Head & Neck 7

Question 1

List some symtoms of ear disease

Answer 1

Pain (otalgia)
Discharge
Hearing loss
Tinnitus
Vertigo
Facial palsy

Question 2

Within which bone of the skull is found the ear?

Answer 2

Temporal

Question 3

What are the components of the external ear?

Hit: 3

Answer 3

Pinna
External auditory meatus
Lateral surface of tympanic membrane

Question 4

What is the mainf function of the external ear?

Answer 4

Collecting, transmitting & focussing sound waves onto tympanic membrane

Question 5

What types of tissue make up the external ear?

Hint: 3

Answer 5

Cartilage
Skin
Fatty tissue

Question 6

What are the possible abnormalities of the pinna?

Answer 6

Congenital
Inflammatory
Traumatic
Infective

Question 7

What is a pinna haematoma?

Answer 7

Accumulation of blood between cartilage and perichondrium, 2ndary to blunt injury i.e. contact sport

Question 8

How is a pinna haematoma treated?

Answer 8

Drainage, re-apposition of two layers otherwise could happen again

Question 9

What can pinna haematoma lead to?

Answer 9

Cauliflower ear if poorly treated

Question 10

Describe the ear canal

Answer 10

Skin lined sigmoidal cul-de-sac

Question 11

How is the ear canal “self-cleaning”?

Answer 11

Hair arrangement + wax production from cartilagenous part cuase skin migration

Question 12

How long is the external acoustic meatus?

Answer 12

2.5cm

Question 13

What is the cone of light in relation to the tympanic membrane?

Answer 13

The reflection caused by the handle of Malleus seen in a normal otoscopic view

Question 14

What is the middle ear comprised of?

Hint: 2

Answer 14

The ossicles

An air filled cavity

Question 15

What is the function of the middle ear?

Answer 15

Amplification of the vibrations from tympanic membrane to chochlea via the oval window

Question 16

What is the pharyngotympanic tube?

Answer 16

AKA Eustachian tube, it connects the air filled cavity of the middle ear to the nasopharynx

Question 17

What is teh function of the pharyngotympanic tube?

Answer 17

Equilibration of pressure in the cavity of the middle ear with atmospheric. Also ventilates and drains mucus

Question 18

What is otitis media with effusion?

Answer 18

AKA Glue ear

Build up of fluid and -ve pressure in middle ear due to eustachian tube dysfunction NOT infection

Question 19

What are the effects of otitis media with effusion?

Answer 19

Motility of TM and ossicles reduced so hearing disturbed

Question 20

How is otitis media treated?

Answer 20

None - usually resolves spontaneously in 2-3mnths

If not then consider grommets

Question 21

What is otitis media?

Answer 21

Acute middle ear infection

Question 22

Who is most commonly affected by otitis media?

Answer 22

Children

Question 23

What are the signs and symptoms of otitis media?

Answer 23

Otalgia
Temperature
Red, bulging TM +/- loss of normal landmarks

Question 24

Whys is ear infection more common in infants?

Answer 24

Eustachian tube is shorter and more horizontal therefore easier passage and more easily blocked

Question 25

Name some complications of otitis media

Answer 25

Tympanic membrane perforation
Facial nerve problems
Mastoiditis
Intracranial complications

Question 26

What are the two important anatomical relationships of the ear?

Answer 26

Eustachian tube & internal carotid

Mastoid cells & sigmoid sinus

Question 27

What is mastoiditis?

Answer 27

Infection or inflammation of the mastoid air cells in mastoid bone

Question 28

What is the function of the mastoid air cells?

Answer 28

Aid in equilibration of middle ear pressures

Question 29

What is the importance of the relationship between the middle ear and the facial nerve?

Answer 29

Chorda tympani branch runs through the middle ear cavity so may be involved in pathology

Question 30

What is cholesteatoma?

Answer 30

Painless ear discharge but can have serious neurological complications

Question 31

What casues cholesteatoma?

Answer 31

Usually secondary to chronic/recurring infections and/or blockage of ET. Skin cells trapped, collect and grow into pocket

Question 32

Why is it important to identify cholesteatoma quickly?

Answer 32

Although rare, can erode structures e.g. ossicles, mastoid or cochlea

Question 33

What is the inner ear comprised of?

Answer 33

Vestibular apparatus and cochlea

Question 34

What is the function of the cochlea?

Answer 34

Converts sound vibration into electrical signals

Question 35

What is the function of the vestibular apparatus?

Answer 35

Help maintain sense of balance and position

Question 36

What is the cochlea?

Answer 36

Fluid filled tube moved around by movements at the oval window. The waves of fluid cause movement of sensory cells in the duct which fire action potentials

Question 37

Briefly describe how hearing occurs

Answer 37

Ossicles vibrate-> cause movements at oval window -> cochlear fluid moves -> sensory cells excited -> action potentials trigger CN VIII -> brain perceives sound

Question 38

Describe the vestibular apparatus

Answer 38

Includes semicircular canals, the saccule and utricle. All fluid filled, respond to position and rotation in all planes

Question 39

Describe Rinne’s test of hearing

Answer 39

Conduction test for hearing loss. Compare hearing in air and through bone of one ear. If louder through bone than air = conductive loss

Question 40

Describe Weber’s test of hearing loss

Answer 40

Tests localisation of hearing loss. Place fork on centre of forhead, if heard louder in one ear that ear has conductive loss

Question 41

What is a false -ve Rinne’s test?

Answer 41

Weber’s louder in one side but that side has better air conduction while other side has better bone conduction

Question 42

How does a false -ve Rinne’s test occur?

Answer 42

Svere sensorineural deafness in side that Weber’s is heard as quieter i.e. bone conduction heard across skull at working cochlea