ENT exam

Question 1

Tympanic membrane - location

Answer 1

End of the ear canal

marks the lateral limit of the external ear

Question 2

Function of external ear

Answer 2

Captures sound waves for transmission into the middle an inner ear

Question 3

Middle ear contents

Answer 3

• air filled

- contains the ossicles (malleus, incus, and stapes)

Question 4

Function of middle ear

Answer 4

Transform sound vibrations into mechanical waves for the inner ear

Question 5

Eusachian tube

Answer 5

From the middle ear

Proximal part connects the middle ear to the nasopharynx

Question 6

Ossicles visible through the tympanic membrane

Answer 6

• malleus (handle and short process)

- incus *sometimes seen through the ear drum

Question 7

Umbo

Answer 7

• point where the eardrum meets the tip of the malleus

- will see the cone of light at this region

Question 8

Location cone of light

Answer 8

• at the umbo

- fans downward and anterioly

Question 9

Pars flaccida

Answer 9

Portion of the eardrum located above the short process of the malleolus

Question 10

Pars tensa

Answer 10

Remainder of the ear rum located below the short process of the malleolus

Question 11

Separation pars flaccida and pars tensa

Answer 11

Anterior and posterior malleolar folds which extend obliquely upward from the short process

Question 12

Inner ear components

Answer 12

• cochlea
• semicircular canals
• auditory erve

Question 13

Function of inner ear

Answer 13

• movements of the stapes vibrate the perilymph in the semicircular canal and the hair cells and endolymph in the ducts of the cochlea
• produces electrical nerve impulses
• these re transmitted by the auditory nerve to the brain

Question 14

How to access the function of the inner and middle ear

Answer 14

Most of middle and all of inner inaccessible to direct examination
Asses by testing auditory function

Question 15

Hearing pathways

Answer 15

1) Conductive phase (external ear –> middle ear)

2) Sensorineural phase *cochlea and cochlear nerve)

Question 16

Conductive hearing loss

Answer 16

-disorders of the external and middle ear
external ear causes:
-infection (otitis externa)
-trauma
-squamous cell carcinoma
-benign bony growth (exostoses, osteomas)
Middle ear causes:
-congenital conditions
-benign cholesteastomas
-otosclerosis
-tumors
-perforation of tympanic membrane

Question 17

Sensorineural hearing loss

Answer 17

-disorders of inner ear
-caused by :
congenital/hereditary conditions
presbycusis
viral infections (rubella, CMV, menieres disease)
noise exposure
acoustic neuroma

Question 18

Equilibrum and the ear

Answer 18

The labrynth of three semicircular canals in the inner ear senses the position and movements of the head and helps to maintain balance

Question 19

Assessment of the auricle

Answer 19

• deformities
• lumps
• skin lesions
• if ear pain move auricle up and down and press tragus, and press behind the ear firmly

Question 20

Tug test

Answer 20

movement of the auricle and tragus is painful in acute otitis externa but not otitis media

Question 21

Signs of pain due to otitis media

Answer 21

-pain behind the ear may be present

Question 22

Visualizing ear canal and drum

Answer 22

• use otoscope with the largest ear speculum the canal will accomodate
• pull the auricle upward and backward and slightly away from the head
• direct the speculum down and forward through the hairs

Question 23

Exostoses

Answer 23

Non tender nodular swellings covered by normal skin deep in the ear canals
Non malignant overgrowths
May obscure the drum

Question 24

Inspection of ear canal

Answer 24

-note discharge, foreign bodies, redness/swelling of skin

-

Question 25

Ear canal in otitis externa

Answer 25

• canal swollen narrowed, moist, pale and tender

- may be reddened

Question 26

Ear canal in chronic otitis externa

Answer 26

Skin of the canal is thickened red and itchy

Question 27

Inspection of the ear drum

Answer 27

-note its color and contour

Question 28

Purpose of cone of light

Answer 28

helps to orient