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Year 2- Head and Neck > Inner Ear > Flashcards

Inner Ear Flashcards

1
Q

Briefly describe the mechanism of hearing.

A

Sound enters ear, through the auditory canal, hits the tympanic membrane which vibrates and creates pressure which is transmitted through the ossicles.

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2
Q

Which part of the ear collects sound?

A

Outer ear

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3
Q

Which part of the ear amplifies sound?

A

Middle ear- transforms acoustic energy from medium of air into medium of fluid

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4
Q

What is conductive hearing loss?

A

Hearing loss due to issues with the outer or middle ear

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5
Q

What would be the maximum level of hearing loss if the sensoneural function is maintained?

A

60dB

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6
Q

Which part of the inner ear responds to the change of pressure due to hearing?

A

Cochlea

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7
Q

How does the middle ear amplify sound?

A

Area effect of the tympanic membrane as go from wide surface area of the membrane to a much smaller area of the stapes footpath.

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8
Q

What is the ratio of surface area from the tympanic membrane to the stapes footpath?

A

17:1

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9
Q

What is the job of the pinna?

A

Part of the external ear which collects soundwaves

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10
Q

Which group of bones can be found in the middle ear?

A

Ossicles- malleus, incus and stapes

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11
Q

What do the ossicles found in the middle ear do?

A

Pass the vibrations from the outer ear to the inner ear by increasing/amplfying pressure.

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12
Q

Why does there need to be an increase in pressure before the vibrations go into the inner ear?

A

Inner ear contains liquid rather than aid so high pressure is required to move vibrations

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13
Q

Describe briefly what the cochlea of the inner ear does.

A

Converts vibrations into electrical signals which go to the brain via cochlear nerves

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14
Q

Which cells activate the afferent nerves of the cochlea?

A

Inner hair cells

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15
Q

How does volume of sound affect the number of inner hair cells which will be activated?

A

Quieter the sound, the more inner hair cells will be activated

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16
Q

What is meant by the tonotopic arrangement of hair cells on the basolateral membrane?

A

Every frequency of sound has a place on the basolateral membrane which is sensitive to that particular frequency

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17
Q

Tuning forks can be used to test levels of hearing.
What can tuning forks help to differentiate between?

A

Conductive hearing loss and sensorineural hearing loss

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18
Q

Which tuning fork test can test both ears?

A

Weber test- a test used to diagnose unilateral hearing loss and distinguish between conductive and sensorineural hearing loss

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19
Q

Which tuning fork test is used to determine hearing loss in one ear

A

Rinne

tests one ear ag a time but doesn’t test unilateral hearing loss

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20
Q

Describe how Weber’s test can determine which side of hearing loss is worst.

A

Tuning fork gets hit central to the patient, the side they hear the ding lounder on is the side with better hearing in cases of conductive hearing loss.

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21
Q

If there is sensorineural hearing loss, will the patient hear noises louder or quieter in the affected ear?

A

Louder

->practice humming and then blocking one ear, blocked ear is louder

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22
Q

In those with conductive hearing loss, will the patient hear noises louder or quieter in the affected ear?

A

Quieter

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23
Q

What physical properties of sound would be useful in the assessment of hearing ability?

A

Frequency
Volume

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24
Q

Describe what puretone audiometry measures.

A

Determines the tones a person can hear at selected pitches/frequencies.
Earphones are worn so info can be obtained for each ear.

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25
Q

What is greater- air conduction perception or bone conduction perception?

A

Bone conduction perception

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26
Q

Which type of audiometry might be done with young children who cannot communicate or those with learning disabilities?

A

Play audiometry

->this involves the child putting a toy in a certain place whenever they hear a sound e.g. dropping a counter in connect four

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27
Q

Which type of audiometry is used for very young children who cannot understand or communicate?

A

Visual reinforcement audiometry

->monitors a child’s reaction to hearing noise e.g. turning to see where the noise is coming from

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28
Q

What are otoacoustic emissions?

A

Sounds given off by the ear when the cochlea is stimulated by sound.

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29
Q

What happens when sound stimulates the cochlea?

A

Outer hair cells vibrate which produces an echo back to the middle ear

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30
Q

What is doe is Emissions Testing?

A

A small probe is used to test the vibrations given at the back of the ear

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31
Q

People with normal hearing produce emissions. At which levels of hearing loss are emissions not produced?

A

Hearing loss greater than 25-30dBs

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32
Q

When may an OAE test (otoacoustic emissions test) be carried out?

A

As a part of new-born hearing screening programme

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33
Q

What does Tympanometry help with?

A

Detects:
-fluid in the middle ear
-perforation of eardrum
-wax blocking ear canal

34
Q

How does Tympanometry allow for the detection of wax, fluid or perforation?

A

Pushes air pressure into the ear canal making the eardrum move back and forth. Test measures pressure and mobility of the middle ear to create a tympanogram.

35
Q

What are some of the ways to manage hearing loss?

A

Surgery
Sound amplification
Direct stimulus of cochlea nerve cells

36
Q

What may be worn to help with the amplification of sound?

