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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
mgmt of perf
1. remove debris 2. keep ear dry until healed 3. no drops unless infection 4. monitor 5. tympanoplasty if not resolved
26
2 main cats of SN hearing loss
1. congential | 2. aquired
27
2 main cats of congential
1. herditary - syndromic - non-syndromic 2. non- heriditary 1. TORCH 2. meningitis
28
6 types of aquired (cochelar)
1. presbycotisis 2. noise induced 3. ototoxicity 4. meniers 5. sudden SN loss 6. temporal bone trauma
29
what is presbycucsis and what is seen on audiogram**
age related | - progressive bilateral loss of high freq
30
what is noise induced and what is seen on audiogram***
prolonged exposure to >85dB - "boilermaker" notch at 4khz - can have perm or temp. threshold shift
31
3 main causes of ototoxicity
1. aminoglycocides 2. salicylates 3. chemo - cicplatin
32
what is mech of ototox
- outer hair cells most susceptable | - high freq. loss
33
what is sudden SN loss
- sudden unilateral loss - idiopathic - must rule out retrocochlear path
34
Tx of SNHL
steroids in 72 hrs
35
functions of vestibular system
- maintain balance and gaze stability | - perceive linear and angular accel
36
def. vertigo
- hallucination of movement | - spinning sensation
37
3 main types of vertigo based on time
1. benign positional - sec-minutes 2. menieres - minutes-hours 3. vestibular neuronitis - days-weeks
38
what is benign positional
- caused by Ca debris in post. semi-circualr canal | - provoked by certain head movements
39
how to diagnose BPPL
Hx | - dix halpike in 50-80%
40
Tx of BPPV
1. REASSURE 2. epley 3. semont
41
3 things for "definite meniers"
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
meniers triggers
1. salt 2. caffeine 3. alc. 4. nicotine 5. stress 6. MSG
43
mgmt of acute meniers
1. vestibular supressants 2. anti-emetics 3. diet 4. diuretics 5. betahistine
44
3 types of surgical mgmt
vestibular ablation 1. gentamicin injection 2. vest. neurectomy 3. labrynthectomy
45
what is vestibular neurontis
spontaneous nystagmus that is unilateral, horizonatal or torsional - neuro Sx are absent
46
2 phases of vest. neurontis
1. acute (1-5 days) - vert/N/V/imbalance - nystagmus 2. convalescent - imbalance, motion sickness (days-weeks) - adaptation - weeks-months
47
Tx of vest. neurontis
spntaneous complete recovery in most | - Tx aimed at stopping inflammation

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