stiffness effect (scarring of TM, makes TM less mobile)
Discontinuity (perforation of TM)

How well did you know this?

Not at all

Perfectly

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

Cerumen impaction
ETD

How well did you know this?

Not at all

Perfectly

Otitis Media
Otitis Externa
TM peforation
Trauma

Transient (will resolve) causes of Conductive Hearing Loss

How well did you know this?

Not at all

Perfectly

Otosclerosis (hereditary overgrowth of bone in inner ear)

Chronic issue which causes conductive hearing loss

How well did you know this?

Not at all

Perfectly

Dysfunction of cochlea, often from loss of hair cells

Sensory loss (sensorineural hearing loss)

How well did you know this?

Not at all

Perfectly

Dysfunction of CN VIII or central auditory pathway

Neural loss (sensorineural hearing loss)

How well did you know this?

Not at all

Perfectly

What is the most common cause of sensorineural hearing loss?

Aging –> Presbycusis

How well did you know this?

Not at all

Perfectly

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

Sensorineural Hearing Loss

How well did you know this?

Not at all

Perfectly

How well did you know this?

Not at all

Perfectly

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

Sensorineural Hearing loss

How well did you know this?

Not at all

Perfectly

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

MRI

How well did you know this?

Not at all

Perfectly

What imaging would you order to evaluate temporal bone

How well did you know this?

Not at all

Perfectly

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

High pitched noises

How well did you know this?

Not at all

Perfectly

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

Low pitched sounds

How well did you know this?

Not at all

Perfectly

Surgical correction is for which hearing loss?

Conductive Hearing Loss

How well did you know this?

Not at all

Perfectly

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

Sensorineural hearing loss

Perception of sound in ear or head.

Mild, high pitched (ringing, buzzing, hissing)

Tinnitus

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

Sensory hearing loss

Turbulent blood flow, indicates vascular abnormality.

Pulsatile tinnitus (hearing one’s own heartbeat)

Rapid series of pops or clicks w/ sensation of ear fluttering
Occurs w/ middle ear muscle spasm

Staccato tinnitus

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

Tinnitus

Which sex is more likely to get tinnitus?

Men

What are the 2 pathologies of tinnitus?

* Comes from somatic sounds near cochlea * Theory: disruption of normal neural firing patterns along auditory pathway

Type of tinnitus which occurs w/ head movements

Pulsatile/Vascular Tinnitus

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

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

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

* MRA * MRV * Temporal bone CT

What is the main tx for tinnitus?

Behavioral therapy * masking * stopping ototoxic medications * Refer to clinic which does experimental therapy

* Interferes w/ sleep/concentration * Causes significant psychological distress

Tinnitus

The 4 categories/differential diagnosis of dizziness

* Vertigo (central or peripheral) * Disequilibrium * Pre-syncope * Non-specific Dizziness

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

Dizziness

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

* Cardiac * Neurologic

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

Vertigo * Spinning * Tumbling * Falling forwards/backwards

The primary symptom of vestibular disease

Vertigo

What is critical to differentiate in cases of vertigo?

Central vs. Peripheral

Causes of vertigo. Peripheral or Central? * Vestibular neuritis/Labyrinthitis * Meniere Disease * Benign positional vertigo * Ethanol intoxication * Inner ear barotrauma * Semicircular canal dehiscence

Peripheral Vertigo

Causes of vertigo. Peripheral or Central? * Seizure * MS * Wernicke encephalopathy * Chiari malformation * Cerebellar ataxia syndrome

Central Vertigo

Causes of vertigo. Peripheral or Central? * Migraine * Stroke/Vascular insufficiency * Tumors * Infections * Vascular compression * Hyperviscosity syndromes * Endocrinopathies (hypothyroidism)

Mixed Vertigo (both central and peripheral)

Which type of Vertigo (central or peripheral)? * Gradual onset * Progressive increase in severity

Central

Which type of Vertigo (central or peripheral)? * Gait and posture significantly impaired (cannot walk/will fall over)

Central

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

Central

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

Peripheral

Which type of Vertigo (central or peripheral)? * Horizontal nystagmus w/ rotary compenet

Peripheral

Which type of Vertigo (central or peripheral)? * Vertical nystagmus

Central