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HEENT > Ears MDT > Flashcards

Ears MDT Flashcards

1
Q

What is auricular hematoma?

A

Accumulation of blood in the subperichondrial space, secondary to blunt trauma

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2
Q

What can auricular hematoma result in?

A

Cauliflower ear

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3
Q

What will you find on physical examination of Auricular Hematoma?

A

Loss of landmarks

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4
Q

Separation of perichondrial blood vessels in auricular hematoma can result in what?

A

Necrosis

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5
Q

How should auricular hematoma be treated?

A
  • incision should be made not to violate perichondrium
  • incision should be on inner curvature of helix or antihelix
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6
Q

What should be done after auricular hematoma drainage?

A
  • Splinting of ear
  • Apply Neosporin BID
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7
Q

How should live objects be dealt with in the ear?

A

2% lidocaine solution to drown them

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8
Q

Sx of ear foreign body

A
  • specific MOI
  • muffled sounds
  • severe pain
  • hearing distrubances
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9
Q

What temperature should water for ear irrigation be?

A

Room-temp

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10
Q

What equipment can be used to assist in ear foreign body removal?

A
  • cerumen loops/scoops
  • right angle alligator/alligator forceps
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11
Q

If you cannot see the TM, should you still irrigate?

A

No, unsure if TM is perforated

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12
Q

What are some c/c of patients with cerumen impaction?

A
  • decrease hearing
  • sensation of pressure or fullness
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13
Q

What worsens cerumen impaction?

A

Q-tips

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14
Q

What equipment can you use for cerumen impaction?

A
  • Loops and scoops
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15
Q

If irrigating the ear, what is the procedure?

A
  • 18 gauge IV catheter
  • Body temp water
  • irrigate along superior portion utilizing pressure of stream to help break up/dislodge impaction
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16
Q

What medication can assist cerumen impaction?

A

Carbamide Peroxide (Debrox) 2-5 drops BID for max 4 days

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17
Q

What is a common injury after ear irrigating?

A

TM Perforation

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18
Q

What is mastoiditis?

A

Mastoid cavity becomes a closed space after a blockage occurs

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19
Q

Mastoiditis is normally a complication of what condition?

A

Otitis media

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20
Q

What will you find on physical examination of mastoiditis?

A
  • Post auricular pain, erythema with spiking fever
  • obliteration of post auricular crease
  • protrusion of the auricle
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21
Q

What radiologic studies should be done with mastoiditis?

A
  • Mastoid radiography
  • CT
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22
Q

What lab should be done with mastoiditis?

A

Culture of drainage

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23
Q

Medications for mastoiditis

A
  • Ceftriaxone
  • Levofloxacin
  • Cefazolin
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24
Q

What should be done with mastoiditis after MEDEVAC?

A
  • Admission
  • I&D
  • possible mastoidectomy
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25
Q

What is otitis externa?

A

Diffuse inflammation of external ear canal with or without inflammation of auricle and/or TM

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26
Q

What are most common organisms associated with otitis externa?

A

Staphylococcus (10-70%)
Pseudomonas (20-60%)

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27
Q

Findings leading to otitis externa?

A
  • purulent exudate
  • hx of recent water exposure or mechanical trauma
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28
Q

What lab should be done for otitis externa?

A

Gram staining of discharge

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29
Q

How should you dry otitis externa?

A

50/50 mix isopropyl alcohol/white vinegar

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30
Q

What medications can you give for otitis externa?

A

Neomycin/Polymxin B
Ciprofloxacin Otic

31
Q

What is otitis media?

A

Bacterial infection of mucosal lined, air containing spaces of the temporal bone

32
Q

Otitis media is precipitated by what condition?

33
Q

Common pathogens of otitis media?

A
  • strep pneumonia
  • hib
  • strep pyogenes
34
Q

Physical findings of otitis media

A

TM bulging, mastoid tenderness

35
Q

Labs for otitis media

A

Tympanocentesis
Fungal culture

36
Q

Medications for otitis media

A

Amoxicillin
Augmentin
PCN Allergy
Cefrtriaxone
Doxycycline
Nasal decongestants

37
Q

What is Eustachian tube dysfunction?

