ENT Disease and Audiometry Flashcards
what is the name of the test that involved placing a tuning fork on behind and next to the ear to compare which area hears its sound best?
rinne’s test
what part of the bone is the tuning fork placed on in rennie’s test?
mastoid process
what does webers test involve?
placing tuning fork in the midline of the forehead and asking the patient if they feel the vibration more in the forehead or an ear
what does the “x” stand for on an audiogram?
left ear
right is never wrong
what does ] stand for on an audiogram?
bone conduction
what does a tympanogram measure?
pressure
tests if the TM is mobile
name the 6 components of the D principle
deafness discomfort discharge dizziness din din (tinnitus) defective facial movement
what nerves can cause earache?
V VII IX X C2 C3
name 3 conditions that can cause ear discharge?
acute otitis media
chronic otitis media
csf leak
what is otorrhoea?
ear discharge
what kind of ENT pain can refer to the ear and why?
tonsil/laryngeal pain
is in the path of the glossopharyngeal nerve
if ear discharge is clear what is it suspected to be and what would confirm this?
csf
glucose test
how could you tell if the cochlea was involved in vertigo?
if there was hearing loss too
presentation of defective facial movement in ear disease?
lower motor neurone problems
facial palsy
how is pain presented in otitis media?
worse when pus is retained
gets better when it is out
another word for “otitis media with effusion”
glue ear
pathophysiology of glue ear?
fluid present behind eardrum -> causes blocked eustachian tube -> middle ear can’t equalise pressure -> transudate collects
Tx of glue ear?
nothing for 3 months
insert grommet or hearing aid for 6 months if not settling
why is there significant hearing loss in chronic otitis media?
TM is destroyed
where do cholesteatomas present on the TM?
upper part
key hearing test used to determine hearing thresholds of patients?
pure tone audiometry
what does the O stand for on an audiogram?
air conduction of the right ear
what does the X stand for on an audiogram
air conduction of the left ear
what does the triangle stand for on an audiogram?
bone conduction of the left and right ear
what does masking do?
plays a narrow band noise to distract the ear that isnt being tested so you can get a true measurement of the tested ear
sensorineural hearing loss is reversible T or F
F
causes of sensorineural hearing loss?
regular, prolonged exposure to loud sounds ototoxic drugs rubella neuroma schwannoma
how does the air and bone conduction compare in sensorineural hearing loss?
are the same
how does the air and bone conduction compare in sensorineural hearing loss?
bone is better -> within normal limits
cause of conductive hearing loss?
anything causing sound to not pass freely into the inner ear eg outer/middle ear problem:
glue ear
ear infection
perforated ear drums
what audiogram feature would make you consider otosclerosis as the diagnosis?
carharts notch at 2000Hz (big dip in bone conduction)
tympanometry is helpful in making the diagnosis of…
TM perforation
otitis media
name the red flag symptoms of head and neck cancer?
odynophagia neck lumps hoarseness stridor sore throat dysphagia unilateral ear pain
how long should ENT symptoms have lasted to be classed as a red flag symptom
3 weeks
most common type of head and neck cancer?
squamous
major lifestyle risk factors for head and neck cancer?
alcohol
tobacco
what is the size of the tumour and nodes in an HPV head and neck cancer?
small tumour
big nodes
1st line analgesia for pain from a cancer?
non opiod
+ adjuvant
2nd line analgesia for pain from a cancer?
opioid for mild-mod pain
non-opioid
adjuvant
what is an adjuvant analgesic?
painkillers whose primary indication is for something other than pain eg antidepressants
what anticonvulsants are used in pain management?
gabapentin
pregabalin
