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Head and neck > Lecture 13- Anatomy of the ear introduction > Flashcards

Lecture 13- Anatomy of the ear introduction Flashcards

1
Q

Signs and symptoms of ear disease (can be varied!)

A
  • Otalgia (ear pain)
  • Discharge
  • Hearing loss (conductive vs sensorineural)
    • Tuning forks
  • Tinnitus
  • Vertigo
  • Facial nerve palsy
    • Through the petrous bone (middle ear)
    • Disease involving the ear may manifest as facial palsy
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2
Q

why do we get reffered ear pain

A

many nerve carry general sensory (not CN VII) from ear

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3
Q

which nerves and branches of nerves can cause referred ear pain

A
  • branches of glossopharngeal nerve (IX)
  • branche of vagus (X)
  • trigeminal (V)- auriculotemporal
  • Facial (VII)- nerve intermedius
  • lesser occipital nerve (C2,C3)
    *
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4
Q

referred pain glossophargeal nerve

A
  • tonsils and oharynx
  • posterior tongue
  • middle ear
  • medial surface of tympanic membrane
    *
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5
Q

referred pain by vagus nerve

A
  • pharynx and larynx
  • lateral surface of tympanic membrane
  • external acoustic meatus
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6
Q

referred pain auriculo temporal nerve

A
  • lat surface TM
  • external acoustic meatus
  • temporal scalp
  • preauricular area and tragus
  • TMJ
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7
Q

referred pain nerve intermedius (facial)

A
  • lateral surface of TM
  • external acoustic meatus
  • concha
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8
Q

referred pain less occipital nerve (C2,C3)

A
  • superior pina
  • supraurticular scalp
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9
Q

referred pain greater auricular nerve (C@, C3)

A
  • angle of jaw
  • majority of pinna
  • lateral neck
  • skin over parotid gland
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10
Q

otalgia

A

ear pain

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11
Q

talgia with a normal ear examination should leave you to suspect

A

an alternative site of pathology

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12
Q

otalgia can be

A

non-otological or otlogical

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13
Q

examples of non-ontological cases of otalgia

A
  • TMJ (temporal mandibular joint )dysfunction (CN Vc)
  • Disease of oropharynx (CN IX)
  • Disease of larynx and pharynx including cancers (CN IX and X)
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14
Q

otological causes of external ear pain

A
  • herpes zoster
  • otitis externa
  • perichondritis
  • foreign body
  • trauma
  • impacted wax
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15
Q

otological causes of inner ear pain

A
  • internal otitis media
  • mastoiditis
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16
Q

anatomy of the ear

A
17
Q

external ear summar

A
  • Pinna- outer curve of the ear
  • External auditory meatus lined with skin air filled canal leading to the middle ear
18
Q
A
19
Q
A
20
Q

middle ear summary

A
  • Air filled cavity
  • Pharyngotympanic tube (PT)
  • Ossicles
    • Malleus
    • Incus
    • Stapes
  • Middle ear lined with pseudostratified columnar ciliated epithelium with goblet cells (resp epithelium)
21
Q

pharyngotympanic tube function

A

intermittently open–> allows air filled cavity of the PT equilibrate with air pressure in the Nasopharynx (NP)

  • mucus membrane in the inner ear absorbed liquid –> creating negative pressure
  • if blockage in the PT then increased negative pressure –> glue ear
22
Q

Inner ear summary

*

A
  • Fluid filled structures
  • Cochlear canal
    • Where action potentials are generated for sending signals to the brain to be perceived as sound
    • Fluid filled
  • Semi-circular canals- vestibular apparatus
    • 3
    • Orientated at 90 degrees to one another
    • Fluid filled
    • APs carried to the brain to be perceived as position and balancer
23
Q
A
24
Q

a patient presenting with hearing loss

A
  1. history
  2. examination
    • inspection and palpation of external ear
    • otoscopy
  3. Gross hearing assessment- whispering a word or number and asking partients to repeat back while masking ear not being tested
  4. tuning fork tests (512 Hz)- Wbers and Rinnes test
  5. referral for more forma audiometry testing - pure tone audiometry
25
Q
  • Tuning fork test for unilateral hearing loss
A
  • Helps determine if its an inner or middle problem
  • How to determine if conductive or sensinoural problem
26
Q

if normal hearing (Rinnes and Webers)

A

Rinnes - AC>BC

Webers- sound heard equally on both sides

27
Q

conductive hearing loss (Rinnes and Webers)

A

Rinnes- BC> AC

Weber- sound is ehard louder in the side of the intact ear

28
Q

sensorineural hearing loss (Rinnes and Webers)

A

Rinnes

AC>BC

Weber- sound heard louder ont he side of the affected ear

29
Q

conductive hearing loss is pathology involving

A

external and middle ear

  • wax
  • acute otitis media
  • otitis media with effusion
  • otosclerosis
30
Q

sensorineural hearing loss is pathologu involving

A

inner ear structure or CNVIII

  • presbycusis
  • noise-related hearing loss
  • menieres disease
  • ototoxic medication
  • acoustic neuroma (shwann cell tumour- benign)

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