A

Disorders involving impairment in the functional valve of the Eustachian tube of the middle ear

38
Q

What is patulous Eustachian tube dysfunction?

A

Excessively open or dilatory dysfunction

39
Q

What kind of sensation does Eustachian tube disorder have?

A

Full ness or underwater sensation

40
Q

Treatment for Eustachian tube dysfunction?

A

Pseudoephedrine
Oxymetazoline
Flonase
Cetirizine
Fexofenadine

41
Q

TM perforations are secondary to what conditions?

A

Barotrauma, blunt/penetrating/acoustic trauma or lightning strikes

42
Q

Where on the TM is perforation most likely to occur?

A

Pars tensa

43
Q

Signs of TM perforation?

A

Visible perforation, otorrhea from canal

44
Q

How does the TM heal?

A

Spontaneous healing occurs in most cases

45
Q

If foreign material is suspected in TM perforation, what medications should be given?

A

Antibiotics
- Augmentin
- Doxycycline

46
Q

Perforations secondary to trauma should be referred where?

A

ENT (otolaryngologist)

47
Q

What is cholesteatoma?

A

Benign tumor in the middle ear or mastoid

48
Q

What is the most common cause of cholesteatoma?

A

Eustachian tube dysfunction

49
Q

What structures get eroded as cholesteatoma expands?

A

Ossicular chain, bony labyrinth or facial nerve canal

50
Q

How is cholesteatoma treated?

51
Q

What is barotrauma?

A

Damage to the TM due to rapid changes in pressure

52
Q

What is dx o f barotrauma based on?

A

Accurate hx and physical exam

53
Q

Most common cause of barotrauma?

54
Q

Sx of barotrauma

A
  • Hearing loss
    -Middle Ear pain
55
Q

Severe cases of barotrauma present with what findings?

A
  • Sensorineural hearing loss
  • Vertigo
56
Q

What is found upon physical exam of barotrauma?

A
  • Conductive hearing loss
  • TM Perforation/Bulging
  • May have fluid
57
Q

How would you treat barotrauma?

A

Treat predisposing conditions

58
Q

How does mild cases of barotrauma resolve?

A

Spontaneously

59
Q

When should patients with barotrauma be referred?

A
  • Inner Ear exposure
  • Sensorineural hearing loss
60
Q

What is sudden hearing loss divide into?

A

Sensorineural and conductive

61
Q

What structures are involved with sensorineural hearing loss?

A

Cochlea, Auditory nerve or Central Auditory processing

62
Q

What structures are involved with conductive hearing loss?

A

External ear, TM, Ossicles

63
Q

What is conductive hearing loss more likely due to?

A

Reversible causes such as:
- Otitis media
- Serous Otitis
- Cerumen Impaction

64
Q

What is sensory hearing loss more likely due to?

A

Irreversible causes, such as disease of the cochlea

65
Q

What is the most common cause of sensory hearing loss?

A

Progressive, high-frequency loss with advancing age (presbyacusis)

66
Q

What frequency does noise trauma begin?

67
Q

What tests should be done with patients with hearing loss?

A
  • Audiogram
  • Weber and Rinne
68
Q

What treatments should be done for hearing loss?

A
  • Remove member from exposure
  • Earplug education
  • Referral to ENT if further eval is needed
69
Q

What causes tinnitus?

A

Damaged hairs may move randomly sending impulses to the brain

70
Q

What are some objective causes of tinnitus?

A

Turbulence in carotid artery or jugular vein and TMJ problems

71
Q

Is the precise pathophysiology of tinnitus known?

72
Q

What are the 2 types of tinnitus?

A

Objective and subjective

73
Q

Sx of tinnitus

A
  • “Ringing noise”
  • Conductive hearing loss
  • Noise intolerance

HEENT (9 decks)

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