A

A hearing aid

37
Q

What would be used for people with difficulties hearing low and mid frequencies?

A

Full exclusive hearing aid

38
Q

What would be used for people with difficulty hearing higher pitched sounds?

A

Open fit hearing aid

39
Q

Describe what is used for hearing if someone does not have an ear canal.

A

Bone anchored hearing aid may be used.
Hearing via bone conduction as sound conducts through the skull to the cochlea.

40
Q

What might be given to someone with severe sensorineural hearing loss?

A

Cochlear implant (essentially a very strong hearing aid).

41
Q

What is the name of the part of the inner ear responsible for balance?

A

Vestibule

42
Q

What does the vestibule contain?

A

2 otolith organs

43
Q

Name the two otolith organs found in the vestibule.

A

Utricle
Saccule

44
Q

What is the endolymphatic sac?

A

Sac filled with endolymph

45
Q

Name the sensory epithelium of the utricle and saccule.

A

Macula

46
Q

How is the macula orientated in the utricle compared to the saccule.

A

Horizontally orientated in the utricle
Vertically orientated in the saccule.

47
Q

Which membrane are the cilia of hair cells of the ear embedded in?

A

Otolithic membrane

48
Q

What is the function of the otolith organs?

A

Sense gravity and linear acceleration

49
Q

What are otoliths?

A

Calcium carbonate crystals

50
Q

What is the role of the cristra in the ear?

A

Sensory organ of rotation

51
Q

What is the name of the extended area at the end of each semi-circular canal of the ear?

A

Ampullae

52
Q

What do the ampullae contain?

A

Crista

53
Q

Why is the movement of kinocilia, crista and ampullae important?

A

Sets up the vestibulo-ocular reflex.

54
Q

What is the vestibulo-ocular reflex?

A

Allows us to maintain a stable image of the world as we engage in movements such as walking

55
Q

Name the three systems which help to maintain balance.

A

Visual
Vestibular
Proprioceptive

56
Q

Name three clinical conditions of the inner ear which can affect balance.

A

Benign Paroxysmal Positional Vertigo
Vestibular Neuritis
Meniere’s Disease

57
Q

What is the most common cause of the utricles (which are set in the otoliths/calcium carbonate crystals) breaking off?

A

Old age

58
Q

List some other reasons the utricles can break off.

A

Trauma
Meniere’s disease
Vestibular neuritis

59
Q

Which semi-circular canal is most commonly affected by getting otoliths in there when they shouldn’t be?

A

Posterior semi-circular canal

60
Q

What can happen with there is otoliths where there shouldn’t be?

A

Vertigo

61
Q

What is vertigo?

A

The sensation of spinning when staying still

62
Q

What happens to the eyes in vertigo?

A

Involuntary movement of the eyes

63
Q

How does the involuntary eye movement differ in vertigo?

A

The eyes will move differently depending which canal has the otoliths.

64
Q

What happens if the otoliths is in the horizontal canal?

A

Horizontal nystagmus- eyes move side to side

65
Q

What happens if the otoliths is in the posterior canal?

A

Vertical nystagmus- eyes move vertically and twists

66
Q

What is the name of the procedure that can help get rid of a loose body in the ear?

A

Epley manoeuvre

67
Q

Describe the Epley manoeuvre.

A

Turning head in a series of movements using gravity to dislodge otoliths (calcium carbonate crystals).

68
Q

Which manoeuvre can help to identify vertigo the type of vertigo?

A

Dix-Hallpike maneouvre

->gal you saw this on work experience at LGP…remember there was a calcium stone in a women’s ear so they did this to try and see if she got dizzy???

69
Q

Describe the Dix-Hallpike manoeuvre

A

Patient sits on examination bed w extended legs and the head slightly turned towards affected ear.
Then the clinician swiftly lies the patient down w their head hanging off the table to check for vertigo.

70
Q

Is BBPV (benign paroxysmal positional vertigo) long or short lasting?

A

Short lasting, as long as otolith is removed

71
Q

Describe what someone with vestibular neuritis may experience.

A

Severe vertigo for hours, can cause nausea and vomiting q

72
Q

Is there hearing loss with vestibular neuritis?

A

Rarely

73
Q

What happens to nystagmus with time?

A

It fades

For example, only seen in those with vestibular neuritis in the early stages.

74
Q

Is vestibular neuritis a one off or long term thing?

A

One off

75
Q

If hearing loss is present with the severe vertigo, nausea and vomiting, what may be the cause?

A

Mumps, measles, infectious mononucleosis (‘mono’)

76
Q

Describe the classic triad seen in those with Meniere’s disease.

A

Vertigo
Unilateral hearing loss
Tinnitus

77
Q

Does Meniere’s Disease come on in episodes or is it continuous?

A

Episodes which can come in clusters.
Can last 30 mins up to 24hrs

78
Q

What causes Meniere’s Disease?

A

Not fully known
->histology suggests increase of endolymph, known as endolymphatic hydrops

79
Q

Which common condition can give people intermittent vertigo?

A

Migraines

80
Q
A

Year 2- Head and Neck (13 decks)

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