Exam 2 - Ear packet Flashcards
Which nerves cause the external auditory meatus and canal to be pain sensitive?
C3, CN V3
What is Arnold’s nerve?
branch of CN X - innervates external canal
What does stimulation of Arnold’s nerve produce?
cough reflex and sometimes lightheadedness
What is the most common cause of conductive hearing loss?
Cerumen impaction (positive feedback loop)
What is the cause of 60-80% of hearing aid faults?
Cerumen impaction
What are the precipitants of otitis externa?
excessive moisture, trauma (over-zealous cleaning), chronic dermatologic dzs
What are the key indications of otitis externa?
localized external ear pain th/ increases w/ gentle traction of pinna, erythema/swelling of external canal, otorrhea (discharge) from external auditory canal
How will tympanic membrane appear with acute otitis externa?
Red
Is “malignant” otitis externa cancer?
NO
Which pts get necrotizing “malignant” otitis externa?
diabetic or immunocompromised pts
What is the main symptom of atopic otitis externa?
Canal ITCHES and appears dry and shiny. Non-infectious
Which lymph nodes can be palpated in cases of otitis media?
post-auricular lymph nodes
What are the 3 layers of the tympanic membrane?
- outer ectodermal layer 2. intermediate fibrous stratum 3. inner mucosal layer
What landmarks of the tympanic membrane are usually seen through the membrane?
short process of malleus, the manubrium of malleus, the umbo, and the light reflex
What is the most common cause of perforation of the tympanic membrane?
acute ear infections
What kind of membrane perforation heals most easily?
central (pars tensa)
What membrane perforations heal less easily?
attic, annulus, and umbo perforations
What is the prognosis of perforated tympanic membrane with persistent eustachian tube dysfunction?
Poorer prognosis
Scars of the tympanic membrane are of little importance unless ______?
pt has signs of conductive hearing loss
In a pt with conductive hearing loss, what can scarring of tympanic membrane be a sign of?
sign of ossicular fixation
How can cholesteatoma of tympanic membrane form?
when squamous epithelium is deposited in an area where cells cannot be sloughed off.
With cholesteatoma, what do the cells that cannot be sloughed off contain, and what can it lead to?
Dead cells contain keratin, which can erode surrounding tissues
Is the medial part of the eustachian tube normally open or closed?
Normally closed
What can obstruction of the eustachian tube lead to?
retraction of the tympanic membrane. Can also cause middle ear to fill with fluid
What is the most common type of eustachian tube dysfunction?
mucosal edema (less complete dysfunction)
What can cause a more complete dysfunction of eustachian tube?
adenoiditis impacting medial cartilagenous portion of eustachian tube (less common type)
Acute otitis media (AOM) or otitis media with effusion (OME): pt appears normal to mildly ill
OME
AOM or OME: ear pain, otorrhea, irritability, fever/chills
AOM
AOM or OME: recent URTI and rapid onset of symptoms (<48 hrs)
AOM
AOM or OME: no fever/low-grade fever; presence of effusion; cloudy membrane/air-fluid levels; retracted membrane; normal to hypomobile membrane
OME
What is acute otitis media?
middle ear effusion that is accompanied by s/sx of acute infection
what is otitis media with effusion?
middle ear effusion WITHOUT s/sx of acute infection
