HEENT 10,11,12 Ear Disorders, Hearing Loss Flashcards
Otalgia with chronic pain for more than 2 weeks. What must be considered?
a tumor
Acute or chronic Bulging, red tympanic membrane, Preceding URI
Otitis media
Rapid change in air pressure as in air travel or scuba diving. Hemorrhage on or behind the tympanic membrane
Barotrauma
What drug is used for Barotrauma?
Pseudoephedrine
Gurgling, crackling, or popping noises, with or without nasal congestion. Unilateral conductive hearing loss and decreased tympanic membrane mobility
Acute Eustachian tube obstruction
Earache localized to the canal, particularly in a swimmer, diabetic, mechanical trauma or seborrheic dermatitis. Erythematous, edematous ear canal
Otitis Externa
Sudden pain, sometimes history of herpes
Small blebs on the tympanic membrane, sometimes herpetic lesions adjacent to tragus
Bullous myringitis
Vague pain accompanied by hearing loss and without other symptoms
Cerumen Impacted or foreign body
What is cerumen?
Earwax
What’s causing the earache? Nasopharynx, pharynx, tonsil, base of tongue, larynx. Often tobacco and/or alcohol use
Sometimes unilateral or remitting middle ear effusion
Cancer
Pain with jaw movement. ‘Clicking’. Lack of smooth temporomandibular joint movement. Trismus
Temporomandibular joint disorder
Sudden severe pain. Followed by bleeding from the ear. Hearing loss. Tinnitus
Traumatic tympanic membrane perforation
Ear drainage, ear fullness, hearing loss, dizziness, facial weakness. Extends from tympanic membrane into middle ear, possibly into bone
Cholesteatoma
Postauricular swelling and tenderness to palpation
Downward or lateral pinna displacement, edema of posterior portion of external canal
Mastoiditis
Drug to treat Mastoiditis
ceftriaxone
A false sensation of movement associated with difficulty in balance or gait
Typically, the perceived motion is rotary—a spinning or whirling sensation
Vertigo
Rhythmic oscillation of the eyes
Sign of disease of the ocular or the vestibular system
Nystagmus
Tinnitus, Sensation of aural fullness, Hearing loss. Followed by Vertigo.
Meniere’s Disease
What drug alleviates the symptoms of vertigo?
Antihistamines
Acute facial paralysis. herpetic blisters of the skin of the ear canal, auricle
Ramsay Hunt Syndrome/ Herpes Zoster Oticus
Ramsay Hunt Syndrome is also known as
Herpes Zoster Oticus
Ramsay Hunt syndrome has been associated with ___ virus infection
Varicella Zoster
Vertigo, Ipsilateral hearing loss, Tinnitus, Facial paralysis
Ramsay Hunt Syndrome/ Herpes Zoster Oticus
Patient complains of rash or blisters on Anterior two thirds of the tongue, Soft palate, External auditory canal, or Pinna
Ramsay Hunt Syndrome/ Herpes Zoster Oticus
What is the drug to treat Ramsay Hunt Syndrome?
Oral acyclovir
2 tests for hearing loss using a tuning fork
Weber’s Test & Rinne Test
What type? Hearing loss occurs from a dysfunction of the outer or middle ear
Conductive hearing loss
What type of hearing loss? Maintains soft speaking voice. Excellent speech discrimination when speech is loud enough. Typically either low frequency or flat hearing loss (equal at all frequencies)
Conductive hearing loss
2 easily treated causes of conductive hearing loss
Cerumen and Foreign bodies
What type of hearing loss? Otitis, Cholesteatoma, Residual middle ear fluid
Conductive hearing loss
Dysfunction of the inner ear or auditory nerve, usually permanent and untreatable. Results in loudness deficit and distorted hearing
Sensory Neural Hearing Loss
What type of hearing loss? Inappropriately loud voice, Tinnitus, Background noise makes listening more difficult
Sensory Neural Hearing Loss
What type of hearing loss? Prolonged exposure to hazardous noise causes hearing loss by the physical destruction of the hair cells in the cochlea
Sensory Neural Hearing Loss
The 4 P’s of Noise-induced hearing loss:
Painless, Progressive, Permanent, and Preventable
___ hearing loss is permanent and untreatable. ___ helps most people.
Sensory neural. Hearing aids may help
No medical or physical reason for hearing loss
Non-organic hearing loss
Occurring within central nervous system (cortex, brainstem, or ascending auditory pathways) as opposed to peripheral organs of hearing (cochlea and middle ear)
Central Hearing Loss
Usually low frequency or flat, affects outer and/or middle ear, usually temporary - or at least medically or surgically treatable
Conductive Hearing Loss
Often high frequency, affects inner ear, usually permanent
Sensory Neural Hearing Loss
Usually affects both high and low frequencies
Mixed Hearing Loss
In Mixed-Hearing Loss what can and can’t be treated?
Conductive can be treated. Sensory Neural cannot
Typically display a flat loss or total deafness in one ear, but may exaggerate a true loss, may (rarely) be involuntary but usually malingering involved
Non-Organic Hearing Loss
Hearing for pure tones often normal, problem is between cochlea and cortex (receptor cells are functional but problem is in transmission or processing)
Central Hearing Loss
