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Senoir 21-2 > Inner Ear And HL > Flashcards

Inner Ear And HL Flashcards

1
Q

What is the fluid that surrounds the membranous labrynth of the ear

A

Perilymph

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2
Q

What is the fluid within the membranous Labryth

A

Endo lymph

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3
Q

Define peripheral vertigo

A

2/2 dysfunction in the labryntth or vestibular nerve

Sudden onset

Vertigo in response to head turning

Fatiguable Nystagumus (horizontal)

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4
Q

Define central vertigo

A

Dysfunction in the balance centers of the Brain
(Cerebellum or in the brainstem)

+slurred speech
+ diplopia

VERTICAL NONFATIGUBALE nystagmus

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5
Q

What is the normal response to caloric testing for vertigo

A

Normal response- COWS
- Cold Opposite Warm Same

  • Fast beat of nystagmus goes away from cold
  • Fast beat of nystagmus goes toward warm
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6
Q

A pt presents with vertigo lasting 2pm in- a few hours, with low freq tinnitus, and UNILATERAL aural pressure

Think

A

Menieres syndrome

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7
Q

What are the two known causes of Menieres syndrome

A

Syphilis and Head trauma

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8
Q

What is the major exam finding in Menieres syndrome

A

ABNML color is on affected side

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9
Q

What is the treatment for Menieres syndrome/ Endolymphatic Hydrops

A

Low salt diet

Diuretics

Diazepam/ Meclizine

+/- Vestibular ablation with gentamycin

Or Surgery

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10
Q

What are the s.s of labrythintis

A

HL

Sudden onset of vertigo, that is continous and severe
+ tinnitus

2/2 a bacterial or viral cause

On exam they will have spont. Horizontal nystagmus that improves with visual fixation

And a positive head impulse test

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11
Q

Head impulse test is sensitive for what type of vertigo

A

Peripheral

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12
Q

What is the Tx approach to labrynthisit

A

If a known bacterial infection the ABX

Otherwise Diazepam. meclizine

Only for 2-3 days@

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13
Q

If a pts vertigo is interfering with life and is persistent what is the appraoch

A

Vestibular rehab

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14
Q

A pt that presents with vertigo from “rolling over in bed” or with head movements and typically lasts on 60 seconds

Think

A

BPPV

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15
Q

What is the most common cause of vertigo

A

BPPV

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16
Q

What is the physical exam finding for BPPV

A

Pos. Did-Hallpke test

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17
Q

What is the tx for BPPV

A

Eppley maneuver

DO NOT USED VESTIBULAR SUPPRESANTS

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18
Q

Pts with frequent recurrence of BPPV should get what study ordered?

A

MRI

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19
Q

A pt presents with sudden onset of veritgo that is worse in the first 24 hours then gets better over a week
+N/V
NO HL!!

Think

A

Vestibular neuronitis

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20
Q

Inflammation of CN VIII, 2/2 a viral infection often a URI and has no HL, + vertigo

Think

A

Vestibular neuronitis

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21
Q

What is the tx for vestibular neuronitis

A

Physical exam will show absent calorics, with + head tilts test

Treat suppporting
+diazepam/ Meclizine

May need referal for vestibular rehab

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22
Q

What is the most common cause of vertigo post trauma

A

Labrythine concussion

23
Q

What is the tx approach to traumatic vertigo

A

Supportive care

Vestibular suppressants for the acute pahse only

+/- vestibular rehab

24
Q

A pt gets sudden onset vertigo with hearing loss while doing exertion activity of diving

Think

A

Peri lymph fistula

REFER!! For tissue grafts

25
Q

What are the two cause of cervical vertigo

A

Hyperextension (trauma)

Degen Disk Dz

26
Q

What is the main complaint of a pt with a vestibular schwannoma

A

Hearing loss

Typically unilateral
With very poor speech discrimination

+continous vertigo

27
Q

A pt presents with unilateral sensoryneuronal hearing loss, with deterioration of speech discrimination

Think ?

A

Possible vestibular schwannoma

Order MRI!

28
Q

Anyone with unilateral or asymmetric Senony Neruo HL should get what?

A

MRI!

29
Q

This is a condition commonly in the elderly that has vertigo with posture changes and neck extension

Think

A

Vasc. Compromise

30
Q

What is the treatment for vertigo caused by vascular compromise?

A

Think eledrly pt

Asprin and vasodilators

31
Q

Define conductive hearing loss

A

External or middle ear dysfunction

Impairment of sound vibrations to the inner ear

32
Q

Define sensorineural hearing loss

A

Sensory- Deterioration of the cochlea

Neural- Deterioration of nerve tracts

33
Q

What are the 4 main causes of conductive hearing loss

A 
Obstruction 
Mass loading 
(EffusioN) 
Stiffness (otosclerosis ) 
Discontinuity (disruption)
34
Q

What is the most common cause of SNHL

A

Presbyacusis

35
Q

What is the treatment for acute (72 hours) SNHL

A

Oral steroids and REFER!

36
Q

Everyone with tinnitus should get what order..

A

Audiogram

37
Q

What should you R.o in a pt with unilateral HL and tinnitus

A

Acuostic neuroma

38
Q

What are the Rx options for tinnitus

A

Nortypityline

39
Q

What is the tx for a pt with hiperacusis and cochlear dysfunction

A

Hearind aids with compression circuits

40
Q

What is the audiometry for 0dB

A

quiet tone that a young adult can hear 50%of the time

41
Q

What is an abNML dB for an Audiogram

A

Greater than 25

42
Q

What is a NML score for a speech discrimination test

A

90-100

Low score= Poor hearing air candidate

43
Q

What is the dB for profound HL

A

Greater than 80

44
Q

What is the dB for hearing loss that is severe

A

60-80

45
Q

Moderate HL

A

40-60

46
Q

Mild HL

A

Less than 40

47
Q

NML hearing

A

0-20

48
Q

What is the sig. threshold shift on an Audiogram set by OSHA

A

Occupational Safety and Health Administration (OSHA) defines this as a change in hearing threshold, relative to the baseline audiogram for that employee, of an average of 10 decibels (dB) or more at 2000, 3000, and 4000 Hz in one or both ears,

OR

if the sum of shifts at 2000, 3000, and 4000 Hz is greater than 30dB.

49
Q

Where is the peak on a normal tympanogram

A

Near 0

With peak complicance from .2-1.8

50
Q

What does a shallow (type A) tympanogram tell you

A

Often associated with ossicular fixation, otosclerosis or TM scarring

51
Q

What does a Type AD (deep) tympanogram tell you

A

The peak of the pressure curve is above 2

Diagnoses: ossicular disarticulation or ossicular chain discontinuity

52
Q

What tympanogram would indicate fluid in the middle ear

A

Flat

Type B

53
Q

What deos a Type C tympanogram tell you

A

retracted TM or ETD

Peak pressure is negative, approx. -150 daPa or less (moved to left)

Senoir 21-2 (77 decks)

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