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Undeleted > Hearing loss and vertigo > Flashcards

Hearing loss and vertigo Flashcards

1
Q

what is in middle ear

A
  1. ossicles
    - malleus, incus, stapes
  2. middle easr cleft
  3. tympanic membrane
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2
Q

what is sense in the cochlea

A
  1. organ of corti

- tonotopically organized - base high freq, apex low

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3
Q

2 parts of labrynth and funct.

A

3 semicircular canals - rotational movements
2 otoliths - linear movement
- utricle
- saccule

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4
Q

what does weber test show

A

normal - hear on both sides

if hear on one side - C loss on same ear, or SN on opposite ear

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5
Q

what are 2 possible findings on rinne and what they mean

A

AC>BC - normals

BC>AC - conductive loss

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6
Q

what is normal audiogram

A

should have range in 20s
O - R
X - L

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7
Q

3 things seen in conductive hearing loss

A
  1. AC are outside normal limits
  2. BC are normal
  3. > 15dB gap between BC and AC
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8
Q

3 things seen in SN loss

A
  1. AC outside normal
  2. BC outside normal
  3. gap less than 15dB between 2
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9
Q

3 Tx of cerumen impaction

A
  1. cerumenolytics
  2. syringing
  3. debridment
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10
Q

4 contraindications to syringing

A
  1. non-occulsive
  2. previous ear surgery
  3. only hearing ear
  4. tympanic membrane perf
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11
Q

clinical features of ot. externa

A
  • PAIN - severe and with touching tragus
  • otorrhea
  • CLoss
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12
Q

etiology and risk for ot. externa

A 
etio
- bacteria
risks
- swimmer
- trauma - Q-tip
- hearing aids
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13
Q

5 Tx for ot externa

A
  1. debridment
  2. analgesia
  3. local AB drops
    - anti-pseudomonal
    - corticosteroids
  4. pope wick
  5. systemic ABs if complications
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14
Q

1 ear drop prescription

A

ciprodex

- cipro and dexamethasone

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15
Q

what is malignant OE

A

osteomylitis of temporal bone

  • elderly, immunocompromised
  • 99% pseudomonas
  • nocturnal pain
  • granulation tissue in audtoyr canal
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16
Q

5 Tx for malignant OE

A
  1. admit
  2. IV AB
  3. debridement
  4. CT
  5. gallium scan
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17
Q

3 middle ear diseases

A
  1. cholesteatoma
  2. otosclerosis
  3. perf
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18
Q

what is cholesteatoma

A
  • squamous epithelium of middle ear/mastoid
  • due to retracted pockets of pars flaccida
  • presents with draining and hearing loss
  • surg. Tx
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19
Q

2 general types of complications of chole

A
  1. local
    - cond. HL
    - SNHL
    - vertigo
    - mastoiditis
  2. intracranial - into dura
    - meningitis
    - sigmoid sinus thromboisi
20
Q

what is otosclerosis

A

bony fixation of the stapes to oval window

  • 1% of pop
  • F>M - esp in preg
21
Q

clinical signs of otosclerosis and what is seen on audiogram***

A
  • progressive cond. HL

- CARHART notch at 2000Hz

22
Q

3 Tx for otosclerosis

A
  1. serial audiograms
  2. hearing aids
  3. stapedectomy
23
Q

2 main etiologies of perfs

A
  1. infections - O media
  2. traums
    - baro
    - direct
    - syringing
24
Q

3 types of perfs

A
  1. central - no annulus
  2. marginal - involves annulus
  3. subtotal - large, with intact annulus
25
Q

mgmt of perf

A
  1. remove debris
  2. keep ear dry until healed
  3. no drops unless infection
  4. monitor
  5. tympanoplasty if not resolved
26
Q

2 main cats of SN hearing loss

A
  1. congential

2. aquired

27
Q

2 main cats of congential

A
  1. herditary
    - syndromic
    - non-syndromic
  2. non- heriditary
  3. TORCH
  4. meningitis
28
Q

6 types of aquired (cochelar)

A
  1. presbycotisis
  2. noise induced
  3. ototoxicity
  4. meniers
  5. sudden SN loss
  6. temporal bone trauma
29
Q

what is presbycucsis and what is seen on audiogram**

A

age related

- progressive bilateral loss of high freq

30
Q

what is noise induced and what is seen on audiogram***

A

prolonged exposure to >85dB

  • “boilermaker” notch at 4khz
  • can have perm or temp. threshold shift
31
Q

3 main causes of ototoxicity

A
  1. aminoglycocides
  2. salicylates
  3. chemo - cicplatin
32
Q

what is mech of ototox

A
  • outer hair cells most susceptable

- high freq. loss

33
Q

what is sudden SN loss

A
  • sudden unilateral loss
  • idiopathic
  • must rule out retrocochlear path
34
Q

Tx of SNHL

A

steroids in 72 hrs

35
Q

functions of vestibular system

A
  • maintain balance and gaze stability

- perceive linear and angular accel

36
Q

def. vertigo

A
  • hallucination of movement

- spinning sensation

37
Q

3 main types of vertigo based on time

A
  1. benign positional - sec-minutes
  2. menieres - minutes-hours
  3. vestibular neuronitis - days-weeks
38
Q

what is benign positional

A
  • caused by Ca debris in post. semi-circualr canal

- provoked by certain head movements

39
Q

how to diagnose BPPL

A

Hx

- dix halpike in 50-80%

40
Q

Tx of BPPV

A
  1. REASSURE
  2. epley
  3. semont
41
Q

3 things for “definite meniers”

A
  1. 2 spontaneous episodes of vertigo lasting at least 20 minutes
  2. audiometric confirmation of SNHL
  3. tinnitus and/or perception of aural fullness
42
Q

meniers triggers

A
  1. salt
  2. caffeine
  3. alc.
  4. nicotine
  5. stress
  6. MSG
43
Q

mgmt of acute meniers

A
  1. vestibular supressants
  2. anti-emetics
  3. diet
  4. diuretics
  5. betahistine
44
Q

3 types of surgical mgmt

A

vestibular ablation

  1. gentamicin injection
  2. vest. neurectomy
  3. labrynthectomy
45
Q

what is vestibular neurontis

A

spontaneous nystagmus that is unilateral, horizonatal or torsional
- neuro Sx are absent

46
Q

2 phases of vest. neurontis

A
  1. acute (1-5 days)
    - vert/N/V/imbalance
    - nystagmus
  2. convalescent
    - imbalance, motion sickness (days-weeks)
    - adaptation - weeks-months
47
Q

Tx of vest. neurontis

A

spntaneous complete recovery in most

- Tx aimed at stopping inflammation

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